Ali's Birth Story

Last week I got to act as doula for my friend Ali as she gave birth to her (of course) adorable baby boy, Elijah Conrad Blum. As is the case most Mondays, she dragged me kicking and screaming (ok, not really) off to Zia Taqueria for their $2.50 fish taco Monday special, which she lovingly and efficiently refers to a FTM on her multiple Facebook status updates regarding said special. Anyhoo, we are all about taking out the proverbial two birds with one stone, so she came by about noon to watch Ayden's birth video and see an actual unmedicated birth of somebody she actually knows before we were to indulge our taco habit. Her first birth was unmedicated, if you don't count the Pitocin the hospital had running through her veins throughout, causing extremely painful and unnatural contractions with her now 3 y/o son, Benjamin. After watching my video and I imagine feeling much justified and reciprocated by getting to see my inhumanly swollen and distorted vagina plastered across the 30" television screen, she informed me that she had been peeing on my couch the whole time, so sorry. This is really nothing too new for her, she peed herself on a regular basis with Ben and again with this baby, being that their giant noggins push against her bladder more than any other pregnant woman I've known. She was quick to inform me that she was indeed wearing a Poise pad just for the occasion, thank goodness. Something as insignificant as incontinence was not going to keep us from FTM, so I kissed my boys goodbye and off we went. Little did I know that I would not see them till the next afternoon.

During our 15 minute ride to Zia she informed me that she had again wet herself at least 4 times, and we were discussing whether perhaps it was not urine and her water had again broken at 37 weeks, as was the case with Ben. The fact that she had not really been having more Braxton Hicks contractions than usual combined with her history of going potty in her pants (hehe) made it difficult to determine. As you can imagine, Ali is a common spectacle waddling through Zia and this day the usually snooty (and hot) bartender asked her if she had a month or two to go until her baby came, and she looked at him in abject horror and informed him that no, she was 37.5 weeks and hoped to have him TODAY. (She had Ben at 37 weeks and was already 3 days more pregnant than she ever had been in her life and was quite put out by it.) While standing in line we simply could not take the suspense and she said she would go to the bathroom and try to determine for sure if it was amniotic fluid. When she had been gone about 2 minutes I got curious and entered the bathroom only to have her tell me she was just calling me on her cellphone to come see for myself. So I go into the stall and she warns me, "Ok this is gross but look at my toilet paper. What is this?" We are giggling maniacally at the preposterousness of the whole situation at this point, but I look and the toilet paper is indeed wet but not discolored. Short of having some litmus paper to test the pH of the mystery fluid, all I had was my own 5 senses. So I tell Ali, "Ok. Do NOT move your hand a fraction of an inch... I'm gonna sniff it." To which she bursts out laughing and is most certainly NOT holding her toilet paper wad still at all, but is still more than willing to let me give it a go. That is friendship for ya. I give it a sniff, fully aware of how insane this is but after all I am practically a professional and fluids are soon to be my lot in life, and it has absolutely no smell. Hmmmm! At this point I'm telling her it would probably be a good idea to call her midwife, but she would rather eat tacos.

Eventually she promised to call them after we ate, so we soon settled into our delicious baja fish tacos, Ali joyously wetting herself every few minutes. She was still a little reluctant to call because she felt silly not knowing if it was pee or fluid, but I told her to just give them the facts and that its their job to figure it out. They told her to come straight to the birthing center and be checked, so off we went. They, unlike me, have bonafide tools of the trade other than their sniffers and within seconds were able to tell with their handy roll of litmus paper that her water had indeed broken and she was going to have a baby today. She was totally shocked, and asked if she should call the bartender at Zia and tell him she really was in labor. I think she might have actually suggested that before thinking to call her boyfriend. :)

She had come back positive for Strep B, which is a totally random strep colonization that some pregnant women have, which means that they are increased risk of the bacteria crawling up through a dilated cervix and getting to the baby if the bag of waters has been broken, which can lead to infant pneumonia or sepsis (bacterial infection in their bloodstream, very bad). She had this with her first pregnancy, too, so when her water broke with Ben she was rushed off to the hospital where they started her on an IV antibiotic and told that she had 12 hours to give birth or her baby would die. Considering she wasn't really even having contractions at the time, this was not going to happen. We got her up and walking and contracting regularly, but a few hours later they said she "wasn't progressing fast enough" and started Pitocin to bring on stronger contractions, which also happens to be excruciating. This is how she ended up going through labor climbing the walls in pain and still refusing medication. So with this pregnancy we knew she'd probably handle natural contractions like a walk in the park.

