Thursday was my usual working-from-home day. My mom came to pick up Isaac as usual around 10:30. I had some food and did some work, and then around 1pm I settled down to really pay attention to the contractions. At this point they were 6-8 minutes apart and getting a little stronger. I dithered over what to do but finally decided it wasn't time to call yet.
That evening, we had planned to go out to dinner: me, Isaac, my mom, my brother and his wife, and Isaac's babysitter Sally. We were going to a diner we really like called Zoe's. I decided to go ahead with that plan although, as I was getting ready to leave to meet everyone there, I felt there was about a 75% chance that we would go to the hospital after dinner rather than home.
We arrived at the diner and as we were studying the menu and ordering, I announced that I felt we would be going directly to the hospital. Everyone was quite surprised ;) but I assured them that I had perused the dessert section of the menu and had no intention of going into labor until after I had sampled Zoe's ice-cream sundae. ;) So we went ahead and ordered. I borrowed Sally's watch to keep track of the contractions, and while we were chatting and eating, I observed that they were down to 4-5 minutes apart.
We finished eating and I ordered my sundae. While we waited for it to arrive, I called the midwives' answering service to have them page the midwife on call. We ate the sundae (it was large so I shared) and the midwife hadn't called back. I called to have her paged again, and we decided to head to the hospital anyway. It's a very short drive from Zoe's to the hospital.
So we split up. Sally was to take Isaac back to my mom's house (because it was closer than mine) and put him to bed there. My brother went with them because Sally didn't have a key. My mom, sister-in-law, and I headed to the hospital.
We got there around 9:30pm, did the whole check-in/registration thing, and proceeded up to Labor & Delivery. I was pleased to see nurse Lori, whom I remember well from my labor with Isaac; she also taught the childbirth class that we half-took back then. She wasn't my nurse, but she came in to chat. They hooked me up to the monitors and saw some mild contractions about 4 minutes apart.
Midwife Marcia came in and checked my cervix and found me about 4cm dilated. She asked how bad the contractions were; could I talk through them? My mom laughed and explained that I talked through ctx throughout my entire labor with Isaac. I said I really wasn't sure how strong they were now. So Marcia suggested that I go and walk around for an hour, come back, see what progress had been made, and then we would determine whether this was "it" or not.
So we (along with my brother who had arrived by now) went down to the lobby of the hospital, which was deserted at that hour. It was 11pm by now. We spent an hour with me walking up and down the lobby hallway while the others sat around chatting and making jokes at my expense. ;) I also called a few friends to let them know what was going on.
At midnight we went back upstairs and Marcia checked me again and said I was at 5cm. I was a little disappointed that there wasn't more progress, but it was enough progress to convince Marcia that I should be admitted rather than sent home. (She did say that I *could* go home, but since it seemed likely enough that I'd turn around and come back within a few hours, we decided I might as well stay.) So we got moved from the triage room to a delivery room, met our nurse Courtney (who was new to the hospital, although not new to L&D in general), and we settled in to wait. My mom, brother, and SIL took turns in the reclining lounge-chair resting/napping; my mom took a few "blackmail" pictures of my brother sound asleep while I lay on the bed making exaggerated theatrical pain-faces. ;) We called Sally and told her we were staying. She had already had her husband bring her some pajamas and stuff so she could spend the night at my mom's place with Isaac.
There followed a very, VERY long period of many hours of walking around, bouncing on the birth ball, etc., with regular contractions, but no progress. (Sitting on the birthing ball, I had plenty of time to stare at the side and bottom of the delivery bed, where there was a sticker reading "Sensitive Patient Areas." I found this quite humorous.) Marcia came back to check me every few hours and I was very frustrated that I continued to not dilate very fast. Around 7:30am, I believe it was, Marcia went off-shift and introduced me to midwife Deb, who was taking over. We also met nurse Maria who was helping out since Courtney was still learning the ropes.
At that time I was up to 6cm dilated and about 90% effaced according to Marcia. Deb checked my cervix so that she could have an idea of what Marcia was calling 6cm, and then she waited an hour and checked me again for comparison, again finding very little progress. She suggested that I spend some time on the birth stool, a specially designed stool that I guess holds your pelvis more open or some crap like that. ;) I sat on it a bit (more looking at "Sensitive Patient Areas") and found that it made the contractions much more intense (i.e.: painful), but yet it seemed not to help much at all in the dilating department.
By now the contractions were getting a lot worse. They were already more painful than I'd ever experienced (I've often said that with Isaac the ctx never got anywhere near as bad as I had been led to expect). I found that whenever I changed position, i.e. stood up from sitting, lay down, etc., it triggered one. I was trying to move around a lot, but it was painful. Being flat on my back was the worst, which was unfortunate since that's how you have to be in order for the midwife to check your cervix.
