If you’ve been following me on Instagram, you probably know I’ve been preparing for a normal (vaginal delivery), natural (unmedicated) birth.
As I always say though, I am aware that sometimes, things don’t always happen as planned, though what’s important is that you worked for it and tried your best.
Of all things I did not in any way consider nor expect, it was how my labor started.
This is my story with my firstborn.
37 weeks – We visited our doctor for our checkup and it was the first time she did an I.E. (internal/vaginal examination) on me. According to her, my cervix was already about 50% effaced and I was about 1-2 cm dilated. I told her I was not sure but there seemed to be a little blood in my underwear the previous night, but I was wearing a black underwear (big mistake! lesson learned: do not wear dark underwear when on your 37th week onwards) so there’s a chance it might be a false alarm. She told me to just observe, asked me if I felt any contractions, told her not yet, but that I would keep an eye on them. Everything looked great so far! When we got home, a series of events happened that led me to thinking I was going to be in labor soon: I had diarrhea all day even though I was eating the same food, I also had irregular contractions for about 2 days, and I would have discharge every once in a while (which I never had throughout my pregnancy prior to this week).
38 weeks – No signs of going into labor. No contractions of any sort. My OB did another I.E. and I was about 2-3 cm dilated. She told me it’s impossible to be dilated without contracting, so maybe I just really wasn’t feeling it. I had a biophysical scan profile (a kind of ultrasound that measures the health of the baby) to make sure the baby was fine, and everything was going as planned. I was happy to reach at least 38 weeks! I wanted to give birth somewhere in between the 39th and 40th week because that would mean full term, but reaching 38 was good enough for me.
39 weeks – Still no signs of labor. No contractions. This time, as per my OB’s I.E, I was about 3-4 cm dilated, 70% effaced, yet I still was not feeling anything. She ordered me to take another biophysical scan profile and there, we found out that Pablo’s amniotic fluid was already within the low-normal range. My doctor was suggesting to induce me already by stripping the membranes. I declined and told her my baby will come when he’s ready. Since the amniotic fluid was already within the low-normal range, she told me to keep on hydrating and to drink coconut water, and then asked me to take another bio-physical scan in 3 days and to also get a non-stress test to check if the baby’s doing okay. We did right away and other than the low amniotic fluid, he really was doing well. Throughout the 30 minutes of that non-stress test though, I only had one contraction: and I wouldn’t have known it’s a contraction had they not pointed it out. After 3 days, we took another bio-physical scan and unfortunately, the amniotic fluid got even lower. From 6.18, it went down to 6.01, the lowest of the low-normal range being 5. Still, I declined when my doctor suggested that I be induced. I told her I will keep trying for natural ways to induce labor and that hopefully, my baby will soon be ready! She told me to take another biophysical scan soon.
Throughout my 39th week, we’ve done almost every suggestion on how to naturally induce labor – from eating spicy food to pineapples to dates to eggplant dishes (including eggplant parmiagana) to getting acupuncture sessions (3 times to be exact!) to walking everyday (and also doing my exercises including squats), to more J-breathing exercises, to nipple stimulation (though not too much of this because when done on your own, it could lead to intense contraction so my doctor advised not to do this at home), and still, baby P was not ready to go down. He was hanging on tight and there really was no sign of him going out soon. I talked to him everyday and hoped he would be ready before the next ultrasound.
40 weeks – I have reached my 40th week and was not worried about the time. Really, him being past his due/guess date was not bothering me, because I know they can extend up to 42 weeks. I’ve always believed that he will come out when he’s ready. After all, I did not feel sick; I was still very mobile, but I was getting a bit stressed for the next bio-physical scan. I was afraid it would be lower than the low-normal range already.
As of October 24, 2016, my baby in utero was 40 weeks, 3 days. That was the day for yet another bio-physical scan. And there, my fear was confirmed: the amniotic fluid was already beyond the acceptable range. I was officially diagnosed with oligohydramnios, with my amniotic fluid being down to 4 (with 2 pockets down to 0). Having low (not low-normal) amniotic fluid was already imposing risks for my baby (such as: cord compression, musculoskeletal abnormalities, intrauterine growth restriction, etc).
