Birth story - Caitlyn and baby Ellie

*Trigger warning* - Use of the word contraction.

I am not a first time mom as we have a son who we adopted from his birth in June 2020, but this was my first pregnancy! I had decided early on in my pregnancy that I wanted to plan to have an unmedicated labor and delivery. I decided to work with a midwife group that worked in the hospital 5 minutes away from my house. They have an amazing alternative birthing suite for those that wanted an unmedicated, home like experience in a hospital setting and even allowed for delivery in the tub.

I was super excited about this plan and did SO much prep work for a natural birth! I drank red raspberry leaf tea, ate dates, bounced like crazy on a birth ball, did perineal massages, listened to birth mediations. But I also took a birth class which was geared toward having an unmedicated birth but included in depth information about all of the types of interventions there are (I.e cervix prep methods, Pitocin, epidurals, c-sections). So I also felt really well informed, prepared and knowledgeable about all things that might come up during my birth. Ultimately my main goal was just for a healthy baby and healthy me at the end of the day, and the plan I had in place was my ideal scenario that I would work for if it was possible.

Pregnancy was definitely not my favorite thing. I had “all day sickness” (I hate calling it morning sickness because it’s so not true) until 20 weeks, bad heart burn, debilitating sciatic nerve pain, and then to top it all off, I developed Pruritic urticarial papules and plaques of pregnancy (PUPPP) rash at 37 weeks. It started off not too bad on just my stomach, but by 39 weeks it spread severely to all my limbs. I tried all the recommended things like aloe, pine tar soap, cold compresses and showers, was prescribed a topical steroid (couldn’t be prescribed an oral one since I was too close to my due date). Nothing worked. The only cure is to have the baby and even then it still takes days or weeks to clear up.

After a a completely miserable Memorial Day weekend where I literally couldn’t wear any clothes and I didn’t sleep more than a total of about 8 hours in a span of 3 days, I was at my mental breaking point. I know myself well enough to know that without sleep, my plan for an unmedicated birth wasn’t going to be a reality as I wouldn’t have enough energy and wouldn’t be able to mentally cope. I met with one of my midwives on June 1st and we agreed an induction would be the best course of action for me. So it was set up for the next morning, June 2nd at 5:30 AM. My midwife explained that since it was my first birth to be prepared that it would likely take 12-24 hours to prep my cervix and then she wouldn’t be born until sometime on June 3rd in the afternoon or evening (which was nice to have that heads up/expectation). Though it was very different than my original birth plan, I felt empowered, educated, and peaceful about what the process would look like. I also felt SO much relief that I was going to finally start actually making progress in getting rid of the PUPPPS. In all honesty as someone who is a planner, such a nice perk of a scheduled induction was to be able to plan a little bit more ahead for my son AJ who would be at home being watched by my mom.

We got everything ready at home the rest of the day on June 1st and then we tried to sleep as much as we could. We made our way to the hospital and got checked into our room by 6 am. Right before the 7 am shift change, I was checked and was at 1cm, 60% effaced. The nurses commented then that baby’s head was pretty low but my cervix was pretty posterior, so they had to reach around her head to measure. The midwife that was on the floor starting at 7am was Mindee and she would be with me until 7am the next day. I was given my first dose of cytotec just before 8 am and contractions actually started not too much after! I couldn’t feel them at all, we could just see that they were happening on the monitor. At about 10:30 is when I did start to feel them, but it was more just a sensation as opposed to any uncomfortable feeling. My husband Jake and I just put on our favorite quarantine show, Survivor, and continued to watch it all day (it was a great distraction and time passer).

After the 4 hours was up, I was checked and was now 1-2cm, 75% effaced- progress! Mindee decided she wanted to try to do a foley bulb, but after 3 attempts it just wouldn’t stay in because of how low baby was and how posterior my cervix still was. I then took my next dose of cytotec. The contractions were still not uncomfortable, but I could feel them happening and they began happening 1 minute apart for a bit. Baby had been tolerating everything really well, but her heart rate did start to rise a bit, so that’s when they started IV fluid and it worked to bring it back down and to space the contractions to every 2-4 minutes instead.

