We arrived to the hospital around 4:30 a.m. Brandon and I get dropped off at the front door and head up to L&D. We get checked in and are brought back to triage. Kathy is the midwife on call at the time, and she meets us in triage to see what's going on. The first thing she said to me was, "I was expecting to see you a lot earlier!" I kindly reminded her that I thought laboring in the hospital sounded miserable, so we stayed at home as long as we could. She examined me and before saying anything else, she asked us, "how dilated do you think you are, and how dilated do you want to be?" Afraid to honestly answer the second half of the question, I simply said "I think I'm a 3 or a 4..." She smiled and said, "How about a 7?" Both mine and Brandon's jaws hit the floor and I'm pretty sure I almost peed on myself out of excitement when she said that. We made her repeat herself to make sure we weren't hallucinating, and she assured us I was 7cm and 100% effaced. I heard the hallelujah chorus right there in the triage room. I hardly had time to process the fact that we had labored at home until I was 7cm before my nurse for the remainder of the night came to take us to our room and get us settled. My mom and Farrin met us in the labor room and were both giddy with excitement at how far along I was. The nurse was wonderful, started up the big jacuzzi tub, and helped me in to try to help get through the contractions. I chose not to have an IV put in, which allowed me to relax as best as I could in the tub and have some motivation to keep myself hydrated. I was so excited. I was so proud. I was sure we would have this baby by 9:00 a.m. Bring it on, labor!
Contractions picked up in frequency and intensity. I stayed in the tub for almost 2 hours. I got out around 7:00 a.m., right at shift change. When my new nurse came in, I got out of the tub and heard and felt a little splash. I said, "I think my water just broke?" It wasn't dramatic, it wasn't even a lot, and no one really was sure at first. We thought maybe it was just water from the tub, until more and more came out. My water broke! It was clear and perfect looking. The new midwife for the day came in to check me, and it's Nancy. Remember? She is the one who saw me at my due date appointment. I am embarassed to say that my first reaction was disappointment, because like I said, she is the midwife that I felt least connected to. But there was nothing I could do about it, and it turns out that throughout my labor I couldn't have asked for anyone better. She was incredible, and I will forever be excited if she is the midwife to walk in the room. So Nancy checked me around 7:30 a.m. and I was 8cm. Progress! At this point, I entered the lovely period of transition. For all of you mamas out there, you know how much weight the word 'transition' holds. It's intense. Contractions ramped up again, even though I didn't think it was possible. They were closer together, making it absolutely necessary for me to focus on breathing and changing positions. But I knew we were making progress, and I was excited. At this point, finding a comfortable position is impossible. I want this baby OUT, and I want him out now. Around 9:00 a.m., Nancy comes in to check me after I tell the nurse that I want to push. Verdict: 9 cm. No pushing yet. So we continued to labor. I am exhausted, and this is hard work. Shortly after 9:30, meconium appeared in my amniotic fluid. That was very disheartening for me to see, since I knew that immediatly changed things once the baby came out. This means that I now have to have closer (but still intermittent) fetal monitoring. This made it tough since I was still getting in and out of the tub. The nurse had to listen to the baby's heart rate through contractions, which was awkward and uncomfortable. Lucas was having some normal decels with contractions, but at this point nothing to be too concerned about. I knew that meconium meant that the NICU team would be present when Lucas was born. Selfishly, I feared who would be on the NICU team, knowing that the residents that I work with in pediatrics rotate through the NICU. I became self conscious, thinking "what if I know someone on the team and then have to work with them later? That would be so awkward." It's amazing that silly selfish thoughts like that can creep into your mind during such a difficult and should-be selfless time. Meconium also meant that Brandon couldn't cut the umbilical cord, we couldn't have delayed clamping of the cord, and the baby would have to go immediately to the warmer to the awaiting NICU team instead of right to me. I was disappointed. I was frustrated. This is NOT how I was expecting this to go. Nancy checked me again, I was still 9 cm. And again, still 9 cm. And I heard her one last time after I kept insisting that I NEEDED to push and get this baby out, "I'm so sorry, Ashley. You are still a 9. There hasn't been much change." How is this possible? I have been stuck at 9 cm for hours! Do you know how close that is? What's one more centimeter, is that too much to ask? With each check, I prayed outloud. Please, please, please, please, please. I had reached my breaking point. I was without sleep for the past two nights. I had been laboring since 4:00 p.m. the previous day. I had been in transition now for going on 4 hours. I was exhausted. I was desparate. I said to her, "you have GOT to get this baby out NOW."
