Confession. I am not a big believer in birth plans. There are certain things in life that are not entirely within our control, and childbirth is one of them. My birth plan generally consists of avoiding induction, patiently waiting 41+ weeks for my baby to decide to make an appearance on their own, heading for the hospital, and signing up for an epidural as soon as they will let me have one! After both my girls were overdue, but eventually came naturally all on their own with almost identical labor and deliveries, I just assumed my third delivery would be more of the same… What ultimately happened last week was definitely NOT part of any birth plan!
This Was Not Part of My Birth Plan
Last Monday, I was 40 weeks 6 days, and had my first ‘overdue’ OB appointment. I knew what to expect. I had been through this twice before. My oldest was born at 41 weeks 6 days, 24 hours from my scheduled induction, and Lil’ M was born at 40 weeks 6 days. I spent the morning dropping Big M at preschool, taking Lil’ M to her weekly class at My Gym, stopped to grab lunch for the two of us, then headed for the OB office.
Fetal Nonstress Test
Once you are overdue, at each appointment they hook you up to a fetal heart rate monitor and give you an ultrasound to check the health of the baby, your placenta and your fluid levels. For the nonstress test, you sit there for 15-20 minutes while it measures any contractions you may have and the baby’s heart rate, and they read it to make sure the baby is responding appropriately.
I got Lil’ M situated in the room with her iPad and lunch, and climbed up to the bed to get hooked up to the monitor. The nurse, who I have known through all three of my pregnancies, quickly got a funny look on her face and said she thought the machine wasn’t working properly. I was not alarmed since I could feel Baby M3 kicking away, and continued attempting to eat my lunch. She made me abandon my food and lay on my side… then went to get the midwife. The midwife watched the monitor for a bit… then went to get my OB. She came in took one look at the readings, and…
“How did you get here today? Where is your husband?”
“I drove… he’s at work… what’s going on?”
“Well, it’s okay. We will just send you to the hospital via ambulance.”
At this point, I immediately went from total calm to sheer panic as you might imagine. I had my 2 year old with me… I couldn’t go to the hospital now. He was kicking; I could feel him moving around. Why the emergency?!? Apparently, his heart rate occasionally dipping to 90 beats per minute was cause for the alarm.
I started making phone calls. I called Big M’s godmother – and now our whole family’s Fairy Godmother – to come pick up my car, my toddler, and then Big M from preschool. The midwife told me to put on an oxygen mask, call my husband to meet me at the hospital, and have him make any further arrangements necessary. They took Lil’ M, who thankfully was more interested in the stickers she gets at the end of every visit than my increasing sense of terror.
I held it together until my husband picked up the phone at work. I immediately burst into tears, as I told him they were putting me in an ambulance and to meet us at the hospital. He beat the ambulance there, despite being 20 minutes further away!
With Lil’ M secured behind closed doors so she wouldn’t see me sobbing while being wheeled away on a stretcher, I was pushed out the office door just as our Fairy Godmother arrived to rescue Lil’ M.
None of this was part of my birth plan.
Labor & Delivery Triage
When we arrived at the ER, my husband was already there and walked with my stretcher up to labor and delivery triage. I was so relieved that my practice, who alternates call with another practice, was at the hospital that day. I was put on constant fetal monitoring from the moment I arrived. The midwife on call, while still on alert, assured me that I was fine, the baby was fine, his heartbeat was more erratic than typical, but it was not overly concerning. Given my overdue state, and the fact they had nearly given me and my husband a heart attack, they wanted to go ahead and induce me.
This was not part of my birth plan.
I try to avoid induction at all cost. The numbers vary, but as an example – in one hospital, first time mothers laboring naturally have an 8% c-section rate. If they’re induced, it’s 44%. There was no way I could recover from a c-section with a newborn, a 2 year old and 4 year old at home.
I had already been contracting for days and was 2 centimeters dilated. My midwife recommended prepping my cervix for induction with a Foley bulb. It is a balloon they inflate in your cervix to encourage dilation to 4 centimeters, at which point your body often begins active labor. It is less restrictive, both physically and in terms of diet, than the chemical alternative. The worst part of the Foley bulb was the speculum they used to put it in. After that, it was mildly annoying, but not overly uncomfortable.
For 5 hours, the hubby and I hung out in the prepartum ward, letting the Foley bulb do its thing. Having never actually eaten my lunch, I was starving. We ate lunch and dinner. After dinner, my midwife came up, removed the balloon, and sent me down to Labor and Delivery to begin phase 2 of the induction process – a pitocin drip.
This was not part of my birth plan.
In Labor and Delivery, I was hooked up to fluids and they began a pitocin drip to increase my contractions. I was contracting roughly 4 times every 10 minutes, and they wanted it to be more like once every 2 minutes and with greater intensity. I was still not what I would define as uncomfortable – or at the point where I would have called to come to the hospital had I been laboring at home.
After 4 hours of pitocin, I had gone from 4 to 5 centimeters. The midwife and L&D nurse both suggested breaking my water to get labor moving more rapidly. I still wasn’t at the point that I was desperate for pain meds, but asked if I should get the epidural before they broke my water. I didn’t. Note to self: always trust your gut.
They broke my water around midnight. My contractions went from uncomfortable, to ‘oh my God, my body is splitting me in half, get me an anesthesiologist now’ in about 5 minutes. I deliver at one of the best L&D hospitals in the country. They had the first NICU in the country, are leaders in the field, and have a dedicated L&D anesthesiology team. No surprise – they are also a teaching hospital.
The Resident administering my epidural seemed to take forever to get it set up. Meanwhile, I was sitting on the edge of the bed, suffering through increasingly excruciating contractions every 1-2 minutes. With the epidural finally in, the first test dose went straight to my head. My head felt light, my ears started ringing… this was not right.
He made a few adjustments, then he and his Attending said to give it 15 minutes to let it kick in. Easy for them to say. Fifteen minutes was ten excruciating contractions. It didn’t. My husband started yelling at them.
This was not part of my birth plan.
They removed the first epidural and put in a second one. But not before they suggested I might be too far along for it to be effective. The midwife checked – I wasn’t. The second one still wasn’t quite right, more significantly affecting the left side of my body than my right, but it was better than nothing.
After my water broke, I went from 5 to 10 centimeters in 3 hours. Baby M3 was born at 3:16AM. And he was perfect, the only part of the birth plan that really matters.
Perfect Apgar scores, 10 fingers, 10 toes. He looks a lot like his big sister, but with dark eyes like his Daddy. He was born on the first day of MLB playoffs, which is highly appropriate given the theme of his nursery and one of his namesakes, my Grandfather, who was the biggest baseball fan I ever knew… until I met my husband. And so far, despite his erratic prepartum behavior, he is the chillest baby we have had yet!
Do you have a birth plan? Tell us your birth story! While nothing about last week was at all according to any birth plan I ever would have chosen, the best part is we are both perfect, and I feel pretty great just 1 week later.
If you enjoyed this post, you might also enjoy A Tale of Two Birth Stories and our Sleep Series – Sleep Tips for Infancy to Preschool. You can find all of these and our other favorites from around the web on our What to Expect and Babies boards on Pinterest.