November 15, 2012

Birth Story – A natural hospital birth in Los Angeles

My birth story is full of rush hour traffic, valet lines, and contractions in and near elevators.  It may not have always been serene, but it was drug and intervention free as planned- and perfect for me and my husband.  A long, detailed account is after the jump!

Birth plan: We had a wonderful midwife, Deborah Frank, who attends hospital births at Cedars Sinai hospital in Los Angeles.  Because we live 40 minutes to an hour plus away from the hospital, we planned for pre and very early labor at home, and to spend early to active labor in a hotel near the hospital.  Deborah checks people as labor progresses and once they are 4 centimeters, she stays for the duration and helps the couple decide when to head to the hospital.

The plan was to have a totally natural / physiological birth – my written birth plan was very short and sweet, requesting intermittent monitoring, asking to not be offered pain medication or to rate my pain on a scale, declining active management of the third stage of labor (pitocin), requesting that newborn procedures be delayed until breastfeeding was established, and asking that residents not be allowed anywhere near me (sorry, residents, I was burned in the past – literally!)

Labor stats:
Pre labor symptoms: 1 day
Early labor: 6 hours
Active labor / transition : 3 hours
Pushing: 1 hour

Labor prep:
Birth Bootcamp online classes in first trimester
Natural childbirth class at Birth and Beyond in Santa Monica, CA
Pre-natal pilates once a week at Bebe Pt in Santa Monica, CA
Walking about 30 minutes per day for most of pregnancy
Regular kegel exercises throughout pregnancy
In final weeks: regular pelvic tilt and squatting exercises

Click on to read the full story!

Birth story:   

The Saturday before Halloween, and a little over a week before my due date, Phil and I went out to one last party.  We had not planned costumes at all, not wanting to waste the time or money if I had the baby earlier.  But that day with no signs of labor, I decided I wanted to dress me and the baby up as a Magic 8 Ball painted on my belly with liquid latex (which despite being freaky is non toxic and all natural).   We found out that costume stores don’t carry the stuff, and were referred to adult toy stores.  After calling quite a few of them, we found a store with one last container in stock.  We had fun painting the belly, and made a sticker that said “Ask Again Later” to be the 8 ball’s response – a little nod to how anxious I was about when the baby was coming and how many people were checking in with me awaiting news.  We walked over a mile to the party, and had a great time.  All the while, visions of me going into labor at the party and somehow winding up at the hospital with a latex Magic 8 ball painted on my belly danced through my head.

Sunday morning I felt sluggish and by the afternoon I had flu like symptoms with some gastro-intestional distress.  I literally couldn’t get off the couch.  My husband said that he should have known something was really up when I sat around all day watching (or not so much watching but tolerating) football.  I had contractions that *seemed* to maybe be getting more regular but had long ago learned not to start timing or paying them too much attention- I’d had Braxton Hicks contractions throughout the third trimester and a couple of false alarms, and Deborah had assured me that no one ever slept through their labor, so I should just try to rest at first if I suspected contractions were starting in earnest.

Taking this to heart, I went to bed around 7:30 PM, and Phil soon followed.  At 1:00 AM, I woke up from the contractions, and had this feeling that I wouldn’t be able to go back to sleep.  It was premature to wake Phil up, so I just killed time in the tub and on the computer. I was timing my contractions a bit and they were every 5 – 6 minutes, but not powerful enough to really take me out of what I was doing yet.

The difference between these contractions and my previous Braxton Hicks was subtle – they were both lower abdominal crampy feelings, but these had a definite beginning, peak and end.  The Braxton Hicks had always been hard for me to time because I would sort of feel one coming on, and eventually be aware that it wasn’t happening any more, but I never knew quite when to hit the button for beginning and end of one.  This time, I knew without a doubt.

At 3:30am, I crawled back in bed with Phil and the contractions were strong enough that I was asking him to rub my lower back through each one.  Around 4, I realized there was no going back to sleep for me or for him, and told him I wanted to get up to time contractions and maybe start preparing to leave.

We timed the contractions at 5 minutes apart for a while more, and decided after much deliberation to call Deborah around 5:00 am.  For whatever reason, it was important to both of us not to be “those people” who call the doctor over every little thing.  We wanted to be calm and sure, and I kept saying that I was waiting for a “hard sign” – since the soft signs I had (contractions, general malaise the day before) were so subjective and I’d had them before.  I was hoping my water would break, because I was really afraid of dragging Phil out of bed in the middle of the night on a weekday, driving to Beverly Hills in rush hour traffic, and then feeling silly and having to go home.

