Third Birth: Hospital with Female OB

This is the story of BoyWonder’s birth at the hospital—the third and final installment of my birth story series. You can read the first one (birth center with a midwife) here, and the second (home birth with a male doctor) here. 

Third Birth: Hospital with a Female OB

THE CHOICE
Choosing to give birth at the hospital was kind of a big deal for me. Despite having a mom who’d worked as a labor and delivery nurse for 20 years, I wasn’t keen on hospital birth. I’d had two lovely births in “alternative” locations, and I was well aware of the cascade of interventions that can happen in the hospital, so it wasn’t really my first choice.

My first choice was to have another homebirth with Dr. Elvove. But when I called to make my first appointment, I was informed that he was retiring from birth attending on December 31. My calculated due date was January 15. I’m pretty sure I cried right there on the phone with the receptionist.

I met with Dr. Elvove anyway to discuss my options, and he recommended a group of OBs who worked out of Highland Park Hospital (northern suburbs of Chicago). Dr. Elvove had worked with them a lot in his years attending births at Highland Park, and he said that if he were going to have a baby, they were who he’d go to. They were covered under our insurance (a major factor), and since Dr. E recommended them so highly, I decided to go with them.

During my pregnancy, I met with four of the five doctors—incidentally, all of the male ones. There was one female OB in the practice, but it never worked out schedule-wise to have her at any of my appointments. I really liked the four doctors I met with. They listened, showed interest and compassion, were thorough and thoughtful—all the things you want a doctor to be. They were also supportive of my desire for a natural childbirth, and seemed to respect that I had some experience and know-how in that regard. I figured since I knew what to expect as far as normal birth goes, I’d be able to have the birth I wanted (barring any complications, of course) no matter where I gave birth.

The only thing that made this pregnancy and birth different from the other two (besides it being a boy) was that about halfway through my pregnancy, I developed a condition called symphysis pubis dysfunction (SPD). I had never heard of it before, but I found out it’s not terribly uncommon. Basically, the ligaments that hold your pelvis in alignment become too relaxed from the pregnancy hormones, which can cause the pubic bone to separate. It causes crazy amounts of pain, like someone has kicked you really hard in the crotch. Walking too long hurt, sitting too long hurt, standing too long hurt, and any movement where I had to separate my legs (like getting in and out of the car) REALLY hurt. I couldn’t walk around the grocery store for longer than five minutes, so I ended up having to use one of those little old lady car carts to shop. It sucked, big time.

(A little aside: Don’t judge anyone you see driving those carts who look perfectly able to walk. No one would have known what was going on with me—I could walk in and out of the store without a problem. But if I’d had to walk the whole time I shopped, I would have been in agonizing pain. But I also wasn’t about to explain to strangers in the store that I was using a driving cart because my hoo-ha hurt. So, no judgey.)

So, that’s the long story of how we ended up making the choice of a hospital birth. It’s a bit backwards from what most women do—I’ve not heard of many women choosing to have a hospital birth after a homebirth, especially if they had a good homebirth experience. I guess I just had to buck the system. Me and my radical hospital birth choice. 🙂

This is about how far along I was when the SPD started. Imagine how silly I felt using the driving cart at the grocery store with this size belly. In the end, I gained ten pounds more with this pregnancy than with the other two, since I wasn’t able to exercise, or even be active at all. SPD is a very annoying condition. I don’t recommend it.

THE STORY
It’s December 30, two weeks from my due date, and we’re staying a few nights at my in-laws’ house. They live about 45 minutes from Highland Park Hospital, with no traffic. I’ve had a few Braxton-Hicks contractions here and there, but no sign of anything more.

In the late afternoon, I start feeling funky. Just funky. Almost like I’m coming down with a cold or flu. I think, “Oh man, if I’m getting sick, I’d better be over it by the time I go into labor. That would suck to go into labor sick.” I lie down and rest a bit, feeling funky all evening.

I notice by bedtime that I’m contracting pretty regularly. I start timing them, and they’re 5-6 minutes apart, and definitely regular. We go to bed.

Around 3:30 am, I can’t sleep anymore. I wake up and time some contractions. 3-4 minutes apart. Since Dolittle’s birth happened so quickly, and I really don’t want to be battling morning rush hour traffic to get to the hospital, I tell Havarti I think we should go. Thankfully, we’re at Havarti’s parents’ house, so we just leave the kids sleeping with them and head to the hospital.

When we get there, I’m excited. And a little weirded out. I’ve spent very, very little time inside hospitals. For the past few months, I’ve tried to psyche myself into thinking that it’s normal to have babies at the hospital, and that it’s not just a place where people who are very sick or dying go. But I can’t help but feel a little disempowered just walking through the door. When you go to the hospital, you’re handing yourself over in a way. And when you’re sick or injured, that’s exactly what you want to do—give yourself over to the people trained to take care of your ailments. For me, giving birth is not a serious medical event until it becomes one. So going into the hospital makes it feel very much like a serious medical event right off the bat. I can totally see how that alone can affect a woman’s labor. I’ve read about the psychological effect of going to the hospital to give birth, and it’s interesting to feel it myself. I’m still excited, though.

