Second stage
Around 9:30 pm I was rocking back and forth on hands and knees when I felt the first urge to push. Or rather, I started pushing because it was almost impossible not to.
“Molly,” I gasped. Jenn had gone home and my new nurse’s name was Molly. She reminded me of Molly Weasley from Harry Potter and it turned out she was the perfect type of nurse to coach me through pushing that baby out. “Molly, I feel like I need to push!”
“Okay, go ahead and push a little bit,” she said calmly, much to my surprise – and relief. Without rushing she called Dr Woo, who came to check on me. Excitedly she announced that I was indeed fully dilated and it was time to get that baby out. This turned out to be easier said than done. Elliot was now starting his descent through the birth canal, but he still had his little sweet face pointed up towards my stomach, which proved to be a bit of a problem. I felt in control of the pushes, I knew what to do. We tried a couple of different positions, but I ended up on my back. This is actually the least ideal position, since you are working against gravity, but I felt like my pushes were most efficient here. Nurse Molly counted to ten with each push, coaching and championing me. Wesley stood at my head, gently encouraging me and giving me sips of water. At one point I caught sight of the clock on the wall and chuckled. It was past midnight and the date was now April 20th. “Happy anniversary, Wes,” I smirked. I had wanted Elliot to be born any day but this day, but he decided to come right in time for us to celebrate four years of marriage. “Happy anniversary, baby,” he said gently and stroked my forehead and the next contraction came.
Around 1:45 am Dr Woo looked at me and Wesley.
“We are going on four hours of pushing now, Molly. You are doing really good, but because Elliot is facing upwards it seems like his head is having a hard time passing your sacrum.” We could see the top of Elliot’s head, but because of his posterior position he was not descending further no matter how hard and long I pushed. They put up a mirror so I could see his head popping out a little bit with each push, but as soon as the contraction was over, he would slide back in.
“More mineral oil,” said Dr Woo, as she quite firmly tried to manually stretch out the passage so the baby’s head could crown. But it was to no avail. The pushing contractions were so strong and I gave it my all. It might sound crazy, but it was actually an incredible experience to feel that power, sourced from an unknown space in my female anatomy. Although I was exhausted there was fresh strength every few minutes, allowing me to work with the contractions with all my might. But after four hours of this, following 18 hours of contractions every 3-5 minutes, I was tired. My legs were so wobbly that I had to ask someone to hold them between each push. Dr Woo worked with me for another 15 minutes. “You have gotten him so far down, Molly. It’s really good. At this point we would actually be able to assist him from the outside by applying a little suction cup on his head. That way we can pull while you push and I think he will come right out.”
Vacuum assisted delivery. I had heard about this. Between the lines of Dr Woo’s calm words I heard her say, if this baby doesn’t come out soon, we will need a c-section. When I opened my eyes I saw a myriad of people in the room and I knew they were ready to cut me open any minute. “Oh no,” I said to myself. I turned my attention to the doctor.
“There’s a pretty big risk of tearing when you use the vacuum, right?” She nodded.
“There is.” I appreciated that she didn’t sugar coat it.
“How long do you think it would take me to get him out without help?”
She looked unsure. “Maybe another 30 minutes, but there’s really no way to tell.” Just then, a contraction rolled through me and the conversation was put on pause. We picked it back up when I caught my breath. I glanced up at Wes.
“What do you think, babe?” I whispered.
“It’s up to you,” he whispered back.
“I don’t know if I can do this for another 30 minutes,” I told him. He nodded.
“Maybe we should do it then?”
“Okay.. let’s do it.” The last part I said out loud and while I strained through another push, they got the vacuum device ready.
“Alright, Molly, you are doing so great. We are attaching this to his head now. Your baby is so close.” The next moments were some of the wildest of my life. With the following contraction I gave everything I had while they pulled on Elliot’s head from the other end.
“Head is out!” I heard. One more push and..
“Your baby is here!”
Those words were immediately followed by the glorious sound of Elliot’s first cry. A scrunched-up, wailing baby was placed in my arms and I looked down at my firstborn son. There’s no words to describe that moment. Some people say that they instantly feel a crazy rush of love. That actually didn’t happen to me, and that’s normal. It was more like a happy shock, mixed with the thought of “what’s happening to my body right now?”
Me and Wes looked at each other, exhausted and ecstatic. “We have a son,” I mumbled as I kissed and caressed his little sticky body, so perfect and complete. They told me the cord had stopped pulsing and it was time to cut it. I tried to ask them if we could please wait a little longer – I wanted all the blood from the placenta to go into my baby before we cut it, but they seemed insistent, so Wesley got the scissors and cut it. In hindsight I realize that they were in a rush because there was quite a lot of blood coming out of me. A student doctor gently pushed on my abdomen. “We’re delivering the placenta now,” he informed me. I felt the big, bloody organ slide out of my body and it almost felt too easy. Everything felt too… open. Dr Woo stepped back in and took a look at me. “This looks like a third degree tear,” she said as she gently poked around, “but I need to make sure.” Her gloved fingers in the open wound of my pelvic floor did not feel good, neither did her next words.
“I’m so sorry, but you actually have a fourth degree tear.”