Phil cooked a pancake and egg breakfast, and we started arranging things around the house how we’d want them if theoretically we left to have a baby that morning – still feeling kind of sheepish about it.

Just after we ate, the eggs and pancakes were forcefully ejected from my body.  I hadn’t thrown up since the very beginning of my second trimester, and at this point started to really believe I might be in early labor for real.  At 5:30, we called Deb Frank, who said it definitely sounded to her like I was in early labor, and that we should come up to Beverly Hills before rush hour traffic.  We finished up at home, and left right at 6:00 am.  (Not surprisingly to those of you who live in LA, there *was* traffic at 6 am – not stop and go, but what would be considered rush hour traffic in any decent city!)

We met Deborah on Rodeo Drive just before the sun rose, and headed up to her office, where I immediately had to run to the bathroom – this time just to dry heave for several minutes.  I checked out at 2 – 3 centimeters in her office, and she told us that I was definitely in labor, and that we could hope to have a baby in our arms by that night.  It was time to check into the hotel, where we thought we’d remain for many hours as labor progressed.  Our first choice hotel, the Sofitel, was sold out, so we headed to the SLS, which is also just a few blocks from the hospital.  The SLS is quite a sceney hotel – it is many things, but certainly not low key, wholesome or serene! I would have felt ridiculous walking in there in the harsh light of day, 9 months pregnant and clearly in labor- if I had the presence of mind to care at all!

Phil had to go through some extra security procedures in order to get our room since it was a walk in at 7 AM, and I worked through several contractions standing by the elevator bank with my head in my hands, leaning up against the wall.  I believe that a few bellmen asked me if I needed help and I am not sure I used my words to answer them “no thanks” – but they got the hint and walked on by.  After what seemed like hours, we got into the room.  I was so happy to be there.  It was really cozy and there was an AMAZING tub – a huge funky shaped footed porcelain tub with both a rain style overhead shower, wall mounted sprayers that hit your sides, and a hand held shower attachment.  Heaven!

We just needed our bags to come, and then we’d have all of the rest of our labor accoutrements.  I’d packed hot packs and tennis balls for my back, a big exercise ball, flameless candles, a meditation CD, a bikini for if I wanted to stay modest in the water when Deb was helping me through active labor, and many other things.

I was working through contractions solo for the next hour or so, while Phil dealt with some logistics.  We both thought there was plenty of time, and though I was really starting to feel like I needed him with me during and even in between contractions, I wanted him to get our bags and get us situated first.  The bags took almost an hour and several phone calls to come up, and then since it was a Monday morning Phil needed to communicate with his office to let them know he wouldn’t be in.

Around 8:30 maybe, a rep from the oven repair company called wanting to know if they could come by that day, and Phil said “today doesn’t work because my wife is pregnant and it seems like she may be going into labor.”  At which point I said pretty emphatically “your wife is HAVING A BABY.  TODAY.  What do you not understand about this?!” I actually waited for him to repeat this to the oven repair man – I would not be happy until I heard him say and accept these words (he was still sort of in disbelief that this was the real deal, because I was pretty quiet and calm still)! After that phone call, I told Phil in no uncertain words that the phone had to go off and away.

He started unpacking our bags and setting out the stuff I thought I wanted to use in labor, including painstakingly hand inflating the exercise ball.  I had done a couple of brief stints in the tub, but then suddenly didn’t want to be in the water and just wanted to get into bed.  I also changed my mind several times about whether I did or did not want music on – poor Phil spent a whole lot of time just changing tiny things around in the environment at my request – the thermostat up one degree, then 2 minutes later, down one degree.  The music to a different station, the volume up, the volume down, finally the music off.  The TV on CNN (hurricane Sandy had touched down and sometimes in between contractions I wanted the latest, then I’d suddenly not want any background noise at all).

I got in bed, and just laid on my side between contractions.  When each one was coming up, I’d get in a position to deal with it – hands and knees on the bed, draped over the bed frame, or sort of crouched on the floor by the bed.  Phil was at my side the whole time now, but I wasn’t vocalizing or communicating much.  He didn’t realize for a while that when I got out of bed, it meant I was having a contraction- I was so quiet that he just thought I was stretching.  I was very very internal and just needed a soft hand on my back during the peak of the contractions.