This time, her midwife started her first dose of IV antibiotics and gave her instructions to go home, pack her bags, make their miracle castor-oil recipe, and come back at 9 pm for her next dose and hopefully she'd be in labor by then. Her boyfriend Tim was out of town but met us at her house at about 7:30 p.m. and took us to Denny's for Ali's last pregnant meal. She had the hep lock IV port in her right hand, which she casually gestured with as she told me, "You always see the most interesting characters in Denny's," looking for all intents and purposes like a woman who has escaped the maternity ward for cheese fries and a grilled cheese sandwich with her two willing accomplices. She was having regular contractions about every 3-8 minutes at this point, but they were so mild she'd talk right through them and forget to mention them. Seeing as how this was at almost 9 pm, I knew I was in for a long night. I had specifically told her a couple days before to NOT call me too soon into labor because I needed to try to get some sleep and preferred not to spend an extra 12 hours or so "coaching" a woman that really doesn't need help yet. Instead, she kidnapped me for a taco at noon and just never returned me to my family. Oh, well. I had been really worried she would go into labor nearer her due date and I'd be off break and back in school and would miss the whole thing, so I was just happy I literally had nowhere to be and a husband who is fully capable of taking care of Ayden at home. So I told her I'd need sustenance and fresh clothes and she could just keep me indefinitely. I made her molotov-castor-oil-cocktail which she gagged down on the way to the birthing center, and Tim and I ruminated on what we were going to do all night, seeing as how Ali was still happy, bubbly, and completely unfazed by her mild contractions. At about 11 pm Ali agreed to go for a walk and try to speed things up and I was unprepared for the pace she would keep with her Amazonian legs, moaning softly and plugging away right through the contractions, determined to get the most bang for her exercise-induced-contraction-buck. About 10 minutes later as we approached the birth center, she yelped and said that the rest of her water had just officially broken and was flowing down her left leg. From then on the contractions got much more serious, and by 1 am she looked like a true woman in labor, moaning and generally not enjoying herself, although still texting between contractions only to vehemently spew forth indignation at some of the ridiculous suggestions virgins and epidurral-moms alike were sending to her cellphone (as Tim and I smiled at each other about her stereotypical labor crankiness). Soon after this picture was taken, her tub was ready and she eagerly got in, where she was able to move effortlessly into any position comfortable during contractions. She was the most active woman I've ever seen in labor, constantly moving and turning and generally traveling all over the tub, which the midwife said was very effective in helping the baby to move more easily down the birth canal. At this point I'm sure Tim was wondering how on earth he'd managed to wind up in a tub with his fertility-goddess girlfriend who was obviously in a lot of discomfort and dealing with it as her body saw fit by moving and moaning and being quite vocal (which I am a big proponent of) with three women encircling the tub who seemed completely unfazed by the spectacle and offering constant reassurance. When a woman is in heavy labor like this, its almost like she is completely gone and her body takes over like a primitive birthing auto-pilot. You can see from this picture how Ali is completely lost inside her own experience, constantly feeling strange sensations and urges and a bit shocked by the whole experience.
In a way it is very difficult seeing a friend or a loved one go through this, but knowing that this is all a part of the physiologic process of birth and that this is something she wanted makes it easier. At this point I was totally willing to "take a few contractions" for her and give her a break (they were every 3 minutes like clockwork since 11 pm), but of course this is not something one can delegate. Instead, when she looked me in the eye with her huge scared cartoon eyes looking panicked, I was able to lean in and tell her "You are doing great, you are ok, your baby is coming" and see the panic instantly dissipate as this simple message filtered down to wherever her consciousness was hiding, which has got to be one of the most satisfying things I get to do in this life.

