An Unmedicated Induction Birth story
We were absolutely thrilled to be expecting and as an “advanced maternal age” mother-to-be, I wanted to experience as much as I possibly could with what was likely going to be my only pregnancy. Having watched “The Business of Being Born” years and years before getting pregnant, I always had it in the back of my mind that if I was to have a child, I wanted to have it be as intervention-free as possible. I read numerous naturally-minded books like Ina May Gaskin’s “Guide to Childbirth” and signed up for an online course to arm myself with additional knowledge. We also chose to deliver with Certified Nurse-Midwives (CNMs) within our hospital of choosing and hired doulas to further help with my goal of an unmedicated and safe birth. The hospital I chose is also “baby-friendly” which means that many of the things I wanted as part of my birth plan were already done automatically.
The pregnancy itself was smooth sailing until our baby started measuring small at the 32 week ultrasound. At that time, we were informed that we should plan on an induction at Week 37 which was very upsetting to me as I didn’t feel that the baby would be ready for the world just yet and that inductions often lead to a “cascade of interventions” during birth, including continuous monitoring, a stronger possibility of an epidural and a higher probability of a Cesarean.
From there, the next few weeks included extra visits to check on the baby, non-stress tests, and an additional growth ultrasound at 35 weeks. Although we bought a little bit of time because of new American Academy of Pediatrics guidelines for babies with Intrauterine Grown Restriction (IUGR), in the end due to an additional small measurement and one high blood pressure reading, we were scheduled to be induced at 38 weeks exactly. By this time, I had time to process the fact that I was not going to be able to wait for my water to break naturally, labor at home as long as possible, or enjoy the excitement of just wondering when the baby would choose to make his or her appearance.
Our night began in triage around 7 p.m. with the insertion of Cervidil, which is meant to soften the cervix and remain in place for 12 hours. I came into the hospital at 1 cm and 50% effaced. Unfortunately, the monitor showed that the baby was experiencing heart decelerations and not reacting well to the medication. The midwife on call removed the Cervidil and we were sent early in the morning to the Labor & Delivery wing to begin Pitocin. The Cervidil didn’t produce any magic results for me and we hoped that Pitocin would help get labor progressing more quickly and because Pitocin is administered manually, that we could also keep the baby from getting too stressed out. The midwife also decided to try to insert a Foley bulb to also soften the cervix but the position of the baby and my dilation (debated to be between 1 – 3 cm) wouldn’t allow for its insertion. At this point, I was feeling down on the process and began thinking that the baby was not going to be able to handle the induction and that we were going to need a Cesarean.
We were in constant communication with our team of doulas and the doula on call arrived in the morning to help us navigate decisions to be made. As I was strapped to monitors, we began to notice that the baby was only happy when I was lying on my right side. I began to feel some minor cramping but nothing of note and a mid-day check showed that nothing had progressed with the Pitocin which was being increased gradually.
The afternoon midwife arrived and let us know that it was really important to get things moving more quickly because the baby was showing signs of distress and basically it was “now or never.” She encouraged us to consider breaking my water and while I was nervous to do so as I anticipated that the contractions would get very intense very quickly and would add further stress on the baby, it seemed like our best course of action.
After my water was broken, contractions began to come on more strongly and I needed to focus on each contraction and could no longer speak through them. I began to vomit during contractions and because of all of my research prior to the big day, knew that this was a fantastic sign of progress. My husband and doula were administering sacral squeezes to help with my discomfort but because of the heart decelerations, I wasn’t able to move around, sit on a ball, or get into any other positions besides one called the “queen’s pose” or lying in bed.
The external monitors began having a hard time picking up contractions and the baby’s heart rate at this stage so it was decided to insert internal monitors. At the same time, the midwife checked my progress around 5:30 p.m. and I was only 4 cm but 100% effaced which was welcome news. At this point, my contractions started coming on very, very strong and I heard myself telling my husband that “I couldn’t do it” and internally panicking because the pain was tremendous and I knew that even if I wanted an epidural at this point, it would take quite a long time to administer it. I couldn’t imagine enduring the pain I was feeling for hours more and considering that I thought I was at 4 cm, that seemed to be my reality. However, at the same time, all of my research told me that saying that I can’t do it any more is a sign of the transition stage of labor. So while I was speaking these things aloud, my brain was also processing that I might be close to having the baby.
At one point just a few minutes later, the midwife, doula, and nurse had stepped out quickly to get a chair that they thought might help me out and suddenly my body started pushing without me having any control over what it was doing. I grabbed my husband’s hand and let him know that I was pushing and told him to tell the midwife. It didn’t seem like my body should be doing any pushing at all at just 4 cm!
When the staff came back in moments later, my husband told them that I was pushing and they quickly assessed that the baby was in fact there and I had reached 10 cm. It was only 20 minutes after my last check! Because of the baby’s heart decelerations, we needed to get the baby out quickly and I was told to bear down and push as hard as I could as each contraction came on. It only took a few pushes and at 6:04 p.m., our 5 lb baby arrived safely and I achieved my unmedicated birth despite having an induction and so many things that could have led us down another path. I was so proud of myself and thrilled to meet our little boy (we were waiting to be surprised). Because I didn’t have any pain medications, I was able to experience the full release of oxytocin, enjoy skin-to-skin and baby-led breast crawling, and within a couple of hours, I was up and walking around without any issues. All of these things were very important to me and reasons why I wanted an unmedicated birth.
In the end, because of the support of the Nurse-Midwives and doulas, if I would have ended up with an epidural or a Cesarean, I know that we would have been able to feel still in control of the situation and that we would have been active players in our son’s birth. While I’m very happy that my son and I worked as a team to achieve our exciting birth, I am most pleased that I went into the process fully informed of all sorts of scenarios and that my husband and I made decisions throughout the pregnancy to support our aims.