At first during this set of contractions (the first that was truly challenging for me to cope with), I was spending my break in between dreading the next one, or being in denial about how soon the next one would be coming and feeling caught off guard when it came.  After a few, I got to a good place where I wasn’t necessarily welcoming the next one, but I was accepting and preparing for it – I’d get into whatever position I wanted to be in a few seconds in advance and just wait for it, so I wasn’t squirming to find a comfortable position as the contraction peaked.  I have to say that although my contractions were painful, (the people who told me things like “it’s not really pain as much as pressure” or “it’s not exactly painful, more just uncomfortable” are very rare and lucky folks) right around the peak of each one, I had sort of an out of body experience for a few seconds.  I’d feel very light and tingly, almost oxygen deprived.  I don’t want to say it was euphoric, but it was definitely a release and a relief – and then I’d know that the hardest part of that particular contraction was over with.

The plan when we left Deborah’s office had been that she was heading to the hospital to see another patient who had given birth the day before, and then we were going to reconnect.  She said to call her anytime I felt like things were picking up, had a question, or if my water broke.  And if she hadn’t heard from us, she would plan to return around noon to check me again.  I was hoping that when she returned at noon, I’d be at least 4 cm.  (Spoiler alert: our baby was born at 11:35 am).

Since we’d gotten to the SLS at 7:00, I had no interest in timing my contractions, but I did feel as 9:00 approached that they were definitely getting closer together, stronger, and that something had shifted.  I never felt panicky or desperate, but really just felt like labor was taking over and I was just along for the ride.

And there was also another incident.  I got up out of bed with a sudden very forceful urge to…I wasn’t 100% sure, but I knew I needed to get one or both ends of me on the toilet, stat.   Well, it turned out to be both, and Phil was grateful that I chose to situate myself the way I did, because he got to clean up vomit instead of the alternative.  Like my sister in law told me, natural labor is a “very fluid experience”! (Our childbirth educator put it a little less delicately: “something will come out of every orifice”)

Phil called Deb at 9:30 and told her things seemed to be picking up steam.  And then while we were on the phone with her, I felt a big gush.  I told her my water had broken, but then looked down to deal with it, and it was a good deal of blood- bloody show.  Phil was on bodily fluid clean up duty for the third time that day, and Deb was on her way over.

She came in, put down a towel on the bed and checked me out.  Then about 2 sentences were exchanged – she said something like “I have exciting news.  You are 8 cm dilated and things are progressing really fast.  It’s time to head to the hospital, you are going to have this baby very soon.”  She rushed over to get a good room ready for us, and Phil quickly packed up all of the labor props that we had never even used.  He somehow changed me back into my jeans, and we were out the door.

I had several contractions on the way to the valet stand, including one sort of dramatic one that had me hunched over our car door, unable to move for the full minute, despite people standing all around me and the car behind us wanting to pull out.  The hotel staff was sort of bemused and congratulated us (though I’m sure they were happy to see us out the door).

When we got to Cedars Sinai Hospital, there was another big back up at the valet- there were at least 10 cars ahead of us, and no attendants in sight.  So we just left our car there with the keys in it, and booked it inside!  I had several strong contractions on the way up the elevator, again silently leaning up against the elevator doors (a big theme in my labor, I’m now realizing.)

When we got to the check in desk, they handed Phil a bunch of intake forms and started asking me questions.  I think that because I wasn’t wheeled in, they didn’t immediately understand my condition- there was no way I was answering medical questions.  I’m not sure I could have spelled my name at that point!  Phil explained that I was in transition and that Deborah Frank had arranged a room and asked in a pretty insistent voice that we just be escorted to the room and be allowed to deal with paperwork later.    We checked in right around 10:30 am.

I walked into our labor and delivery really having contractions right on top of each other.  The nurses made some effort to draw my blood and do other standard intake procedures, but it was very clear that I wasn’t going to be able to hold still long enough to have anything done before the baby came.  I never even got in the hospital bed to be monitored.  They tried to monitor me while I was standing up leaning against the bed, but I “didn’t tolerate it well” (which was my midwife’s diplomatic way of saying I ripped it right off and said “get that thing off of me”), so they also agreed I could be monitored just on the handheld doppler.

Right then, I felt an urge to push that I didn’t recognize.  I thought I just had to go to the bathroom again and I believe I shouted “Oh my God, I’m going to poop!” Everyone in the room told me that it was OK, but I really didn’t want it to happen, so I fought a short battle against the urge to push.  Needless to say, I lost that battle! With that first push, my water broke – forcefully, and all over the place.  There was a river running the entire hospital floor.

