10 lbs., 7 oz. (4731 grams)

21.5 inches

15.5 inch head

15 inch chest

Hospital (planned)

Mother’s height: 5 feet, 1.5 inches

How was your pregnancy?

Great! I only gained 17 pounds. Passed the glucose tolerance test, had some normal pregnancy complaints-heartburn, insomnia, etc. No real problems. I worked up until I was 40weeks 3 days, full time as a labor and delivery nurse. I loved every minute of being pregnant. I looked as big as a house, but blamed it on my being short. I didn’t gain much weight and my other babies were big, but not macrosomic- (all btw 8-9lbs)

How did you feel about your upcoming birth?

Excited! I was going to have an unmedicated birth, something I had not had yet. I knew I didn’t want to be induced, either, and my OB was okay with that. At 40w6d, I was 4-5cm (not contracting) and he suggested Pitocin, I said no, he said okay, that'd we do biweekly testing the next week. This was a Friday. I went into labor on Sunday night. I was so excited!

Description of your birth experience:

12:00am

My husband (here on out called N) came hom from work. Wanted to go to WalMart to buy a keyboard, as ours was broken. I told him I'd feel better if he didn't go, b/c I was feeling the ctx. Still not exceedingly painful, just uncomfortable. Try to lie down in bed to sleep through it. Not working. Tummy feels a little off. Maybe hungry, maybe nausea, maybe nerves. Not sure which. So I get N to make some mashed potatoes that I try to eat. Doesn't work. My skin feels funny, too. Sometimes I feel hot, sometimes chilly. Turn the a/c on and off. Try to find the thermometer to take my temperature to make sure I'm not sick.

12:45am

Page my OB (here on out called OB) to tell him I'm coming in. At this point, I'm not 100% sure I'm even laboring, but it does feel like it did when I went into hospital with Charlotte, and I was 7cm.

1:10am

Get to hospital.

1:18am

Get to my room, I wanted to labor in my own clothes. Not because of some anti-hospital thing, but b/c the gowns just don't look comfortable at all, and my shirt/skirt were very comfy. I wanted my nurse (here on out called RN) to check my cervix, and she said she could do it, or that OB would be coming around soon enough. I wanted her to check b/c I was afraid that I really wasn't in labor, and didn't want to look silly when he came to check. I was hurting some, but the ctx were irregular, and I didn't hurt THAT badly. She checked, and said I was 7cm, 80% effaced. I had been 4-5cm and 50% on Friday morning. Woo-hoo, I wasn't crazy. Transition is the worst part, and here I am, in transition and not hurting that bad. I felt very happy about this.

On with the formalities. She put me on the monitor, and said we could do intermittent monitoring. I said that being on the monitor didn't bother me, as I could move around and such, and I didn't feel like walking in the halls anyways.(side note-b/c I didn't know that intermittent monitoring could be done with a Doppler! I thought I'd have to have the belts on/off/on/off which just sounded annoying. Oh, if only I'd known.. another thing a doula could have told me)

RN started my IV and told me we'd just heplock it, without me even asking. I felt sick, and that was worse than the pain for me, so I asked for Zofran. I knew I didn't want Phenergan as that makes me feel loopy and sleepy, and I would have lost control then. I was also allowed to have some apple juice, too. I was told I could have whatever I wanted. Not that I wanted much: some juice, a few bites of ice cream

Labored on the birth ball, which was nice, leaning over the back of the bed, stood up and leaned over the bed, sat on edge of bed and leaned on N, who was kneeling on the floor. (he didn't like that, made his knees hurt)

I wanted OB to come check me, as I wanted to know where I was. He came a little after 2:30am, and said I was 8-9cm and 100% effaced, I don’t know if he ever said what station I was at, but the baby was fairly high up still. I was so excited to have made progress that quickly!

We kept on. I remember walking to the bathroom and hated laboring while sitting on the toilet. It wasn't soft, and put way too much pressure on me. I thought I'd like that, lol. Nope. Probably just the stupid hard hospital toilet.

I remember it did start to hurt more, and what i was doing wasn't helping as much. We tried breathing, then moaning, etc. I asked to be checked again, and was just a lip of cervix. I don’t remember the time on this, somewhere in the 4am hour.(so from 2:30 to 4:30, I went from 8-9cm to 9.5cm, which was disappointingly slow) I asked for 50mcg of Fentanyl IV for pain. Just enough to take off the edge, but not enough to make me sky high. I felt I was starting to lose control. The Fentanyl made me feel dizzy and fuzzy, and made my vision strange, but I was clear headed. I lied on my side, hoping that would help that one side of cervix go away.

