First birth, with a midwife, in a hospital

During my first pregnancy, I found myself drawn to books like The Thinking Woman's Guide to a Better Birth by Henci Goer, which led me to a ruthless determination to avoid an epidural. I remember thinking that:

Epidural + Stirrups = C-section

My husband adamantly opposed a home birth due to his profession as a nurse, but we had a great support system in Raleigh, NC for low-intervention and natural alternatives to hospital births. We ended up pursuing care through a midwife in a hospital. She discussed my birth plan at length with me, and specifically asked me, "When you ask me for an epidural, do you want me to give it to you, or try to talk you out of it?"

I smiled. "I want you to talk me out of it."

My contractions started on Halloween, five days after my due date. My husband and I walked around the mall a while, enjoyed the neighborhood festivities, and then I went to bed by ten that night. I awoke at midnight with harder contractions. I spent the next six hours in the guest bedroom and the shower, rolling on my birthing ball, doing squats, and breathing through the contractions. When they reached five minutes apart and one minute in length, I called the midwife. She agreed to meet me at the hospital. The hospital didn't have any bathtubs, but they did have a wonderfully powerful shower that never ran out of hot water. I spent the majority of my eight hours there in the shower.

Even though I had a midwife to deliver the baby, the hospital still wanted to monitor the baby's heartbeat for 15 minutes out of every hour. So, every 45 minutes, I climbed out of my very comfortable shower, dried off with the puny towel provided by the hospital, and clambered up to the bed for monitoring.

My husband left the room for breakfast. I joked with him that it didn't seem fair that he could eat and I couldn't, since I was doing all the work.

The midwife suggested breaking my water at noon, after four hours in the hospital. The contractions really gained intensity after that!

After twelve hours of labor and very little sleep, I asked for the epidural. My midwife put her face nose-to-nose with mine and said, "Listen to me, Dorothy. You do not need an epidural. Just breathe with me." I think she started a LaMaze pattern of breathing, but it seemed to calm me down. She then suggested that I take a dose of Stadol. to take the edge off the pain. I dropped into a wonderful doze almost immediately, even managing to sleep through the hard transition contractions.

As the Stadol wore off, the midwife expressed concern that the baby's heartrate was dropping. Since I had a lip on my cervix, she said I wasn't fully dilated, and she would manually dilate me on the next contraction so I could push. She donned her gloves, performed the manual dilation, and told me to push! I pushed so hard that I burst the capillaries in my eyes and spent the next four weeks wearing sunglasses to hide the bloody mess! I also vomited.

I don't think she was prepared for what a powerful pusher I could be, because Saja was born with two pushes, and the midwife caught her barehanded. She was unwrapping a surgical scalpel to perform an episiotomy when Saja's head popped out. She was 8 lb 8 oz, and had the cord wrapped around her neck. My midwife told me to stop pushing while she unwrapped the cord, but I thought she surely couldn't be talking to me, because everyone had been yelling at me to push just moments ago! The midwife placed the baby on my bare chest and covered her with a blanket. She announced, "Here's your baby!" Chris had to lift the blanket up to check what kind of baby we had. "It's a girl!" he announced. I nursed her almost immediately, and we roomed in with her, never sending her to the nursery.

I ended up with two stitches from a tear, but I experienced a quick and easy recovery.

I am glad I avoided the epidural, because at one point after the Stadol had been administered, the midwife told me my contractions were slowing down, and I needed to get up and walk around if I wanted them to start up again. This would not have been possible with an epidural. I may well have been a great candidate for a C-section.

What I would repeat:

Hiring a midwife. She stayed with me the entire delivery. She honored my birth plan. She acted as a liaison between what I wanted and what the hospital wanted.

No epidural. Because I maintained feeling, I was able to change positions, walk, or squat to encourage labor.

Nurse the baby immediately. Hospitals don't encourage this.

What I would do differently:

Hire a birthing coach or doula. My husband just didn't cut it as a breathing partner. I can't blame him--even though we attended a birthing class on natural childbirth, he still didn't know what he was doing and wasn't comfortable with guiding me through the pain.

Labor at home longer. The hospital policies interrupted my pain management. I also would have been able to enjoy my bathtub.

Eat and drink, even if I had to sneak it. I needed the energy!

Learn to push properly. I burst my capillaries with two of my six children. My husband eventually learned to whisper to me, "Don't push too hard," "Breathe," and "Push from your abdomen," while the doctors and nurses yelled, "Push for ten seconds as hard as you can!"

Bring my own towels. Large, fluffy ones. But I would have expected them to get bloody. Childbirth is a bloody business!