The Birth of Alexander Conrad Smith
Our son Alexander Conrad Smith was born at 9:50 p.m. on November 28, 2013 at UCSF. He weighed 9 lbs 8 oz and was 22 inches long, and the finished product is one of beauty and absolute love. This is the story of the 41 hours of labor that lead up to his birth.
We visited labor and delivery on Tuesday, Nov. 26 at 8 p.m. for some antenatal testing with the expectation of being admitted for induction. At that point, I was at 41 weeks and 4 days, and though not pleased about it, had accepted that unless there had been some real progress (according to measurements the day before, I was at 1 cm dilation and my cervix was still very thick), I would need a little help along. However, they had no rooms available so were sent home. My waters broke very subtly at 4:30 a.m., so I met my first goal: I was in natural labor. Awesome!
We were admitted at 7:00 a.m. into an ante-partum room where my husband and I let a few people know my status and we talked about how excited we were that it was really happening. I was still at 1 cm, and after a few hours, was sent into a labor and delivery room.
My labor progressed naturally and very slowly until 6 p.m. when I consented to turn on the Pitocin to speed things up. I continued to feel like I was having menstrual cramps, and they got progressively worse until 1 a.m. when I genuinely felt like I was in transition. I could not sit still or focus during contractions, though I was breathing through them really well. There was no pressure for me to do anything other than continue to have a natural birth, but I did ask to be checked for dilation, having decided along with my husband and doula that if I was further along than 6 cm, I would ride it out, and if I was less, I would get an epidural. I was at 2 cm and knew that not having an epidural was not an option. I needed to rest for what was going to be a long haul. They administered the epidural at 1 a.m. and I almost immediately fell asleep and stayed that way until around 7 a.m. when they checked me. 3 cm. I was assured that any progress was good progress, and that the first 5 cm are the hardest. So, my team and I settled in and watched the Macy’s Thanksgiving Day Parade, then part of a Harry Potter marathon. We also played cards and kept me occupied. Being bedbound by the epidural definitely sucked, though. I really wanted to walk around and I disliked having a catheter.
At 3:30 p.m. my second bag of waters ruptured resulting in intense pressure which got my Pitocin turned off. My body was taking over, which was thrilling. I was ready to push at 6 p.m. and though the doctor detected a little bit of an anterior lip she said it would be OK for me to start. I did that for the next 4 hours, and it was a wild ride. First off, my epidural had a window, which means that I felt everything in a specific area (my left torso), and then wore off almost completely. Normally, an epidural leaves you unable to use your legs, but that was not the case for me, so I was squatting, kneeling, and doing all kinds of moves on the bed. I could feel almost everything that was going on, and the doctor later admitted that I delivered “essentially unanesthetized,” which is what I had wanted in the first place. So, I guess I got the best of both worlds: ability to sleep through the early contractions, but then the full body experience of birth. Also, here I salute my husband who was there for me 100% during the birth, feeding me water like a coach and making sure the fan stayed on despite the fact that the room ws freezing for everyone else.
Since I could move around so much during pushing, I had quite a few positions that I used. My standard (read: least strenuous) was on my back, feet on the push bar, doing a slight sit-up to help him down. When those pushes were over, I would drape my legs wide over the sides of the push bar and relax completely. I really liked laying on my side and holding behind my raised knee (pose I learned in yoga classes!), particularly on my left side since that was where I had 100% sensation. However, my favorite was leveraging the bed where the head was fully inclined. I was on my knees and would rest with my arms and head draped over the back of the bed. To push, I would lean back onto my folded legs, arms all the way out with my back arched, and just go for it. Gravity helped a lot here, and because this position alleviated the extreme back pain, they brought in the ultrasound to confirm the nurse’s suspicion: Alex was coming down face-up (also called OP or sunny-side up). This makes for a slower and more painful delivery, but at that point I knew I could deliver him myself. Soon he was crowning and I reached down to feel. He was hot, smooth, wet, and weirdly flexible. I basically stopped pushing to process that, but a contraction brought me back.
In addition to being OP, Alex face presented (most babies come out crown first, but he arrived face first, which requires more accommodation from the birth canal), which we only realized at the last moment. Most births like this end in a C-section, but the doctors, nurses, and midwives all agreed that I was strong enough to do this, which I credit to my pre-natal yoga practice. I did need an episiotomy and got 2 tears, but those were nothing compared to the warm sensation of him slipping out of me and into the world. He cried and I said, sight as yet unseen, “Oh, he is perfect!”
I tried to go into this without expectations, just hopes: no C-section, minimal medical intervention, a healthy baby, and an empowering experience. I got most of that and the further away from the birth I get, the more prominent the sense of empowerment becomes. I feel it every moment I spend with my son. I have an even deeper respect for my husband and how he supports us, and feel endless gratitude for my doula Alyson and the UCSF team. I am also deeply thankful to Yoga Garden SF for prepping me for this totally unexpected (I mean, who really expects 40+ hours of labor, including 4 of pure pushing?!) experience. Thank you!