Toward the end she wound up having the fabled "back labor" because Elijah was facing forward with his back grating against her tail bone, which has been known to actually break a woman's coccyx in labor. Back labor could effectively function as birth control for hoards of teenage girls if they had the opportunity to witness it. I will just say, it seemed very, very painful. Even so, between contractions she would have 1-2 minutes where she would quietly rest and take comfort from Tim, which her nurse said is worth 1 hour of sound sleep.
Every so often between contractions, Ali would surface and say something so totally casual and off the wall that she had us almost rolling on the floor. For example, after suffering through two particularly gruesome contractions back to back with almost no break between and generally about to lose her mind, something bloody floated by and she instantly snapped to attention and said in the most fascinated/excited little girl voice, "What is THAT?!" to which we all burst out laughing and her nurse fished it out with a fish net and said, "A fish, honey." Another time she was just coming down from a contraction that looked very much like it was about to break her back and then looked between her legs and serenely said, "Oh.... I'm peeing. Look, its yellow. Thats nice."

I had always wondered exactly how a midwife is able to tell that a woman is done dilating and ready to push her baby out, seeing as how the mom is left to labor in peace in the tub and not constantly being checked by nosy doctors and nurses as often happens in the hospital. Ali had been in the tub for 2 hours, moaning and generally acting a bit weepy during the contractions (perfectly normal and she was eagerly anticipating this sign that things were drawing to a close), then during one contraction things were totally different and she stopped writhing and got a focused look on her face and bared her teeth like a wolf and growled deep in her throat; it was positively primal and powerful and mama-bear all rolled into one and it gives me goosebumps just typing this. Judy, the midwife, wanted to check her cervix one last time to make sure there was none left so she could start pushing. As you can imagine, having somebody's hand in your vagina when it is already painful and occupied trying to oh, I dunno, PASS A HUMAN THROUGH IT, is not much fun. Judy felt a small anterior lip of cervix left, but said that she might be able to push it out of the way during a contraction and then she could begin pushing, but that it would be very painful. Ali agreed, and during the next contraction screamed bloody murder in Judy's face while she moved the cervix past the baby's head. Judy was saying, "I'm sorry, honey" as Ali bellowed and then all of a sudden Ali would take a breath and say sweetly "Its ok not your fault, AHHHHHHHHHHHHHHHHHHH!!!" It was crazy.

Within seconds Ali was pushing and I could see the head crowning as she leaned back against Tim who helped hold her thighs back for her. Her back was pretty much in agony at this point and it was all we could do to get her attention and tell her to keep her legs open because her baby's head was already out. One more big push amidst the blood curdling screams and he popped out, and Judy instantly lifted his head out of the water. Ali went from completely absentee and screaming to instantly present and literally snatched her baby from Judy's hands saying, "My baby!" Always the professional, I burst into tears and blubbered a bit. In the matter of a second everything she'd been through ceased to matter and she held her baby contently and said, "Tim, touch him" as she guided his arm around her and cupped his hand on Eli's naked bottom. It was beautiful.
Afterwards, Judy told Tim to change into dry pants and had him lie down on the bed and put Elijah, still covered in vernix, directly onto his chest and covered them both with warmed blankets. He stayed there for the next 20-30 minutes while we got Ali out of the tub and laid her on the bed next to them where she delivered the placenta and was told she had not torn. Lucky duck.

So that, ladies and gentlemen, is how baby Elijah was brought into this world. Every birth I attend I learn something new, and this one was no exception. It was fascinating how she went from a woman barely in labor at 9 p.m. and pushed a baby out at 3:30 a.m., which I honestly did not see happening. Back labor is also a new phenomenon for me, and something I spent the next 24 hours living in active fear of and rethinking my current plans of getting knocked up in the next 12 months. Seeing her suckle this tiny little thing as he gazes up at her adoringly has pretty much cured me through sheer jealousy, though.

And the best part of all this? I caught it ALL on video. >:)