Silvia

My water broke at 12:30pm, while I was at work, approximately a week before I had expected my labor to begin.  I wasn’t having strong or frequent contractions at the time that my water broke, which classified me as a patient with PROM (Premature Release of Membranes).  This is when the amniotic sac breaks before active labor starts.  This placed me on a timeline with my care providers, as the risk of the mother or baby acquiring an infection rises if the baby isn’t born within 12-24 hours after the water breaks.  I went home from work and waited for my husband to be able to join me, and stalled a bit so I could try some more natural methods to progress my labor.  I cleaned the house, went on a walk with my dog and ate some spicy food.  My husband arrived home around 7:30pm, and we set off to the hospital to be triaged and admitted.  

A few hours after we were admitted, my contractions were stronger but were still more than 5 minutes apart on average.  An oral misoprostol tablet (a prostaglandin) was recommended to cause further effacement of my cervix and to hopefully augment my labor enough for me to give birth before our infection risk rose. At that time it had been about 12 hours since my water had broken, and as this was my first child, we didn’t know how long things might take naturally.   Our midwife said that because my labor had already begun naturally, any labor augmentation would be unlikely to cause a cascade of interventions that would lead to a c-section. It felt important at that point to do our best to balance our concern about interventions negatively affecting this natural process and valid medical data about threats to our baby’s safety.  We ideally wanted a completely natural birth, but after discussing it privately, we felt good about saying yes to the misoprostol.

Approximately 1 hour after taking the tablet (around 2am), I felt I was in active labor.  My contractions were occurring every 3-5 minutes, they were powerful, and they were lasting 1.5 up to 4-5 minutes in length. I was breathing through my contractions, listening to my positive Hypnobirthing affirmations and remembering to stay positive and focused when a sense of fear or pain crept into my mind. My husband stayed by my side, helped me adjust my position, assisted me to get to the bathroom and back, used massage techniques and spoke to me with kindness and encouragement to let me know I was doing everything correctly and that I was safe.  I closed my eyes and focused on each surge, knowing that I just needed to get through the intense peak and then it would subside and I could rest before the next one.  

Around 4:30 in the morning, I went through transition.  I didn’t know it was transition at the time as I wasn’t having cervical checks due to my water having broken, so there was no quantitative measure of my effacement or dilation progress.  Looking back, I knew I was in transition as the surges were coming right on top of each other, they were a lot more uncomfortable than they had been, and I felt nauseous.  I powered through this period that now seems like it happened in a dream state, and I remembered that this was my body preparing itself to give birth and that everything was happening as it should.  My husband stayed right with me, talking to me, keeping a hand on me when needed, helping me move around the room and checking in with me nonstop.  

After this intense period, the pain of the surges started to lessen and we were both overcome with fatigue. I laid down on the cot in the room and while the surges continued, they spread out and were a bit more bearable.  I was able to doze off a bit between each one.  I laid on my right side with a birth ball between my knees to keep my pelvis open and my husband held my hand while he sat next to me.  I was aware that the sun was rising but I kept my eyes closed and focused.  Around 6:30am our nurse came back in to check on us.  She took a look at me and my contraction monitor and told us that she didn’t think I was in active labor yet.  She indicated that our midwife might recommend another dose of misoprostol or even starting Pitocin to ramp things up. 

This was so disappointing for me to hear, and my husband and I both felt that something wasn’t right…my surges were strong, close together and had been going for hours.  If I wasn’t even in active labor yet then maybe I had really under-estimated how challenging this would be. I didn’t know if I could make it another 10-12 hours given what we had been through and how tired we were. I felt I might need pain-relieving medication and was upset that given the time, our baby was definitely going to be at a higher risk of infection soon.  I was so worried about what might happen next and discouraged.  The nurse then offered to have the midwife come do a cervical check to see how dilated I was before we discussed or decided on any further interventions. 

While she was out of the room I suddenly had a very different and earth shattering contraction that caused me to vocalize and move without the calm and control I had leading up to it. I felt my pelvic floor open and our baby ratchet downwards.  The nurse came back in just as another of these surges was happening and she called for the midwife.  The midwife was there right away and performed a cervical exam. It seemed like it took forever for her to finish her exam, and I was anxious for the results but also was feeling that things had got to be quite progressed, given these new, powerful surges I was experiencing.  I was exhilarated and had a new sense of energy when she said “You are 10 centimeters dilated! You can push!”  Both she and the nurse acted completely surprised. They said they had no idea I was this far along, as I’d been so calm and collected over the evening. They thought I would be much more painful, would be swearing and upset when I was in active labor, so they didn’t expect this at all.  They got me to the hospital bed and only 20 incredible minutes later after an extremely intense second stage of labor, our baby girl catapulted into the world.  She made a short cry right away, latched on to breast feed within minutes and was just the perfect picture of a healthy baby. I wasn’t aware of much of what was happening in the room at this time, but my husband heard the care providers rounding to each other at the 7am shift change. He said they were all surprised and impressed that I did this without an epidural or any other pain medication, that it was my first baby and that it all happened so quickly and smoothly.  

I credit my mental and physical preparation, the Hypnobirthing techniques we practiced and used during labor, and my wonderful and supportive husband for our successful, calm, quick and almost completely natural birth!

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