I felt really out of control just then – I just didn’t know how to handle the urge to push.  It was the first time I was panicky, and the first time I really vocalized during a contraction – a loud yelpy scream that I’m sure scared some other ladies on the floor.  Deborah then showed me how to work my energy down and out instead of up and out, which made sense to me.

Everything I’d learned in the childbirth classes was out the window by this point.  I’m glad I took the classes, but I never used any visualization or breathing techniques I’d learned for contractions.  When the time came, I really just did what came naturally to me.  And even though we were taught about transition and pushing, I needed Deborah to get me through them – there’s no way I had the presence of mind to think back to a class by that time, and I didn’t have an instinctive sense of what position I wanted to be in or what to do at those points either.

Deborah suggested I move to the toilet to push. I welcomed the suggestion, and we made our way over.  It was go time, but I was still afraid.  I remember very clearly that what got me through the first few pushes was taking comfort in the thought that although I had no choice but to finish what I’d started and push this one baby out, I was absolutely never going to give birth again.  (I took that back about 15 minutes later when I was holding my baby and thinking “how soon do we get to do this again?!”)

She told me to hold my breath like I was underwater with each push, and to not be afraid to bear down with all of my might – she would tell me if it was too forceful.  She was also using her fingers to apply counter pressure of some sort to the baby’s head, so I could feel the progress I was making.   I pushed in sets of three per contraction, for maybe 5 contractions, with Phil by my side holding my hands and shoulders and generally being in awe.

Deborah invited me to use my fingers to feel the baby’s head, which was not yet crowing but really close, and warned me in advance that it would feel squishy and strange – but I wasn’t quite prepared for what I felt.  I knew it wasn’t a part of me, but it didn’t feel like anyone’s head! It just seemed too soft and it freaked me out, so I got my fingers out of dodge.

I was finally feeling sort of on top of the pushing when she told me the baby was about to start crowing and it was time to get in the bed so that she wouldn’t come out too quickly (or be born on the toilet!)

I don’t know how we got me in that bed, but we did, and she turned me on my side and had me bend one leg up.  The nurses asked whether I wanted a mirror to view the birth, and I said yes.  I hadn’t thought I’d want one, but who can pass up an opportunity like that when the time comes? Phil and I had also both strongly agreed that he shouldn’t be on the “business end” of things, and would stay up by my shoulders.  Needless to say, he was right down there with Deborah narrating what was happening with the baby’s head as she crowned : )

Speaking of which, seeing her head crowing also freaked both of us out – I knew that the skull shifted to fit its way out, and had already felt her head so knew how soft it was, but what we saw seemed way too crescent shaped to be the head of a normal baby!

But I didn’t have too much time to dwell on that, because the ring of fire began.  This was the one thing from the classes that I actually recognized very clearly as it happened.  I remember crying out “it burns, it burns!” to the room, but I already knew before they reassured me that it meant the baby’s head was really close to being out.

In a push or two, her head was indeed out! The rest of the birth happened really quickly, but the rest of her body didn’t just slide out easily like I thought it would – her shoulders actually hurt more than her head.  I later found out that this was because she came so quickly, she didn’t have time to turn them like babies usually do, and they shot out straight on.  (They also caused a second degree tear in the process, but I couldn’t feel the tearing per se, it was all subsumed in the ring of fire sensation).

All of the sudden, she was all the way out.  She was bright pink and crying immediately – it was so clear to both of us that she was a healthy, robust baby and that was such a relief.   She got 9’s on the Apgar scale, we later heard.  They placed her on my chest, but she only reached up to about my belly button because she was on a short leash.  So until the cord stopped pulsing and could be cut, she was about a foot away from me, just checking things out while I rubbed her head.  After Phil cut the cord (another thing he wasn’t sure he’d want to do), she came up to my chest and I held her for what felt like just a few minutes, but I think it was actually nearly an hour.  During this time, I delivered the placenta, which was easy and painless, and Deborah started stitching me up.  They’d left the mirror in place from the birth, and I had to squak a little bit to get the nurses to move it while I was being stitched – there is a limit to what I wanted to see, it turns out, and myself getting stitches down there was it!

I also could have done without seeing the placenta.  The nurses asked me several times if I was saving it to encapsulate (read: dehydrate and eat) which is about the last thing on earth I’d want, but I did feel obligated to check it out when Deb offered me a view.  It’s an amazing organ in theory, but it’s just unsightly! We took some obligatory pictures of it that I don’t think I’ll be revisiting any time soon either.