I don't think that I will ever forget the look in the eyes of everyone in the room. Brandon, Mom, Farrin, and Nancy all looked at me in a way that let me know something had to change. Lucas was showing changes, letting us know that he wasn't a big fan of this long and hard labor. Between the meconium and the decels, we knew he was getting antsy to come out too. I looked at Nancy and asked her what we needed to do to get this baby out. With a sincere kindness and empathy in her eyes and voice, she told me that at this point our best options were either an IV with fentanyl to help my body relax in between contractions, or an epidural. Either way, she knew I needed something to help my body relax and dilate the last tiny centimeter in order to push Lucas out. The unspoken words from her and my nurse told me this needed to happen quickly or we would be headed for a C-section. As soon as she spoke the word 'epidural' I immediately felt defeated. My plan was for a natural childbirth. My plan was to have this baby 3 hours ago at this point. My plan was for clear amniotic fluid, and absolutely no meconium or NICU team. My plan was for Brandon to cut the cord and for us to cry happy tears as our son was given directly to us. An epidural was never in this plan. I still didn't even have an IV at this point. As all of these thoughts were going through my head, I knew I was completely incapable of making a decision on what to do. I looked at Brandon and my mom and pleaded for an answer. Someone needed to tell me what to do. I looked at my mom, who was holding back tears. She couldn't give me an answer. She's my mom, also a nurse, and our incredibly experienced labor coach. She looked at Nancy, our dedicated midwife who had been by our side the entire time. Nancy, knowing none of us could make this decision, said "Do you want to know what I would do if you were my daughter?" Choking back tears, we all shook our heads 'yes.' She said, "you need an epidural." I closed my eyes, fought back feelings of frustration and defeat, and told her to do whatever she had to do to get this baby out safely. Healthy baby, healthy mommy is their motto after all. I kept praying, please don't let me have a C-section. Please let me deliver this baby. Please take away the feelings of defeat and disappointment. In minutes I had an IV in, started getting pumped with fluids, the anesthesiologist came in to get consent, and the epidural was placed around 11:30. They gave me a combined spinal epidural for immediate onset since I was already 9 cm and time was of the essence. The only little glitch was that my blood pressure dropped to the 70s/30s, but I didn't feel it. My nurse just pumped me with more fluids (causing me later to have Fred Flintstone feet) and kept an eye on it, and it resolved pretty quickly. The nurse had to insert a foley catheter and also place us on a continuous fetal monitor, more things to add to the list of things that I never wanted during labor. But I did feel pretty immediate relief, which was refreshing. I was able to breathe and even rest a bit. I was instructed to take a nap, but there is no way that was going to happen. I mean, I'm about to have a baby. Nap? No way. My dad came in to see me, which I know he needed because he was worried. Brandon's parents came in too, as did Jon and Kelsey. I think everyone knew what a hard time we were having and knew things weren't going as planned, and they wanted to see for themselves that we were hanging in there. Everyone was so encouraging, I definitely needed that. I will never forget my dad hugging me while I was hooked up to an IV, an epidural, and monitors, and telling me that he was proud of me. I NEEDED that. As I was resting, I watched our little guy's heart rate on the monitor. I would see when a contraction was coming, and see his heart rate in response. He continued to have those normal labor decels, but also started having some late decelerations. Basically, another way of him telling us that he wasn't a fan of this ongoing labor. I was instructed to roll to my left side, let's see if that helps. It did for a little while, but not for long. Pretty shortly after, the nurse brought me oxygen. Here I am, again fighting inner feelings of "this is not what I signed up for." Stuck in bed on a monitor, being pumped full of IV fluids, an epidural in my back, a foley catheter in, restricted to my left side, and now a mask with oxygen on my face. Really? Oh, and did I mention they aren't letting me eat or drink? Ice chips only. Fears of them wheeling me to the OR for a C-section started to get all too real. Then there was another 'helpful' nurse who poked her head into our room, just 'making sure everything in here was okay.' I have been the nurse on the other side of the door, poking my head in. I know that's because someone is worried because of what they are seeing on the monitor at the nurses' station. After the door closed, I looked at our nurse and bluntly asked her what was wrong. She explained that Lucas was still having late decelerations and she was going to call the midwife to see where we were, because we needed this baby to come out. Nancy came in to check me, and praise Jesus I was 10cm and at a +2 station. Mom joked and said "don't sneeze!" when she heard how low the baby was at this point. So here we were, ready to push.
I pushed for a little while before the NICU team came and took their positions, waiting for Lucas to arrive. Brandon was at my head encouraging me, and mom and Farrin had my legs. Bless their hearts. Because of Lucas's heart rate, I was pushing while lying on my left side. It was awkward and again, not how I expected the delivery to go, but at this point I knew it was necessary for the safety of our baby. So we pushed. And pushed. And pushed! And then I heard Nancy say something that I never even thought of not wanting...she said to my mom, "she's going to tear. I think we need to do an episiotomy." Time out. What? The midwives have a 2% episiotomy rate. It's not standard anymore and people try to avoid them. I never ever even considered that this would be a possibility, now you're telling me I'm part of the 2%? Unbelievable. Well, she did it, it was unavoidable. So I continued to push with all of my might. The 'baby nurse' came in and it was a girl named Erin who I went to college with. I was so glad to see her because I know that she loves Jesus and is a great nurse and would take extra good care of my baby and even talk to the big Man upstairs about him. She encouraged me and said she had been keeping an eye on me from afar from out at the nurses' station. She also said she was proud of me for going through all of this. I continued to push with every ounce of energy in me. I gave it my everything, physically, mentally, spiritually. Finally, here comes his head. Brandon will tell you that this was the most memorable part of the delivery from him. Just his cute little head sticking out, eyes WIDE open looking around, already taking in the world. Brandon says he was 'parascoping.' Before we knew it, he was out, Nancy cut the cord, and off he went to the NICU team. He was only with them for a few minutes while he got deep suctioned and checked out, but it felt like an eternity waiting for him to cry. As soon as they were done, Erin brought him back over to me and as soon as he was in my arms, Brandon and I cried tears of joy. He was BEAUTIFUL and perfect, bright eyed and taking us all in. We stared at him and kissed on him and were left in awe of this little miracle we were holding.
This is what we had been waiting for. This is why we worked so hard. This is our lesson in patience. Not our ways, oh Lord, but Your ways. One week late, a crazy labor and delivery, all of my thoughts of how labor and deliver were going to be but weren't, it didn't matter. As I sit here typing this, looking at our sweet son who I know without a doubt is fearfully and wonderfully made, I know without a doubt in my mind that it was WORTH it.