Amber, amazing mama of beautiful and rambunctious boys! I was ecstatic to hear that you wanted me to be a part of your birthing time! We talked about your main goals for this birth, and two stood out: you wanted to feel your birthing time, and you wanted to not tear after having had torn with your other two births.
Both prior births happened well before 40 weeks, so you anticipated birthing around 38 weeks. As 38 weeks came and went, you began talking with your doctor about your options. You decided to break your water to start labor.
After wrapping up a few lunch consultations, I arrived at the hospital and you rocked, moved, and joked your way through early labor contractions. It was easy going for awhile. But pretty soon, you started getting a little more serious about making it happen.
We finally found 'the sweet spot' for your labor, where you felt more pressure, and we worked there. The jokes came less and less frequently, and I could see you were racing toward the finish line. Your last check, only moments before your labor began ebbing and flowing so strongly, was 6cm.
About 40 minutes after that check and you looked at me with conviction and said, "I don't want to do this anymore, I just need a break!". I talked with you about your options and where I really thought you were in your labor. You shook your head and started asking Ron, your husband, to help you get the epidural. He looked at me with raised eyebrows and I shook my head just a little.
He began encouraging you in words while holding your face close to his through another contraction. At the peak of this one, though, I heard your range drop into a guttural groan. As it ebbed away, you let out a little whimper of frustration. You had hit the labor wall where you realize you have to go through it to be done with it. At that moment, your nurse came in and you asked her to find the anesthesiologist. She, too, looked at me and I smiled and shook my head a little.
Instead she began encouraging you that she thought you were close and reminding you that you didn't really want the epidural. And then another contraction rolled over your body and your nurse heard the same guttural groan. Her eyebrows shot up. At that point, Amber, you looked at your birth team and said, "I know I said I didn't want it, but I can't do this without it. I want the epidural". I reminded you once more of my mantra - 'no regrets'. You searched within yourself, looked at us all in the eye, and said, "no, I really don't think I will regret this. I want it."
So your nurse went in search of the anesthesiologist after a shared look between the two of us that we both thought your baby might come out while she was gone.
The anesthesiologist was in your room within 2 minutes, in the space that it took for you to have one more groaning contraction, during which you bent your knees to it's power and I watched red water drip down your thigh.
Ron and I left you in their hands, with a promise from your nurse to come get us if 'anything happened'. We went out to the waiting room and stood at the ready to be called back to your room. It wasn't long before the nurse came running out to get us. On her way into the room, she gave me 'the look'. When we walked in, you were just getting settled in your bed and the anesthesiologist was finishing his charting. We had been gone for 20 minutes.
She sat on the edge of your bed, "Amber, you have the bolus of medicine in your back, but this isn't the epidural. The relief you feel right now will only last about 20-30 minutes before you regain sensation in your uterus. Before I turn on your epidural pump, I really want to check you."
You agreed, and, sure enough, you were 10cm and baby was low. We talked a little about your options:
start the epidural pump so that you had full coverage for the birth, and take a moments rest
leave it off and start pushing now while you had full coverage
wait until it started to wear off, get a moments rest, and then start pushing when you could feel to push
You decided to wait, so we turned off the lights, Ron laid down on the couch, and I covered up the monitor with a rebozo. I settled down beside you to watch on you as you rested.
Three minutes later, your eyes popped open like two white saucers in a dark room. about 45 seconds later, you closed them again. Three minutes later, again, your eyes popped open. I leaned in and asked what you were feeling. "Lot's of pressure" you said.
So I asked if you thought you could get rest. You said no. I asked what you wanted to do.. you laughed and said, 'I guess have a baby!'.
So I let Ron know and stuck my head out the door to flag down your nurse. She hurried back in and we started getting ready for baby.
You pushed in earnest, and your feeling was quickly returning. Your nurse said 'let's get baby's head crowning and then call your doctor. And that didn't take much time. As you felt more and more of your contractions, your pushing was stronger and harder.
As your doctor came in the room (before we had a chance to call him) your baby was just about to crown. We knew that at least some of your tearing from your last births was from the impatience of the doctor, and also in part because of how they had you push... So, I leaned in close to this wonderful OB and said, "she tore with her other two and really wants to avoid it this time, if you can be extra gentle and patient?"
"Of course!" he said, with a soft and confident smile.
He supported your perineum while coaching you to pant, blow, and breath your baby out. He didn't pull on babies shoulders either - he supported babies ears and shoulders between his palms and waited as baby rotated himself around and slowly squeezed his way out. It was truly the most gentle emergence I had seen in a hospital setting in a long time. As he began to rotate out, both your doctor and I encouraged you to open your eyes, reach down, and catch your baby. As you reached down to help bring your baby up onto your chest, your doctor leaned toward me and said, "I think we did it!"
As you loved on your beautiful baby, your doctor checked your bottom and confirmed that your bottom had not even a scratch. You had done it! Congratulations and welcome baby boy!