I kept on, and it kept hurting. Kept feeling more pressure, and got RN to check again, somewhere around 5am. Still a lip of cervix. Getting disappointed here. 4th babies are supposed to come quicker than this. Started to discuss with RN about letting him break my water, to see if he would come down lower and be ready to push. She said it was quite likely. I was nervous, since I knew that it would hurt more after my water was broken, but I was getting quite ready for this to be over.

OB came around 5:30, we discussed this, and he broke my water. He used a spinal needle to go up there and rupture the amniotic sac, so it would leak down instead of gushing out. There was light meconium in it, just as I expected. Let me tell you, they aren't lying when they say it hurts more after membranes ruptured. I turned into the raving crazy lady. I was screaming at the top of my lungs. Screaming, “help me, RN, help me!” It was horrible and I’m actually quite embarrassed. I have a preexisting anxiety disorder and think that the extra pain, and the fact that I had no desire to push, the baby didn't come down, all being not what I expected made me have an anxiety attack, which made the pain worse. Of course, threw my control out the window! A doula would have really helped here, helped me to regain my focus and control. I scared N. I don’t know if RN knew what to do. I don’t remember what she did at this point.

Thing is, I was still at a lip of cervix. It didn't go away like I thought it would. Decided to try to push past it. It can happen. It has happened. I asked to have the foot pedals put up, b/c I didn't want to use stirrups. I didn't feel an urge to push, I just wanted to try, b/c I was so ready to get this over with! It hurt just as bad, if not worse! Who ever said that pushing feels better? Ha. While pushing I kept asking if he was moving down, and OB said “a little”, but they said they couldn't see him yet.. I was so disappointed. Why not? Didn’t they just say that he would be right there after my water broke? That's why I wanted to do it!

Got more IV fentanyl. Didn't help this time! Asked for a pudendal block. That was pure torture. Holding still enough for him to do it was miserable, then the darn thing didn't work! I was screaming help me, screaming I was scared, asking if he was too big to descend and that’s why he wasn't coming out. Everyone was very calm with me, which I appreciated. I know I was out of control and crazy. With the bottom of the bed off, I was trying to lie sideways in the bed and crawl away from the bottom of the bed. They were calmly telling me to lay back down b/c they thought I'd hurt myself with what I was doing. I wanted to turn around and push from on my knees, and wanted to get in that position RIGHT NOW, but they waited until the bottom of the bed was back on.

After this having my water broken for a while, an hour or so, pushing intermittently and not well, since I had no urge to push, with no progress, screaming for help, feeling like I couldn't move-I was draped over the back of the bed, screaming. I couldn't move b/c I was paralyzed by the pain. I lost control of myself completely, though at the time, I didn't care. All I cared about was getting away from the pain. I remember being told that they thought baby might be presenting OP . I was upset about that, too.

I asked for an epidural, finally. I couldn't stand it, I was not able to focus on anything except for screaming, which wasn't doing any good. (afterthought- I honestly don’t remember if I asked, or if it was suggested and I accepted. I remember screaming "help me" and OB said "do you mean you want an epidural?" which sucks since he knew I didn’t want one! RN tells me later that I was asking for one first) I hadn't had any IV fluids up to this point, so I had to get a whole liter infused first. So, while screaming my head off and scooching all over the bed, I had to hold my right arm out straight so the IV tube wouldn't kink and not infuse.

Got the epidural somewhere around 6:30 or 6:40 or so. Thank goodness it was a decent anesthesiologist, and not one of the ones I dislike. He comes in, says “I have to ask you a few questions first” so I yell, “I know what you want, I have no allergies, no medical problems except anxiety, no surgery, have had 3 epidurals before”. I asked him how long until I felt better, and he said about 7 minutes, which seemed like an eternity to me. He stressed how important it was that I had to hold still, which seemed nearly impossible, but I did it when I had to.