“Oh shit,” I muttered. The worst possible tear. I had not calculated for something like this. I looked at Wes, who had caught sight of my condition down below, and from his facial expression I could tell that it didn’t look good. I zoomed in on my baby boy, who was settling into the world in my arms and decided to let the medical staff worry about me. After about 30 minutes of skin to skin cuddles, they told me we had to go to the operating room for the repair. An anesthesiologist came in and informed me that they usually put the patients into partial sedation for this procedure. Skeptically I looked at her.
“Then I can’t be with my baby,” I said.
“No..” she said, and I cut her off.
“Okay, then I don’t want that. The baby stays with me.” She looked surprised, but I asked her to please find a way to make that happen.
“And can Wesley come too?” I asked.
“Normally we don’t do that.”
“Please, I really want him to be there,” I pleaded
She promised me she would see what she could do.
Someone took the baby while they unhooked me from the monitors and transported me into the OR. They helped me move to the operating table and get my legs in the stirrups, which felt so relaxing. The door opened and a nurse walked in with Elliot, closely followed by Wesley, now dressed in a gown and hairnet. A thankful sigh escaped my lips. My family was with me.
The reconstructive surgery took two and a half hours. My wish for local anesthesia was honored and I only felt the needle a few times. The chief resident and her supervising doctor tag-teamed the tedious task of making me look like a woman again. Meanwhile, Elliot laid on me. He ate for the first time and the delivery nurses did their examination, weighed and measured him right there next to me while I got stitch after stitch after stitch. A fourth degree tear goes all the way through the rectum, so there’s a lot of layers to put together.
Wesley sat beside me the whole time. We chatted quietly together, both exhausted and emotional. When we finally got back to our delivery room we all fell asleep for a few fantastic hours until the day-shift nurse came in to introduce herself and check on us.
Postpartum
We stayed at the hospital for a few days. With such a severe injury they allowed us a little more time to rest before sending us home. It was a couple of wonderful days, despite the challenge of getting around. UC Davis actually serves delicious food. On the first day we were given a menu to pick from for our “celebration meal”, courtesy of the hospital to congratulate their patients. So nice. Salmon never tasted so good.
Saturday at noon we were discharged. People had told us that it is a crazy feeling to go on that first drive to take your baby home, and they are right. So nerve-wrecking and exciting. Slowly I walked up the stairs to our apartment, holding my newborn baby in my arms. I sat down in the rocking chair and cried quiet tears of joy while Wesley unpacked.
Birth was much different than I planned and hoped for. So was postpartum. In order to heal well and avoid long term complications, it was very important that I rested and laid down as much as possible. If you have had a newborn, you know how hard that is. Praise God, Wesley was able to take some extra time off from work and he was such a sweet caretaker for both myself and our son. My injury prevented me from rocking and bouncing the baby too much when he was crying, so Wesley spent hours soothing Elliot while bouncing up and down on the yoga ball. I hardly left the apartment for a month, but not for lack of wanting to get out. I had to tell myself to stay put, to not overdo it and take my healing seriously. About three weeks after birth I ran out of acetaminophen (tylenol), which I was supposed to take every six hours, paired with ibuprofen. Instead of getting more right away, I decided to try and see how I would feel without taking them. I gravely regretted that when the last traces of the drugs left my body around 9 pm. The pain from the wound was actually shocking. I didn’t realize how strong my dosage of prescribed painkillers was until this moment. This was the moment I understood what a big wound I had and I was crying in pain. It was worse than labor, to be honest. Wesley ran out to get more tylenol right away. It took about a day for it to really work, and after that experience I was even more careful to take it easy.
The confinement paid off. As I write this I am ten weeks postpartum. My wound has fully healed. I have no pain. I am not dealing with any of the scary long-term effects that other people experience after a fourth degree tear. The things some women deal with really compromise their quality of life for many years, and I am extremely grateful to be spared.
In the aftermath of this whirlwind I sit with many big thoughts and the cutest, happiest baby I’ve ever seen. It took some time to reconcile my experience with the unfulfilled dreams for this birth. Our experience at UC Davis was actually good – the nurses were so accommodating to my wishes and I am so glad I was in a facility equipped to handle Elliot’s heart rate and a sunny-side-up baby. The meconium that sent me to the hospital in the first place turned out to be harmless, thank God, and I am actually grateful it happened. That way I got to the hospital from the beginning and I avoided a dramatic ambulance transfer later on (which Ruth, my midwife, said I would’ve needed when I called and told her all about the birth). Although it was a good experience overall, and I feel proud for pushing through (literally), accomplishing the unmedicated birth I wanted, there’s also been grief. Not so much for what happened, but for all the things that didn’t happen. No water birth. No slow crowning. No quiet moment to greet my baby. No postpartum walks amongst the spring flowers.
“At least you have a healthy baby.” That’s often what mother’s are told when the birth is difficult. And yes, I have a beautiful, healthy baby that I love more than anything. I also had a painful recovery that was hard to accept, and I have found that there’s room for both feelings. Now I praise God to have reached the end of the tunnel. I have been hiking in the mountains with my little family and emerged out of the postpartum cave. My body feels almost back to normal and we are establishing life as a new little family. There was so many amazing lights in the darkness, so many caring friends and family members, and so much help to be had. It was not easy, but I think we are better for it.
Welcome to the world, Elliot Walter. We are so very glad you are here!
1 day old and my face was still quite swollen and my eyes blood-shot 🙂
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