Photo by Jeannette Breward
Content warning: birth, change in birth plan, failed induction, caesarean section, surgery, previous miscarriage, placenta (including picture of my placenta at the end)
I’d planned for a totally natural water-birth at home with my team of midwives, a doula, and my partner with our gentle shepherd dog looking onward. I had read about orgasmic births on Ina May’s farm and which essential oils were best for birth and the benefits of salt lamps and yoga balls. I arranged my birth pool rental and for my placenta to be encapsulated and wrote things like seeding and delayed cord clamping into my birth plan, which I printed out and secured in the binder the midwives gave me to keep at home with my charts and information for after the baby was born along with instructions on how to contact the woman who was to encapsulate my placenta and a phone tree with the phone numbers of family and close friends and who was responsible for each call. In the weeks leading up to my due date, I ate spicy food, had lots of sex, walked my dog for hours up and down steep hills, walked the stairs in my building repeatedly (note: these aren’t easy things to do with a 70+ pound weight gain…), took evening primrose oil, drank a ton of raspberry leaf tea, made art, and wrote affirmations about trusting my body and welcoming my baby.
Then, my due date came and went. I wasn’t too stressed initially, two of my close friends who had given birth within the past year had both gone 10 days over their due dates and I knew that, statistically, something like 60% of first time birthing people went over their estimated due dates. But once I was officially 41 weeks, with my induction scheduled, I started to feel stressed out. I knew I didn’t want an induction and I resented the fact that my baby was already being forced to adhere to some schedule without a medically relevant reason. Sure, there is an increase in some risk factors (including stillbirth) associated with going past 41 or 42 weeks, but my ultrasound and nonstress test showed a happy, healthy baby who we expected to be a bit on the larger side. As the threat of medical induction loomed, I drank two doses of midwife’s brew, a concoction containing apricot juice, castor oil, almond butter, and a strong infusion of lemon verbena. Although I had multiple friends tell me to prepare to go into labour shortly after taking the drink, as they had, it did absolutely nothing to help bring on my labour.
After a long conversation with my doula and an even longer one with my partner about options and how to navigate balancing advocating for my dream home birth with my midwives and their concerns, I decided to go into the hospital, as instructed, at 41+5, to receive a medication that would make my cervix more favourable (I’d been stuck at 1cm dilated for a couple weeks already with no forward motion) in hope that when I went home, I’d be able to relax a bit more and dilate my way into having my home birth after all. I was technically scheduled to continue the induction process (with the midwife breaking my water and starting me on Pitocin) the next day, but I was hoping I’d be able to avoid that part.
When I got to the hospital, I had a long conversation with the patient OB who had followed me throughout my first trimester (due to a history of recurrent miscarriage) and he explained his concerns with me not giving birth within the next few days. He pulled up a chair and took time to answer all of my questions and heard me out about about my concerns. By the end of the conversation, I honestly believe that he was committed to supporting me and my team in achieving as much of my birth plan as possible and that a bit of medical assistance was warranted in this situation. The first step remained what I had already decided I felt okay about doing- the medication in my cervix to increase its favourability. I also opted to stay in the hospital for the night and to reconsider my home birth. The extra couple of days increased the risks for my baby and, at this point, that was my only real priority. I also knew by that point, although I didn’t say it out loud, that the medication was unlikely to work. Something was causing my cervix not to dilate and I just felt, like, SO deeply, that it wasn’t going to budge.
The medication was super uncomfortable. I started cramping, and by the time my partner my doula, and I went out for dinner, I was feeling pretty awful. I hoped this meant that I was wrong and that it was working. The next morning, when they checked my cervix, it hadn’t changed at all since the day before. As per my discussion with the OB, he agreed to administer a second type of medication meant to achieve the same result- one that my midwife said tended to work better in her experience. Six hours later, my midwife attempted to check me and, this time the check was so painful I screamed. My cervix still hadn’t changed, it was still so far back she could barely reach it and now so irritated, the extreme discomfort I normally experienced during cervical checks had become a searing pain that terrified me far more than the idea of labour itself. My midwife decided to check in with the OB to discuss possible next steps and came back within a few minutes to explain that neither of them felt comfortable moving forward with the induction as we had planned it, but that at 41 weeks and 6 days pregnant, my pregnancy was too high risk for them to feel comfortable with it continuing. I was presented with two options:
- Get an epidural and go through with the induction plan otherwise, in spite of my unfavourable cervix and hope it worked
- Elect to get a cesarean section
I was scared. All I wanted was my baby safely in my arms and I didn’t feel that continuing to put my body through an extended course of failed intervention was particularly respectful to it. There’s also something incredibly emotionally exhausting about your body repeatedly reacting poorly to failed methods of induction, both natural and medical. I started to cry and asked the midwife if my partner and I could have a few minutes to discuss what we were going to do. We talked about the options, and my partner brought up that his main concern was me feeling sad or disappointed in straying so far from my original birth plan, and I explained to him that, at this point, the game had changed and I felt good about adjusting my expectations. I explained my feelings about something going on with my cervix that we didn’t understand and not wanting anything else to be stuck in it and also that I felt that, for this reason, this birth was going to end up in cesarean whether I continued to put my body through the induction process or not. I tearfully phoned my doula and talked through the situation with her and she, along with my partner, supported my decision to do what I needed to do to emotionally process the change in plans and to shift my mindset around how my baby was going to enter this world.