Now, why did I hold on to artificial induction for a long time? Of course, there’s that angle that I wanted everything to be done naturally, as many women have before me. But more than that, artificially inducing you can result to the following:
TO THE BABY:
-increases risk of abnormal fetal heart rate (because powerful drugs are used to bring on contractions or devices are used to break the water bag before labor starts, the baby can go on a fetal distress)
-increased risk of baby being admitted to a neonatal intensive care unit (NICU)
TO THE MOTHER:
-labor is anything but natural – powerful drugs are given to double time your body, hence, contractions are too strong and too close apart that mother will not get to rest in between
-higher chances of water bag breaking, which can bring even more painful contractions
-higher chances of post-partum hemorrhage
-increases chance of mother asking for an epidural due to abnormally strong and frequent contractions, which increases the use of forceps/ vaccuum extraction for vaginal birth, or an emergency c-section
I was devastated when I got the result of my biophysical scan profile, but I knew that I had to be induced already, whether or not I liked it. It was no longer up to me, because not being induced equally posed risks for baby P.
I told my doctor about the result right away and she told me to proceed to the hospital. On the way to the hospital, my husband and I made peace with the fact that I might end up in a c-section. That no matter how much I prepared (physically and mentally), some things were beyond our control. He hugged me and told me that what was important is that we tried our best for our baby, and if that was the most we could do, there was nothing to regret.
I really don’t know why I had low amniotic fluid – I had no leaking, my water bag did not break, and I was always hydrated. Worse, I really did not expect that problem at all – it seems it doesn’t happen too often (I read somewhere that in the US for example, it only happens to 4% of pregnant women) that I hardly read about it. I honestly was not prepared for that scenario.
But anyway, to the hospital we went. There, I was given another round of non-stress test to check on the baby. Again, other than the amniotic fluid level issue, he was doing fine.
While doing the non-stress test, my doctor did consistent nipple stimulation to hopefully start labor and see how my baby would react. Mild contractions started coming in, and my baby showed no sign of distress. However, we needed to speed things up. So she gave me propess, a pessary containing an artificial ingredient called dinoprostone, which is supposed to mimic the role of the natural hormone prostaglandin (softens and thins the cervix) in labor. Before going home for the day, my doctor also did the sweeping of membranes. That was about 03:00 or 04:00 in the afternoon if I remember correctly. I was just asked to move to my hospital room and wait for the contractions to start. My doctor and I agreed I would do most of the labor in my room and move to the Lamaze room when I’m already in intense pain or in need of their help. Before I moved, they did an I.E. and I was still at about 4 cm.
So, we settled in a regular private room where I set up all the things I needed for labor: my birth ball, my yoga mat, my books, and my birth affirmations (which I posted on the wall). It took a while for the contractions to come in that I was still able to do work for our travel agency, read, put on some make up (I mean, hey, if I’ll be in pain, I might as well do it in vain, haha!), take a bath, watch a few videos on YouTube, do some walking, and listen to some music.
My sister came to support me, and we still had time to talk. All that time, I was updating my doula what was happening, but told her that I would just ask her to come in when I really needed help already.
Every hour or so, my doctor’s team would check on me, but the contractions were still very mild. Though I think they were already regular.
At about 08:30 PM, that’s when the strong contractions came in. That’s the time I officially count as the start of my labor, because really, that’s only when I started feeling the contractions. They would come every 3 minutes, and at that point, the birth affirmations helped a lot. When strong contractions came, I would imagine that I was surfing the waves and for the most part, it worked. What also worked for me was just focusing on each contraction and breathe through it. Then get ready for another round of contractions. Thankfully, at first, the contractions were not always strong. It would be something like mild-mild-strong-mild-mild-mild-strong-mild-strong. Well, that’s what I remember.
But as expected, in induced labor, your body is asked to work double time. So apart from intense contractions, the rest periods were getting shorter and shorter. Before I could even breathe and rest, I would have strong contractions again. At around 11:00 PM, I asked my husband to please call my doula in already. I felt I needed her around me or I would not survive the night.
When my doula arrived, she immediately helped me get through the contractions. Intense and painful they were, but Irina was really a big help. She would massage me or hold me or whisper affirmations or help me try other positions.
I won’t lie – the pain was INTENSE. I don’t get dysmenorrhea, but I imagine it’s something like it – only 100x stronger. Now, I understand why some women cannot stand up when they have their period. My lower abdomen was working and aching for a minute every one and a half or two minutes! I honestly felt they were never ending. I was having the kind of contractions for transition period (9-10 cm), only I was nowhere near 9-10 cm! When they did an I.E. again on me, I was just 5 cm! 1 cm difference for all that pain. I was so devastated. In my head, I was thinking “how much longer will this last?!?”
