Alison & Matt’s Birth Story - The Birth of Linus
After the world’s most wonderfully boring pregnancy, our birth story started unexpectedly at the 35-week mark, when Alison was diagnosed with cholestasis (a condition in which the liver can’t keep pace with the strain of pregnancy on a person’s body and bile acids begin to build up in the blood, which can be dangerous to the baby). The treatment for cholestasis is typically to induce labor as soon as it’s reasonable to do so, generally at 36 weeks, so the diagnosis came with the surprising declaration that we’d be parents by the following weekend. Since we’d assumed we’d easily go full-term, this was a huge surprise.
With less than a week before the 36-week mark, the next few days were incredibly stressful as we prepared to go on leave from work and bring our baby home. Additionally, the risks associated with cholestasis meant daily monitoring appointments to make sure our baby wasn’t in distress. (He was always fine, but the hours between monitoring sessions became very nerve-wracking after we learned that our baby could be at risk.)
After that whirlwind, it was a relief to report to the hospital for our induction. We checked in at 6 PM on the day we hit 36 weeks, which was a Thursday. We were given a private room in the OB triage area to spend the night during the first step of the process: Cervidil to soften Alison’s cervix. Placing the Cervidil was like a moderately intense Pap smear (it’s a medicated string/tampon-like-thing that is inserted into the cervix); after it was in place, we had to wait 12 hours for it to take effect. Alison was hooked up to an IV and fetal monitor, but other than that we were able to just chill, as if we were spending the night in a particularly lame hotel. Alison started feeling minor contractions around midnight, but nothing too intense. Getting any sleep was tough, though, as we were both pretty keyed up.
In the morning, the midwife removed the Cervidil and confirmed that Alison’s cervix was indeed soft enough to proceed. We were given a break to eat breakfast, take a shower, and regroup. Around 10 on Friday morning, we moved to Labor and Delivery.
The first step in L&D was a Foley balloon to dilate Alison’s cervix. Imagine a small, un-inflated balloon that is inserted into the cervix, and then filled with fluid to expand the opening. This was an incredibly intense step: as soon as the balloon was inserted, it took contractions from “no big deal and easy to ignore” to “completely wrenching,” with no mental or physical preparation. Alison went from laughing and chatting to moaning on her hands and knees very quickly. However, the midwife and nurse were great, and helped us talk through the pain. As they promised, things were super-intense for 20 or 30 minutes, then gradually improved over the next two to three hours. Something that helped: an on-call doula from Chicago Volunteer Doulas was able to visit to help us get through this stage, and also stayed with Alison for a bit while Matt took a break after a very intense morning.
By early afternoon, the Foley catheter was out and, as promised, Alison felt much better. Alison was dilated about three centimeters, and contractions were again manageable. Pitocin had been started, but at a low level. It was weird to feel like we were starting at the beginning of the process after the high-stakes morning, but it was also a relief because we had the time and mental energy to regain control.
The afternoon was actually pretty relaxed: we were able to replace the wired fetal monitor with a telemetry unit, and spent a lot of time walking up and down the hallway. We also watched TV, played cards, and listened to podcasts. It was easy to imagine how, in a different situation, we would been biding our time at home. Alison was having regular contractions every 3-5 minutes or so, but they were pretty mild: enough to take a short break from whatever we were doing, but not strong enough to be really upsetting. Meanwhile, the nurse increased the pitocin dosage every couple of hours to try to get things moving.
Around 7 PM, we had maxed out the top pitocin dose, but there hadn’t been much progress. Alison was still dilated just three centimeters, and contractions remained constant but low-key. To try to get things moving, the midwife did a membrane sweep, and the pitocin dose was cut in half so it could again be slowly increased. One or both of these gambits worked: by 9 PM, things were getting pretty intense. Alison was no longer able to concentrate on anything other than the constant, strong contractions, and we were clearly in active labor. It was uncomfortable but bearable.
The next change came around midnight, when Alison’s water broke. This sent things absolutely through the roof (again, without any warning or warm-up), and Alison called for an epidural. The midwife did another cervical check in case we were fully dilated, in which case the epidural wouldn’t be needed... but we were still at three centimeters. (“Yeah, you’re going to want that epidural,” was the midwife’s winningly understated comment.)
The next stage was rough. Alison was in a lot of pain and not coping well (okay, not coping at all), but needed to be given more fluids before the epidural could be administered, which took about 20 minutes. When the anesthesiologist arrived, Alison had a lot of trouble sitting in the right position, and couldn’t reliably identify when a new contraction was starting because it seemed constant. And apparently, there was some spine curvature that made things more difficult. It took about half an hour to get the epidural in place. And beyond that, the epidural tanked Alison’s blood pressure, which then made her breathing shallow enough to drop her oxygen level, which required an oxygen mask to correct… Overall, the roughly two hours from “water breaks” to “epidural is in place and blood pressure and oxygen are stable” were the roughest part of the process for everyone.
After that, Alison slept for several hours (and is now a huge fan of epidurals); Matt had less success sleeping after all the adrenaline (and a distinct lack of narcotics)... but overall, we were now playing a waiting game. Around 7:30 on Saturday morning, after a new medical team started their shifts, one more cervical check confirmed that Alison was fully dilated and ready to go. The baby was still pretty high up, however, so Alison was left to labor down for a bit. Matt took this opportunity to take a shower and step out for breakfast and a mental re-set (very much needed after the tough night).
We started pushing just before 8:30 AM. Alison found the first 90 minutes or so of pushing very manageable, but the last bit was tough. The constant pressure as the baby got lower in the birth canal was very intense, and we were coming up on 40 hours since we started the process, including two full nights in the hospital. We were both beyond exhausted, so the relief when our son was actually out in the world after two hours of pushing was incredible.
Because our son was delivered at 36w (+2 days, after the long labor), the birth was attended by a neonatologist, and we were mentally prepped for a possible NICU stay. However, we were fortunate; our son was born pink and screaming and a relatively hearty 6 lb, 6 oz, and was declared okay to stay with us.
Overall, the birth we got wasn’t the birth we planned: we assumed our pregnancy would remain boring and low-risk; that we’d labor at home; that our hospital stay would be relatively short… instead, we got all the monitoring and all the meds and a full four nights in the hospital (two during labor, and then two with our baby). We went through enough shift changes that we were attended by no fewer than four midwives and five nurses (not counting everyone who cared for us after our baby was actually born). But overall, we couldn’t have asked for things to have gone more smoothly. The staff at IMMC was uniformly fabulous, and we were given a ton of information and guidance at every step of the process. Our experience was a good reminder of why we’re fortunate to live in an era (and a location) where prenatal care is comprehensive and interventions are possible… and perhaps good prep for parenting, which we’re told is also full of challenges you don’t get to choose!