We told the midwife that I was going to opt in for the cesarean section, and within an hour I was being taken through paperwork, given information by my midwife, by the OB, by the amazing nurse, and by the anesthesiologist, who told me he would be putting a spinal block in so I wouldn’t feel the procedure at all but would be fully awake. I signed the papers, and got to hug my doula before I was taken to the OR and the spinal block was administered.
Everyone in the OR was amazing, casually talking about their weekend while checking in and communicating with me every single step of the way. At some point, I started to cry…not because I was sad as much as because I was a crazy mix of scared for both my body and my baby’s body and also because I was just so physically and emotionally exhausted from the past few days- no- from the past week since my pregnancy had changed to increase in risk each day. My midwife checked in and asked if I was okay, and I said “yes” unable in that moment to explain to her exactly what was going on for me. My partner came into the room (I learned later that when the anesthesiologist had gone to get him, he had warned him that I was pretty emotional) and didn’t need to ask me any questions- he knew exactly where I was at emotionally. He was confused about how violently my body was shaking though, until the anesthesiologist explained that it was from adrenaline. My partner stood right by my head and the procedure began. The midwife and anesthesiologist talked me through the whole thing, though I remember very little of what they actually said.
When they cut me open, they were surprised at how much I bled and I remember the midwife warning me there was a lot of fluid and there was going to be a lot of the sound of suctioning going on. My blood pressure got very high (unusual for me, whose baseline blood pressure is barely that of a conscious person) and also dropped very low at certain points, so the anesthesiologist kept having to give me medications to alter it. The team asked my partner if he wanted to see our baby come out of my body, and he asked me if that was okay with me. I said, “of course”, and he excitedly peaked over the curtain to see our baby be taken out of my body, head and one arm first, and then the rest of him. I heard him cry, and thought with relief, “that’s the most beautiful sound I’ve ever heard”. Someone held him up above the curtain and I saw his screaming, bunched up, red face and thought, “there you are” and “who ARE you” and “holy shit, there WAS a human in there”! This abstract thought that was my “rainbow baby”, who I was almost afraid to believe, even until the end, would ever be here, was real after all. He was here. After almost two years of pregnancies, three miscarriages, and a day short of 42 weeks with this being growing inside my body, I could barely believe it. Wilhelm Erik Warmland was born at 6:27pm on March 2, 2020, weighing 7lbs 15.6 oz at 20.5 inches long.
The midwife placed him on my chest and I held this being who I knew so intimately and it was completely surreal. After a few minutes, the midwife asked if my partner wanted to do some skin-to-skin as well while they finished closing me up. My partner asked if I was okay with that and I said, “of course”. I just wanted one of us to be with him. They went back to my hospital room and I joined them shortly after. I held my baby and didn’t let him go for hours. My dad and brother came to meet him and eventually my partner did more skin to skin and my brother went out to get us food and then he did skin to skin with his long-awaited nephew while we ate. My friend came and took gorgeous photographs of our first hours together.
The woman who was encapsulating my placenta was on route, so my doula reminded me that I could ask my midwife for a “placenta tour”, which I had mentioned being interested in. When she did this, she noticed that my placenta contained an extra lobe with veins. This can happen when the pregnancy started out as a twin pregnancy, though I also wonder if it could be related to my previous miscarriages, including an early miscarriage I had the cycle before conceiving Wilhelm. It turns out this can cause issues with bleeding if it’s ruptured during the process of water breaking and often results in cesarean section, which validates my decision to stray from my birth plan. This wasn’t the only extraordinary thing about Wilhelm’s birth though. In spite of being almost 2 full weeks “late”, he had vernix on him and there was tons of clear, meconium-free amniotic fluid. There was also no calcification of my uterus at all. My body knew. I kept saying I knew I could trust my body, and it turns out I was right. It just didn’t look the way I expected it would.
Photo by Jeannette Breward