At this point Deb started talking about breaking the bag of waters (officially called AROM -- artificial rupture of membranes). I had a clear memory that some of the doulas/midwives on my Attachment Parenting email list were firmly anti-AROM, but I couldn't remember why. I asked Deb to discuss the pros and cons with me, which she did. Pro, she felt it would speed things up, as she felt that the bag (amniotic sac) was providing too much of a cushion between baby's head and my cervix, thus preventing me from dilating. Con, it's an intervention, thus not "natural"; and it somewhat increases the risk of infection (which she didn't think was a huge deal), and it would make the contractions stronger. Yikes. As I said above, they were already quite strong.
Deb made it clear that it was my decision. She said that I could certainly continue laboring, and eventually the bag would break on its own, or not, but eventually I would get to fully dilated on my own. But the "eventually" part was a sticking point for me. I was already getting quite tired, and I didn't want to end up as one of those women who, when they finally get fully dilated, are so exhausted from all the contractions that they don't have energy left to push. I've heard those birth stories and I could easily see that happening to me if I had to labor another twelve hours!
So I decided to do it. Deb broke the waters around 11:45am, and the contractions did get stronger. I could handle it, but I was definitely worried about my ability to cope if this intensity continued for muuch longer. I think it was around this point that Sally returned, having taken Isaac to daycare and gone to Whole Foods to get lunch for everyone. I wasn't allowed to eat so I had to just smell it and watch everyone else. :P
At some point around then, Deb began to theorize that the baby had the umbilical cord wrapped around her neck. This is fairly common and can cause long labors like I was having, because the cord prevents the baby from moving down into the birth canal. The monitors were showing that the baby's heart rate dropped with each contraction and then recovered, which was what clued Deb in. So she had me put on an oxygen mask and IV fluids (saline) to rehydrate me. All of this was meant to help the baby cope better with the contractions, and it seemed to be working. My spirits were low at this point, though, because I felt very "medicalized" with the oxygen mask covering my face and the heparin lock in my arm -- very far from the natural birth I had planned/expected. I was half convinced that the next words out of Deb's mouth would be to declare "failure to progress" and send me for a c-section, which I desperately didn't want. :(
Eventually, around 1:15, I started to feel very stiff from having been lying down for so long, and claustrophobic from the oxygen mask. So I asked whether I could remove it and get up and go to the bathroom, and they said yes.
As soon as I stood up, it triggered another contraction (see above re: changing position), and I felt this enormous involuntary shudder take over my whole body. I had to hold onto the bed for support. I didn't realize yet that this was my body pushing, or that getting up had caused gravity to take over and pull baby down into my pelvis. I went into the bathroom with nurse Maria yelling, "NO PUSHING ON THE TOILET!"
I got onto the toilet, had another ctx as soon as I sat down (see above re: changing position), and felt another big uncontrollable shudder. I struggled to stop my body from pushing as I finally realized that was what was happening. I yelled out, "I can't help it, I'm pushing! help me!" The nurses rushed in and hustled me back to the bed as Deb got herself in position to catch. She told me that when the head came out, I must stop pushing so she could remove the cord from around the neck, then resume. The idea of stopping seemed pretty incredible ;) but okay, whatever. The nurses got my mirror into place as requested (beside Deb so I could see the action "down there").
The pushing seemed like a breeze after all those awful contractions. I felt such pressure and such a strong urge to push like I never felt with Isaac. After the first push with the mirror, I thought it looked like this was going to take a while, but I was wrong. It was only about another 2 or 3 pushes and out popped Ruth's head!
I felt such relief, physically and emotionally. I knew that the head was the worst part and now that it was out, we were home free. I stopped pushing, Deb quickly slipped the cord off Ruth's neck (it wasn't tight), then one more push and her body slid out and they put her on my belly. I was so thrilled. I never got to experience that with Isaac because they whisked him away the moment he came out (because he was premature).
There was a whirlwind of activity, the nurses rubbing the baby with towels and everything, and in the middle of it I lifted up a leg to check the sex. I honestly couldn't even believe that I had a little girl so I didn't say anything, until a minute later the nurse said something about "her" and my mom said "oh, is it a girl??" I probably cried at that point. :)
Then Deb cleaned me off a bit and told me that I had torn slightly and she thought it should be stitched up. So while the nurses were cleaning the baby up, Deb put two stitches into my sensitive patient area. ;) Then they brought Ruth back, I told everyone her name, and I offered her the breast. She nursed much more skillfully and enthusiastically than Isaac did so soon! After she finished, we passed her around for everyone to hold her, took some pictures, and then she nursed on the other breast too.
And that's about it. It truly was the polar opposite of Isaac's birth (the contractions were awful and the pushing easy -- with Isaac, vice versa) as well as the opposite of what I had expected -- I was so worried that it would be a much shorter labor than Isaac's, but instead it was much longer.
But all's well that ends well; I did it vaginally without any pain medications as I had wanted, and I got the most perfect baby girl imaginable, so it's all good. :)