After hours of trying induced labor without any artificial help on pain management, I finally gave in at the wee hours of the morning – somewhere between 02:30-03:00 AM. I was too tired and was in too much pain that I asked for my doctor’s help. My doctor, who knew I was not for epidural from the start, was kind enough to offer something else: sedation! I was taken aback, because usually, doctors would go on to suggest epidural. I was not ready for her suggestion! I was not able to research on sedation at all, so at that point, I just trusted her. She told me what it would do, which is to make me sleep and relax during some contractions, take the edge off the pain, but when the strong contractions start kicking in, I would wake up. I asked her for the possible side effects for the baby and since she said that since I would be sedated, the baby would, too. I agreed at that point, and that’s when she asked me to finally move to the Lamaze room.
It was a short walk to the Lamaze room (same floor, a few steps away), but it took me forever to get there. They gave me a wheelchair but I realized at that point that sitting was even more painful, so I gathered all my strength to reach the Lamaze room. When I got there, I immediately went to the bed and waited to be sedated. I still had a couple of intense contractions before the effect kicked in.
I don’t know how long I was asleep. All I know is that I woke up to a strong contraction (the pain was as intense! No wonder this is not suggested often by doctors – it wasn’t painless at all!) and heard my doctor say I was already at 7cm. From time to time, I would fall asleep, get the rest my body needed, relaxed during those times, then wake up (like a zombie! literally!) to strong, painful contractions, and then fall asleep again.
I knew before giving birth that being relaxed was the key to a fast birth. Relaxed jaw and body opens the cervix more and more. And essentially, I think this is what happened to me. I couldn’t relax before sedation because the contractions were too intense and too close apart, and then with sedation, my body got the rest it needed, so I moved fast from there on.
From the time I was sedated, everything became a blurry memory. I would hear bits and pieces of what my doctor would say, or what my doula/ husband would whisper. But I was too groggy to actually remember most of the things they said. At some point, I heard my doctor saying I was almost dilated (or that I was fully dilated?) and that all I needed to do was push.
Oh my gosh! I thought pushing would be easy. I would always hear stories from friends about how they practiced pushing with their birthing team around 3 or 4 times and the baby would be out by then! Boy, I was soooo wrong.
PUSHING took so long for me! That’s the downside of sedation. At that point, I couldn’t sleep anymore because the contractions were strong and the pain even more intense, but I was too groggy to keep the momentum during pushing.
At one point, I heard my doctor say my baby’s heartbeat was going down, so they put oxygen on me and it worked (although my doula told me when she visited that babies’ heartbeats really go down during contractions and assured me baby P was doing okay during labor, so maybe that’s what I heard). In my head, I knew I had to work double time (or I would end up in an emergency c-section), so I was concentrating so hard and talking to baby P to please work with me! I decided to stand up from a lying down position and push from an all-fours position! My baby’s heartbeat got even better! But pushing was still a fail for the most part.
So, I tried another position: squatting! I squatted and squatted but still, I failed. I was too tired to stand up, so I went back on all fours.
I don’t know how long I pushed. All I know is that it felt like forever. I was humming through the pain, then I was screaming through the pain. Then I was crying (out of frustration) and laughing (laughing because I knew I looked so silly at that point, and also they say laughter helps a lot during labor!) and smiling at the camera and my husband at that split second when my contractions were on resting period. I was ready to give up and just head to the operating room for a c-section, but my head was telling me: “You did not go this far just to be opened up. Do this for your son.” So I tried, and tried, and tried. It’s a good thing my doctor was so good in keeping the positive light: she would encourage me by telling me the head was almost out, that she could already see his hair, etc.
Finally, at 06:42 AM, October 25, 2016, our little darling came out of my birth canal! And I swear, right at that moment, all the pain WAS GONE! In an instant. It’s so surreal. From my all fours position, I just sat and held my baby.
Finally, I met the little guy that’s been living with me for months! Whenever I look at him, I still don’t know how I brought him out, but I did, he worked with me, and we’ve finally seen each other!
Sure, it wasn’t the all-natural, normal delivery I imagined my birth to be. The fact that I was induced already took out the natural part of my plan.