Of course, the epidural made my anxiety worse. I was shaking, which is normal in late labor and with epidural and although I knew it was normal, I was freaking out. I also was convinced I was going to die from the epidural. I kept looking over every time my blood pressure took, to make sure it wasn't too low. I kept saying "I'm going to die" I kept crying “I'm scared” and OB, RN and some other nurse friends reassured me that I was okay. I had to look out the window and focus on the view of the mountains and sunrise and try to calm down. I wanted to sleep, as I was tired, but was too excited/scared/nervous to sleep. I was telling myself I'd feel better about getting the epidural if he ended up OP or 10 pounds. I cried and told RN that everyone, all the nurses and such, would all be disappointed in me, b/c I'd been saying for so long that i didn't want an epidural.

Baby's heart rate was having some variable decels, not too deep, and they came right back up, but they were doing it with every contraction. I knew what they were just by hearing them, and tried to turn on my side to help. OB came in and put in an IUPC so we could do an amnioinfusion, thinking maybe there was a cord wrapped around him somewhere. They also asked if I was okay with starting Pitocin, because maybe some stronger contractions would help me progress past that last lip. This was fine with me, I wanted it OVER.

Somewhere around 8:30 or so, Baby's heart rate went down to 90, which I heard, and tried to turn on my side to relieve. Thing is, it didn’t come back up, it stayed at 90. RN came in, and I asked her what was wrong. She turned off the Pitocin. OB came in and did scalp stimulation and this should make the baby's heart rate have an acceleration. Baby's didn't. I asked OB if it was coming up and he said no. I was crying and saying “help me” again, and crying that I was scared. I still had a lip of cervix left. We decided to try to have me push past it. They knew I didn't want to push in stirrups, so N held one of my feet, and I didn't know where to put the other one, as I was kind of on my side. My eyes were closed, and I think I was shoving my foot against OB's thigh, since he was sitting on the bottom of the bed.

I don’t think he was coming down very well at all, and his heart rate was staying down at 90 for a few minutes now. OB called out for help in the room, and another nurse, RN 2, came in. I was really scared now. I heard mention of a c-section if it didn't come up and I screamed, “NO.” (I was later told that I said "hell no I'm going to push" )They then put me up in stirrups, which RN told me she knew I didn't want, but it would help. I was then told to push with all my might, and had an oxygen mask on too, for his heart rate. I was feeling the contractions in my abdomen, and not down in my perineum, which made it difficult to push in the right place. I was being instructed to push as hard as I could, not take a big breath between pushes, and just go, go, go! I knew his heart rate was down, so I did it as hard as I could. This was really difficult, especially to do while being scared out of my mind. They did respect my wishes not to be counted at while pushing. I kept wanting to reach down and feel him crowning but they told me no, b/c they needed me to focus on the pushing. This pisses me off.

OB asked for a vacuum extractor, as one of my pushes got him right down to crowning finally, but it was dropped on the floor, and another vacuum was also dropped. I kept on pushing and then he finally started to be born! My eyes were closed and next thing I know, I feel someone shoving on my pubic bone really hard, and I knew this meant I had a shoulder dystocia, which scared me too, as I didn't expect that!

He FINALLY came out, though in reality, that last part all happened so fast b/c I only pushed for 9 minutes RN tells me. I wanted to hold him on my belly/chest, but he was blue, so I didn't get to. They let me cut the cord, and I asked to at least touch him before they took him over, and I touched his foot and cried like a baby. The NICU team was over there, as is standard with meconium babies, and suctioned him. His Apgar's were 2 and 9, he perked up quickly.

Then, they were going to get to weigh him. They guessed 4100 grams, I asked them to hold him up, so I could guess. I guessed 9 pounds 5 ounces by looking. My other 3 were 8#2oz, 8#8oz, and 8#11oz, in that order, and they were all overdue as well. They put him on and called out 4731 grams, to which I yelled “are you serious?” I didn't know exactly how much that was, but knew that 4000 was about 9 pounds, so it must have been huge.

Then they say 10 pounds, 7 ounces. Wow! RN then asked OB about my perineum, and he said intact! NO episiotomy, no lacerations, nothing!

I got to hold him and it was great. He was big and beautiful, I nursed him right away, and he did great.

Later that night, with time to process everything, I was embarrassed at how I acted so out of control, and sad that it turned out so crazy and wild and not peaceful like I hoped. I was sad I got the epidural, and I didn't last. I was at least slightly hopeful though, thinking that maybe if I didn’t have the epidural, I wouldn't have been physically able to push as hard as I did as fast as I did to get him out before he needed a c-section. So that made me feel somewhat better. I was quite proud of making it until 9.5cm before getting the epidural, though.