We declared her name, both parts of which are very special and meaningful to us.  We had been undecided about what to call her as recently as the Friday night before the Monday she was born, and it felt wonderful and strange to declare her name once and for all- the name suited her perfectly.   Phil escorted the nurses over to the weigh station, where she clocked in at 7 lbs 4 oz, and 19”.

Soon after, we were breastfeeding for the first time.  She was alert and latched on easily.  I had a wonderful sense of accomplishment and was in awe that our baby was finally, really here.  I was overwhelmed (in a wonderful way) with the realization that even though we’d been talking about her for months and taking guesses about who she was based on her behavior in utero, we really didn’t know this baby at all and we were all starting from square one.

I’m sure it had a little something to do with the brevity of our stint in labor & delivery, but our experience there was wonderful.  The hospital nursing staff was supportive and respectful – one nurse said she’d had homebirths for all of her three children, and they both told me they loved witnessing natural births in the hospital.  It amazes me that in a hospital setting, I never had one thing affixed or attached to me during the birth- not a monitor, not an IV, not even an ID band! I was keenly aware that most labors don’t go quite as planned, and felt so lucky that besides progressing more quickly than we banked on and cutting the hospital arrival a tiny bit too close for comfort, my labor really had all gone according to my hopes and plans.

They wheeled us from labor and delivery to post-partum recovery, where our experience was not as hot.  There seemed to be random nurses and staff barging in constantly, barely introducing themselves or explaining what they were there to do, and there were lots of annoying policies and procedures.  Case in point: to administer the Motrin I was taking every 6 hours for my stitches, they had to turn on a huge bright computer monitor right next to the bed, scan my ID bracelet, and record me stating my full legal name and allergies- not a welcome process at 4 am when my baby and husband had both just fallen asleep!

At the end of Monday, we told them we wanted to check out as early as possible the next day.  As soon as possible ended up being the late afternoon, and we left right at the peak of rush hour traffic, but were so ready to go home that we were willing to accept it.  Before we departed, there was just one last detail to attend to – finding the car that the morning prior we’d just left in a parking garage with the key on the seat! Phil circled the parking garage and finally spotted the car, and after a stern talking to by the valet on duty, he got the keys back and we were turned loose with our baby.

We had a rough first few nights, and generally got our butts kicked those first few days, but it was all punctuated with falling more and more in love with our baby and each other.  I remember Deborah telling me after a strong contraction in her office “you will never have to do that one again.” It was very comforting, and after one really rough night, I told myself the same thing – that is one sleepless night down, one we will never have to do again.  But then I was overcome with an intense bittersweet feeling, because at the same time it was one night with our newborn that we’d never get to do again – the only night when she’d ever be quite that small, and it was gone already.

I suppose that’s where my birth story ends, and my motherhood journey begins – I will share some memories from the first week home with baby soon!



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Comments (7)

  1. So what did you end up naming her?? I didn’t see it in the post! Amazing story! I’m not sure I will be that brave come May!
    Good job Momma and Congrats!

    • Her name is Daniela Opal – Daniela is after my husband’s father (Daniel) – we also both have brothers named Daniel so it’s a big family name on both sides. Opal is both of our birthstone – she was born the day before my own birthday!

    • And re: bravery – I got lucky w a fast labor, didn’t have back labor, etc. I don’t know if I would be “brave” given those circumstances. I think it’s part luck, part preparation, and only a little bravery is involved. The only time I was really scared and had to be brave was during pushing – and then it really was too late to turn back (or request drugs, lol!)

  2. Oh Lord, the downtown LA rush hour traffic. I know it all too well. Your day sounds woefully hectic to me. But I guess that can’t be avoided downtown. And at least you spent a bit of time in the SLS. That hotel would be nice under any circumstance! Congrats on the all natural birth. That’s amazing. And seriously, you look gorgeous in your picture. Good luck worth baby girl!

  3. Pingback: Birth Story – A natural hospital birth in Los Angeles « Spearmint Baby | Baby Story

  4. What a marvelous telling of the story of Daniela’s birth, Kate. It brought back so many terrific memories I have of the birth of Daniela’s mother. You and Phil are just beginning a wonderful journey. I know that Daniela will fill your lives with joy the same way that you have filled your mother’s and my life with joy. Relish every moment.

  5. Thank you so much for sharing your story. Im 11 weeks pregnant with my first, doing so much research trying to learn if its even possible to have a natural birth in a hospital. This is so informative and helpful, not to mention beautiful.

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