But you know what? It’s still a great birth experience, especially in a hospital! And let me tell you the reasons why:
* With my back problem (disc dessication on L5-S1), I was told by the Orthopedic Surgeon early in my pregnancy that only 20% of his patients succeed in a normal delivery. I tried to counter this by doing Pilates. And you know what? It worked! My back DID NOT EVEN HURT at all throughout my labor! Amazing!
* With an induced labor, your chances for emergency c-section is high. With powerful drugs to double time your contractions, the baby could go on distress early on. And with the actual pain, it was crazy enough that I did not give in to epidural. This is why my husband and I already made peace with the fact that I might end up in an emergency c-section. Thankfully, my baby worked with me: he did not poop while I was in labor, and he was not showing fetal distress. Yoohoo!
* I had a vaginal birth with no epidural. You can look up and research on the possible side effects of epidural to understand why I was really trying my best to stay away from it. Yes, the pain was intense. Yes, I was really tired. Yes, I’m sure the epidural would have made me the happiest girl alive at that point. But I kept reminding myself why I didn’t want it, and through all that pain, I’m proud to say I survived without it. (PS: In sedation, once the strong contractions kick in and you wake up, the pain is exactly the same as before sedation. It’s not painless nor less painful. But it’s good – because I needed that pain to be able to push!)
* I couldn’t have asked for a better BIRTHING TEAM! I swear! My OB-Gyne + doula + husband make the best team. From the start, I already knew the value of a doula especially in a hospital birth. That’s really why we got one. I researched for doulas and liked Irina Otmakhova the most – her philosophies and her style (in terms of dealing with the hospital team, etc) resonated with ours. To learn more about what doulas are and what they do, click HERE. Irina was a huge help in my success for a normal delivery: she helped me throughout my contractions, helped me with breathing and exercises, gave words of affirmation and hope, and basically stayed with me throughout the night to give her physical, emotional, and psychological support. Without her, I would have asked for an epidural right away. Love that her name says so much about birth: “iri na” which in Filipino means “push” (as in push the baby out!)
* As for my obstetrician, let me tell you about her. Her name is Dra. Catherine Howard. She was not recommended to us by anyone. We just happened to look for an OB in Cardinal Santos (nearest hospital from our place) because we wanted to find out if I was pregnant and what we’re supposed to do. So we searched for the doctors available on the day we were free, and checked who was there at that time. We thought we could easily change if we didn’t like her anyway. But you know what? We loved her from the start. She was so fun to talk to, and I felt so comfortable with her. When we met her, she had no experience working with a doula yet and she was not so familiar with doulas. So I made the two of them meet to see if they could work together, and I got positive feedback from both sides, which made me and my husband really happy. Throughout my pregnancy, I would ask her things that many patients don’t, and ask favors that she was not used to, like “Dra., would you allow me to give birth in any position I want?”. I asked her a gazillion questions that probably shocked her at some point (see questions HERE). But you know what? She was so open-minded, and we absolutely love her for that. She would watch videos and read up on whatever subject I brought up, bring it up with me the next checkup, and see how we can work on it together. When I was nearing 37 weeks, I submitted my birth plan, asked her to review it, and told her to get back to me with her objections if there were any so that we could revise it. I was surprised she did not have objections. Still, I was not sure she’d really follow my plan. I’ve heard of stories where doctors would say yes to everything in your plan but come delivery time, they would change their minds and still do their usual routines/procedures. We’re really glad we took a leap of faith with Dra. Howard. I still had a gentle birth because she did everything she could to follow my birth plan: she induced me only when there was already a medical danger (and she started with nipple stimulation and propess before moving on to the more common Pitocin), she did not offer pain management until I asked for it, she allowed me to eat and drink during labor, she allowed me to try different positions for pushing even if I had IV on, she did not order me to push and instead respected my request to allow me to try a mother-directed pushing first, she did not perform an episiotomy even though that’s her usual routine and she’s very good at it, she followed the setting I wanted for my room: dim lights, room not chilled, minimal number of people, all-female team, etc. And for my post-delivery, she also granted my request to cut the umbilical cord one hour later (semi-lotus birth). Usually in hospitals, delayed cord-clamping is just about 5 minutes. By allowing me to do a semi-lotus birth, I was also able to do skin-to-skin with my baby for an hour. She also made sure my baby was given a bath 24 hours after birth as requested (the usual for hospitals is about 6-8 hours after delivery). When we talked the day after, I was thanking her for doing an amazing job and giving me a beautiful birth experience. On her end, she told me she felt like she couldn’t let me down because every single time I went to her clinic, she felt I was so confident and very much preparing for my birth that it would be sad to put all of that to waste. I’m really glad we worked together for this birth. I told her, “Dra., the pushing stage was so hard I was so tempted to ask for an emergency c-section.”, to which she replied, “Ay diyan tayo mag-aaway! (Ah, that’s where we will fight!) After all your preparation?!” I love how she totally respected me and the birth experience I wanted. It’s amazing to have a doctor like her. We’re so glad we took a leap of faith and put all our trust in her. My birth was a success because she made it happen – believe me, in a hospital setting, your OB would set the whole tone of your birth come delivery day. S/he is the key to your birth’s success! S/he will be the one to decide whether or not your birth plan pushes thru, s/he will be the one to tell make things move towards the direction you want. So make sure you are on the same page as him/her.