Once I get admitted and checked, I’m a little less excited. I’m only dilated 3.5 centimeters, but doc says that’s enough to admit me. It’s one of the male doctors I’ve met and liked, and the labor nurse assigned to me is awesome. So far, so good. I start chatting with the nurse about my last birth, and when she hears Dr. Elvove’s name, she starts GUSHING about him. She said all of the nurses there just love him, and they’re so sad he’s retiring. She said some of them literally cried when they found out. I totally sympathized.

They hook me up to the fetal monitors, which I’m not used to. With my other two births, they did intermittent monitoring, rather than having me strapped to something. Here at the hospital, they let you take off the monitor to walk around, but when you’re in bed they want it on you. Kind of annoying, but not a huge deal, I guess.

I don’t really like seeing my contractions as jagged lines on a printout. It feels so…clinical. It seems odd to me that I had two care providers in two previous births who didn’t need to see my contractions on a printout to know what was going on with my labor and my baby. (Continuous monitoring in low-risk births is a routine procedure not supported by evidence, so it’s not like it’s something necessary or ideal.) It’s a small annoyance, but an annoyance nonetheless.

We call my two friends, Paula and Bahia, whom I’ve invited to come to the birth. Havarti’s mom would come a little later as well.

I labor for several hours, walking up and down the hall, chatting with people, trying to stay distracted. I’m hungry, but all I can eat are popsicles and Jell-O. This is one of the biggest drawbacks to laboring in the hospital, I find. Popsicles and Jell-O give you absolutely zero energy. They give you a jolt of sugar, and that’s it. After my second popsicle and fourth container of Jell-O, I’m feeling kind of gross and wishing I could have a nice bowl of soup.

After hours and hours of wandering the one long hallway in the maternity ward, I’m bored out of my mind. I’ve gotten to 6.5 cm, and stayed there for a couple of hours with no change. I seriously think my labor has stalled out of boredom more than anything else. I’m handling the contractions just fine at this point; I’m just getting annoyed that it’s taking so long and that I have nowhere else to walk but up and down this one hallway. I’d take a bath, but there’s just a shower. I shower and groom a bit, mainly just to have something to do.

It’s now mid-afternoon, Dr. G’s shift is over, and I’m handed off to the fifth doctor in the practice—the female that I’ve never met. Not thrilled about having someone I don’t know deliver my baby, but what am I going to do at this point? She comes in and checks me. Still not quite 7 cm. She suggests we could break my waters to get things moving. I tell her I’d like to think it over.

My awesome nurse comes in and tells me her shift is over, too. Bummer. She’s so sweet, though. She says she hopes for my sake that I give birth sooner, but she hopes for her sake I’ll still be there in 12 hours when her next shift starts. Then she gives me some AMAZING news: Dr. Elvove is delivering a baby in the room next door—his very last birth! I’m torn between feeling ecstatic that he’s there and miffed that I actually COULD have had him deliver this baby, since it was coming two weeks early. I decide to go with ecstatic.

Dr. Elvove comes in to say hi, and we go over what’s been happening with my labor. I ask him his opinion on breaking my water, and he says if I’ve been at 6.5 to 7cm for that long, it might not be a bad idea. He says I could wait it out, but I’m getting tired. (He also commiserates with me about the popsicles and Jell-O. Ridiculous.)

Then Dr. Elvove’s nurse (whom I know from his office) comes in and suggests that Havarti and I could “get busy” to move things along. I know that nipple stimulation is a common way to induce or move along labor, but I’m in no mood for such shenanigans. I say no freaking way. But Paula, Bahia, and Havarti’s mom (yes, his mother!) insist on leaving the room anyway under the guise of going to get something to eat. I am in labor, people. Maybe there are some laboring women who can get their sexy on, but I’m not one of them. I don’t even like to be massaged during labor. I tell Havarti there is no way on God’s Green Earth we are doing anything resembling sexual contact. I believe my exact words were, “DON’T TOUCH ME. I’ll stimulate my own nipples if I feel like it, thank you very much.” He was totally fine with that. A laboring woman is not to be trifled with.

I actually do try it, but it doesn’t do much good. My OB comes back in, and I tell her to go ahead and break my water. Then the real fun begins.

With my first two births, my waters stayed intact until I was pushing. I don’t realize until the next contraction how much of a HUGE difference that makes. The contractions are SO much more intense after the water is broken. Holy moly. I start regretting having her break my waters.

I’m working through the contractions on the bed, and decide in between contractions to stand up and see if they’re easier to handle that way. As soon as the next one hits, I just stand there leaning on the bed, rolling my hips and shaking my head, saying, “NO NO NO NO NO.” Standing was a very, very bad idea. That one contraction may be the worst pain I’ve had in of any of my labors.