At the next 4 hour mark which was at 5pm, contractions had started to get mildly uncomfortable, but very very manageable. I could distract myself and talk through them, and I would also tap/count 4 seconds for breathing in and 6 seconds for breathing out. I was checked and was now at 2cm and still 75%, but again, definitely making forward progress so that was great! Took my third dose of cytotec and continued to have uncomfortable but very manageable contractions. My doula, Lauren, arrived at 7:30 and we talked through how at this point with the way things were progressing, I knew it was going to be slow and steady and an epidural was likely going to make sense at some point so I could actually get some sleep for the first time in days to be ready when I needed to push her out! We decided planning to get one at around midnight would make the most sense and we let my nurse and Mindee know what I was thinking and they thought it sounded like a great plan.

At the next 4 hour mark at about 9pm, I was checked again and was now 3cm, 80% effaced. Something with this check really got things moving however and things started to feel very different. Looking back it was clearly the transition from early labor to active labor. The contractions got much more intense- I could no longer talk through them or distract myself from them and I went more inward. I was also having a lot of double and sometimes even triple contractions. Additionally, I got cold, had the shakes and became a bit nauseous. I had to really put into place all the coping skills I had learned. 4 seconds for breathing in and 6 seconds for breathing out with low “ooo”s while squeezing Jake’s hand and having Lauren apply counter pressure on my back were what helped me get through the best. Because we had already talked about how the epidural would likely make most sense sometime around midnight, the nurse had plenty of time to make that a reality. I worked through the contractions for 2.5 hours and my epidural was placed at 11:55 PM. I was so grateful I got to use the coping skills I had practiced for a bit and was glad I got to experience that before getting the sweet relief of the epidural! I was very tired at that point, so it was definitely the right call as I wouldn’t have been able to continue to have the energy to cope well with labor without any pain meds for the long haul.

At this point I was checked again and was now at 4cm and my cervix was finally more anterior. I was then started on Pitocin. The next few hours Jake slept and Lauren was able to support me while I rested. I slept on and off some, but did occasionally get sick and was also having the shakes a lot. Cold compresses for the nausea and massages from Lauren on my legs, shoulders, and neck really helped me to relax and feel rested! Baby was handling the contractions very well, there were a few times the nurse came in to have me lay in certain positions to make sure her heart rate stayed stable.

At 4:30 I was checked again and was now at 5-6cm. My water still hadn’t broken at this point and so we knew once that happened, things would likely start to progress faster. At about 5:30 I felt some fluid and wondered if this was my water breaking. Mindee came to check in and she could still feel the bag around baby head but thought that there could have been a small tear in it which is why I felt the fluid. At this point I was 6-7 cm, 100% effaced and 0 station, so really making great progress. I started to get really shaky again and started to feel a lot of pressure (not pain thanks to the epidural) with contractions over the next hour.

By 7 am I started to have the typical feelings like I needed to poop. They started to set up the delivery table at this point because they knew it wasn’t going to be too much longer. By 7:30am, I started to feel the constant pressure in my bottom, so Jenny (the midwife who was now on the floor after the 7am shift change) came to check me at 7:45 am. I was now 2-3+ station, no cervix, and fully dilated! She also couldn’t feel the sac anymore, but I hadn’t had a lot of fluid come out yet (Mindee’s thought before that it might have torn was accurate, baby’s head came through the top of the sac but all the rest of the fluid was all still above her and didn’t end up coming out until I pushed).

By 8am I started to push and pushed through two sets of contractions on my back, but we then switched to my side which was much more effective. It was also SO effective for me to have a mirror to watch. After only 21 minutes of pushing, our beautiful daughter Elizabeth “Ellie” Madelyn entered the world!!! She was 20.5 inches and weighed a whopping 9lbs 3oz, which we were not expecting at all (being with midwives there are not growth scans or anything so we had zero clue she was going to be so big). I did have one small internal second degree tear that needed a few stitches, but given how fast I pushed her out and how big she was, I was super impressed that was it!

I am honestly in complete disbelief at how smoothly the entire labor went. Just about 24 hours start to finish, no complications, my body and baby did what they needed to do thanks to the help of the induction medicines and epidural. I also would truly describe my labor as pain-free, which is not what I was expecting at all! There were moments of a lot of discomfort and intensity, but I wouldn’t classify anything I experienced as really painful. It couldn’t have gone as smoothly as it did without the amazing support/encouragement Jake, Lauren, the nurses and midwives gave. Additionally thanks to having my daughter out of my body and now being able to take an oral steroid, my PUPPPS rash started doing so much better almost immediately. Though it wasn’t my original plan of an unmedicated labor, I am BEYOND happy with my experience. It was so so so positive, empowering, and wonderful. I have never felt so proud of myself and I feel like a complete badass for bringing my daughter into this world.