My doula, who worked with her for the very first time, has this to say: “As gentle birth advocates and doulas, we never stop emphasising that the choice of your main care provider is the most crucial choice you can make during your childbirth preparations. And this is why when I work with a doctor I never worked with before and notice his/her genuine support to the family, shared belief in the gentle birth philosophy and willingness manifested in actions to go beyond habitual comfort zone in terms of labour management, my heart sings with joy.
In this picture, you see a new mama who just gave birth to her baby in “all fours” position on the hospital bed. Here she just crawled back over her newborn baby and positioned herself upright to take in the look and the smell of her first child. While the mama was pushing on all fours her wonderful doctor had to practically semi-lay down on the bed behind her and cheerlead the baby’s appearance. While his happening is very common in home or Shiphrah birthing center births, it is nothing to take for granted in the hospital setting. On several occasions doctors would state resolutely that they would support natural birth and the mother can do whatever she wants during labour, but for the actual delivery they would need to have her on the stirrups, legs spread wide apart and would most likely perform an episiotomy.
Honestly, I was holding my breath yesterday if this new doctor would eventually demand the mother to assume a lithotomy position, but she did not! She supported the mama on every point of her birth plan and literally had to go out of her bodily comfort zone and assume the most uncomfortable position for herself to receive the baby if only to keep the mama in peace and focused.”
* Of course, I couldn’t have done all of it without my husband by my side. Nevermind that we had to attend a Lamaze class just so we could use the Lamaze room (the only room where my husband was allowed to stay with me throughout labor and delivery), nevermind that we had to pay extra for the Lamaze room – I wouldn’t have survived without him. We made the baby together – it’s but logical that we welcome the baby together. When I was getting frustrated and losing hope, he made sure he was there to hold my hand or massage me or whisper words of affirmation. I am so lucky that my husband did not hesitate to prepare everything from pregnancy to birth with me. I never felt alone in this whole journey.
* Lastly, it was still a great birth experience because of our hospital experience. Like mentioned, we chose Cardinal Santos Medical Center because it’s the nearest one from our place (with good standing), but we did not expect that good an experience with the whole team, too. For the next 2 days after delivery, my husband and I were able to rest because they were doing everything for us (we realize it more now that we’re doing everything on our own here at home) – from diaper changing to helping me with breastfeeding (they have round-the-clock lactation nurses helping you at no extra cost) to reminding me to take my meals to helping me change my clothes. We really couldn’t have asked for a better team.
So there’s my birth experience. It was beautiful and gentle. And you know what? Frederick Leboyer was right – babies born in a gentle environment hardly cry. When our son came out, he let out about 2-3 cries, only to tell us he’s alive and doing okay. But he was really just chill (well, too chill he did not want to go down. My placenta did not want to come out, too! We waited for an hour and had to be induced again just so it would eject! They love being in my tummy too much! Haha).
I know it’s a long story, so, thank you for reading!
If you’d like to get in touch with my birthing team, here are their details:
Other Service We Got From Her: Placenta Encapsulation
DRA. CATHERINE HOWARD
Cardinal Santos Medical Center (Medical Arts Building), Room 210
+632-7270001 local 2210 (Cardinal #)
Schedule in Cardinal: MWFS (10-1 or 2 pm)
Schedule in Clinica Manila (SM Hypermart): Tuesdays (10-12) | Thursdays (10-2)
You may contact her sister and secretary, Pauline here: +63923-6375530
Just kidding! He’s mine 😛