I get back on the bed and just keep working through the contractions. Paula laughs because in between contractions I talk and laugh and am totally normal, and then as soon as a contraction starts, I close my eyes and I hold up one finger. At that signal, everything stops. No one is allowed to talk during a contraction. It’s such an odd frame of mind to be in, working through contractions. It takes enormous focus and concentration. I breathe, try to visualize what’s happening in my body, try to ride through the pain/discomfort, knowing it’s only going to last a couple of minutes. Once it’s over, I pick up the conversation right where I left off. This happens over and over and over.

The contractions get stronger and stronger, and finally, I start feeling the need to push. Oh, that need is so intense. The nurse (whom I’m not nearly as fond of as the first one) calls the doctor. She comes in, all doctory-looking, and puts my feet up in the stirrups. I’m laying back, but somewhat upright, as I was when I pushed the last two times. But this time it’s different. The room is very bright. I don’t know this woman who is coaching me through the pushing. She’s nice enough, but she feels kind of bossy. The only word I can think of to describe how this moment feels is “hospitally.” Totally made-up word, but that’s how it feels. Hospitally. I’m struck by the fact that this the norm for the vast majority of birthing moms, and how weird it is that this is weird for me.

With each push, I can feel BoyWonder move down the birth canal. I’m very aware of every sensation in my body. I don’t remember feeling this much detail during pushing with the other two, I’m guessing because they were still encased in water when they came down the birth canal. With the girls, it was just a general pressure and pain; with him, I feel every contour of his little body as he moves down. I feel the stretching, the burning as he crowns; it feels like it’s taking a long time, but it’s really just a handful of contractions. I have to work very hard to push—nothing at all like Dolittle’s birth, where my body just pushed her own on its own.

I feel his head come out, including the details of his ears and face. Very bizarre. On the next two pushes I feel the shoulders and arms. My other babies just slid out once their shoulders were out, but with BoyWonder, I even have to push to get his little bubble butt out.

And then he’s here. 9:15pm on New Year’s Eve, after about 18 hours of labor. He’s perfect. He looks like a soft, silky, scrunchy little old man. I’m immediately smitten.

After we deliver the placenta (I feel that, too—zoiks), the doctor says, “I’m going to give you as shot of pitocin now, to help contract your uterus.” I’m dumbfounded for a second. I’m sure this is normal, but I’m not used to having a doctor tell me she’s going to do something I know isn’t necessary. “Is that necessary?” I ask. “With the other two, I just breastfed and that seemed to work really well at contracting my uterus.” I’m not snotty or anything—I just don’t see the need to use drugs for something nature takes care of just fine. The doctor says, “Okay, if that’s how you want to do it.”

It’s bizarre to me that she was just going to give me a shot, informing me rather than asking me, and a little bizarre that she was going to do it at all—breastfeeding naturally releases oxytocin, which is what pitocin was created to mimic, to contracts the uterus. Pitocin is great if you start to bleed heavily, but that wasn’t happening with me. I know it’s often done to prevent excessive bleeding, but I prefer to wait and see if that’s even going to be an issue, especially since I’m already at the hospital.

I have one small tear, requiring one stitch, so the doctor stitches me up. I’m really missing the hot washcloths and olive oil Dr. Elvove used in Dolittle’s birth.

I stay in the hospital for the required day. My mom arrives from California a couple of hours after the birth, and stays with Havarti and me in the room. The food’s alright, but they don’t have my favorite post-birth meal: hot rice cereal. I don’t know why, but I have an insane craving for hot rice cereal after each birth. I settle for oatmeal. They serve me a steak dinner, which is a nice gesture, but I don’t really like being there. It’s hard to sleep. The labor, delivery, and recovery all took place in the same room, and it’s getting old. I’m very happy once we get to take our little bundle home.

Our little newborn nubbins. 🙂

LESSONS LEARNED

– I imagine my experience was pretty standard for an uncomplicated hospital birth, and as far as that goes, it was a lovely birth. Still, of my three birth experiences, this one was my least favorite. I’m struck by how much of the standard protocol of the hospital—even as minimal as they were at Highland Park—affected my labor and birth. Continuous fetal monitoring, not being able to leave the maternity ward, not being able to eat, etc. really affected how I labored. I’m left with questions such as:

• Did my birth stall because I wasn’t 100% comfortable at the hospital? Because I was fatigued and lacking nutrients from not eating? Because I was afraid of how the SPD might affect the birth and recovery? Or would it have happened no matter where I was?
• Should we have left the hospital when we found out I was only 3.5 cm so I could have more freedom to do different things during my labor? I really liked being able to do chores, walk around outside, take a bath, eat if I needed to, etc. during my labor time at home. Those things made labor much more manageable—even enjoyable—during my first two births. Giving birth at the hospital wasn’t so bad, but laboring there SUCKED. 
• Did I tear a little this time because I didn’t have the excellent and attentive care over my perineum that I had with Dolittle’ birth? Or did BoyWonder just have very wide shoulders?

Our birth center, home, and hospital babies. All three lovely births. 🙂

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