In the hospital, they didn’t think he had any problems with his clavicle or any suspicion of Erb's Palsy or any brachial plexus injury. At the 4 day old pediatrician appointment, the ped felt a bump on his clavicle and sent him for an x-ray- he did have a clavicle fracture. C’aused him no pain, didn’t treat it, no lasting effects.

I look back and see the good and the bad. I see how before the epidural, it was all in my control. My clothes. the heplock, the position I wanted, the food I wanted. I asked for the Zofran I wanted, I asked for the AROM. My requested were honored without any hesitation on OB or RN's part.

The AROM started the downward spiral though, that famous cascade of interventions. -the anxiety attack, the stupid pudendal (though i asked for that, too), the epidural, the more anxiety. What caused the decel in his heart rate? I don’t know. I didn’t have hypotension. Can't blame it on the hospital policy, or on an overbearing OB, or a pushy RN-it’s all my fault. I thought I knew best, and I asked for the AROM. I'm a labor and delivery nurse! I should have known better.

If I'd had the support, kept on going natural, been able to push upright, would he have gotten stuck? I was very mobile until the epidural, so it wasn't that long I was flat and not mobile-2 hours?

I guess I had a sign he was going to be big when I was an anterior lip dilated for so long. Glad he didn't try to cut me for that. I've seen other docs do that to other women. Glad I had no idea he was going to be so big. That would have made me more anxious.

How did you feel after the birth (first month)?

Like a failure. I failed miserably at having an unmedicated birth. Glad and proud that I could have such a big baby vaginally, glad I worked there and knew what was going on. Another doctor may have tried to section me earlier! Glad that myself and the OB had no idea he was going to be so big going into it so I didn’t have that fear.

How did you feel six months after the birth? One year? Now?

6 months-still disappointed about the unmed thing.

One year-still disappointed about the unmed thing. Determined to get it right next time now (17 months old)-still disappointed about the unmed thing, plans for the next one.

Maybe a little apprehensive about an even bigger baby (mine have gotten bigger each time) and whether or not I could do it, mostly confident I can. Knowing I will NOT be suckered into a section, will hire a doula, and not push flat on my back! IN a way, I want another big baby, just to show it can be done again. Since my birth ended up so different from what I planned, the fact that I had such a big baby vaginally was a shining moment. On the other hand, I am afraid. What if I get a bigger baby and he won’t come out? I know that’s unlikely, especially if I get the much needed support and go natural, but it’s the anxiety talking. BUT, I know it can happen, even if it is rare. A c-section is my worst fear.

What did you learn from this birth?

That everyone needs a little help. I thought that I was a labor and delivery nurse,

I knew all the interventions and why they were done (this did help), that I didn’t need a doula, b/c I knew all the helpful things I could do, the positions, etc (too bad I was in too much pain and concentration to suggest those to the people with me). I feel if I had hired a doula, she could have been of immense help to me. Wish I would have written a birth plan-I thought I didn’t need one of those, again, b/c I would be able to tell everyone what I wanted, and I knew all the staff anyways! Yeah, I became too in pain and unable to say what I wanted... scared my husband and he's not the speaking up type anyways. I learned that support means everything. Being that I work where I birth, I have the ability to request my nurse. I will NOT choose a nurse based on my friendship, like many do. I will choose based on the ability to support a natural birth, encourage me the way I need, and help me combat my anxiety.

Any words of wisdom to impart?

Hire a doula! Find a care provider- OB, midwife, etc., who you can trust. Know their standards of care and that of the hospital, the standing orders. Ask early on about their beliefs on induction.

Know that you can refuse anything you want!!! Exercise that right- when they suggest something you are not comfortable with. He suggested Pitocin and I said no, he was very kind and not judgmental at all.

Write a birth plan- I wish I had. Oh, and big babies can come out of very short people! You wouldn't believe how many people are amazed that short little me had a big baby.

NO late term ultrasounds to guess baby's size. They are wrong! I've seen people have a c/section for "macrosomia" and the baby was only 8 pounds when it came out! I can't do anything about this, change the patient’s views, b/c by the time I meet them they are in labor already. Makes me so frustrated to see this happen- inductions, c/sections for macrosomia!