Like everything else in pregnancy, I researched the heck out of labor & delivery. I quickly learned that there's the textbook timeline and not a single mother I talked to experienced it.
Actual labors are as varied as snowflakes, and the textbook labor is as real as a unicorn.
What did immensely help me was hearing as many labor stories as I could. So here's my story, in all its glory, its detail, its humor, its pain, everything on the table. If you're pregnant, I hope my story helps your arsenal of knowledge. If you're male or not pregnant, I hope the details and uncomfortableness raise general awareness about labor so it's not such a black box enigma in today's society.
the textbook labor
- Early Labor. Lasts up to 12hrs, cervix dilates to 6cm, contractions are irregular 15-20min apart. You stay home for as much of this part as possible; hospitals will actually turn you away at this stage.
- Active Labor. Lasts up to 10hrs, cervix dilates from 6cm to 10cm, contractions are regular 3min apart. Hospitals will admit you in this phase.
- Pushing. Average ~2hrs, pop!
my birth plan
Birthing classes and pregnancy media will have you plan for eventualities like epidurals, episiotomies, cesareans, fentanyl, delayed cord clamping, pitocin, skin-to-skin. In reality, my birth plan boiled down to:
- Avoid a cesarean at almost any cost
- Go natural for as long as possible (no pitocin, fentanyl, epidural, etc.)
- Have an open mind
In my regular OB appointment 2 days before my due date, I bled 1/4 cup of blood on the exam room floor when the OB checked my cervix dilation. That, combined with an elevated diastolic blood pressure, prompted her to send me directly to Labor & Delivery.
By the time I got to the hospital 30 min later, I was having regular contractions 3 min apart (that normally doesn't happen until hours later in Active Labor) but I was only 1.5 cm dilated--my body was ramming a baby's head through a closed door. I was admitted and spent my entire labor in the hospital.
6 hrs later, I was still 1.5 cm dilated with still-regular contractions 3 min apart. The OB inserted a water-filled balloon to sit on top of my cervix so that each uterine contraction put more pressure to induce dilation. It's about as comfortable as it sounds. My contractions were mildly irritating to pain that would almost stop me from talking, but nothing that warranted pain meds.
8 hrs later of the balloon up my cervix (and boredom of a hospital room), my water broke, and my pain immediately went from a 4 to an 8 out of 10. The pain was immense but not unfathomable as media would have you think--but I wouldn't have been able to go for hours. My diastolic pressure was still spiking, so the OB strongly suggested an epidural to prevent me from seizing or having a stroke, given that pain and actively pushing both raise blood pressure. Epidurals have the nifty side effect of vasodilation to reduce blood pressure. I didn't take Fentanyl (usually precedes an epidural) or Pitocin (usually proceeds an epidural).
5 hrs later happily on the epidural and 18 hrs after being admitted, I was dilated and ready to push. I remember thinking "thank god, something I can do!" A nurse started me off, I pushed twice, and Jeremy's face was priceless as he proclaimed, "keep going, Melodie, you got 2 inches of head out on that push!" And at the same time, the nurse's face was in stark contrast in fear as she said, "Stop pushing! It usually doesn't go this fast! The doctor is in another building finishing up a c-section!"
So I waited for 10 min not pushing with Baby's head crowned until the doctor was suited up in the room. The nurse said "well, Baby has mom's hair!", then asked if I wanted to feel Baby's head as it came out, which was awesomely weird, since the part of their head that crowns first is their soft spot. Yes, I stroked Baby's head between my legs in between contractions. There's some opportunities in life you need to seize.
Then the doctor asked if I wanted a mirror (I so did), and I thought it'd be a dentist's-like mirror, but they wheeled out a free-standing wardrobe mirror for me to watch Baby's entire birth. So cool. The doctor coached me to push 100%, short bursts of 50%, 80%, etc. 8 pushes later, under 30min, Ash was born!
[In hindsight, I think the act of checking my cervix in that OB appointment induced my labor; had I just let nature take its course, my labor might have progressed "normally". It's like Heisenberg's Uncertainty Principle at play.]
First few days: It was pretty rough and uncomfortable to sit--you're bleeding heavily, you're swollen, you're exhausted, but it was manageable. You end up dealing with what you need to.
Week 1 to 2: I was walking a couple miles a day; by 2 weeks, I was heading into the gym for light workouts and for sanity getting out of the house. It was pretty terrible with hormones, the torment of breast feeding, and adjusting in general. The gym helped immensely.
Week 2 to 4: Slowly introduced bodyweight and dumbbell exercises. Felt my abdominals getting back!
Week 4+: Reintroduced normal activities slowly, like climbing and kettlebells.
so did all that fitness training help?
I definitely think so, and it's my #1 recommendation to anyone during pregnancy if you can work out--even a little will help! I believe society and popular medicine err on the side of being too conservative with fitness during pregnancy.
I'm very lucky I could work out my entire pregnancy, and I at least like to think that all that climbing, weight lifting, and interval training helped. Here's my observations that could be attributed to fitness:
- I amused myself over the 18 hrs of being awake in a hospital room attached to monitors by watching my and Ash's vitals. On the money, my pulse would rise to over 90bpm 30 sec before I could feel the next contraction. It was trippy to know a contraction was coming by an involuntary increase in pulse! Those ~320 contractions over 18 hrs take a physical toll, and being used to heartrate accelerations really helps you cope, since the hardest part of pushing is at the end.
- Ash did "phenomenally well" during 18 hrs of labor according to multiple nurses. Normally during labor, it's a sign of fetal well-being when their heartrate accelerates for at least 15 sec during contractions; it shows they're responsive, getting enough oxygen, and coping. Ash's heartrate would jump after each contraction for 1 min long and then come back down. It's been shown that regular maternal exercise throughout gestation results in significantly lower fetal heartrate and increased heartrate variability (both positives).
- The epidural allowed me to push harder; I barely felt anything. Despite being numb, I instinctively knew what 50/80/100% effort was from years of climbing & weightlifting. My main concern with getting an epidural was that it lengthens labor, even leads to more c-sections, because you can't feel & you lose muscular control. The doctor and nurses commented multiple times how much control I had over pushing.
- Watching Ash's birth through the wardrobe mirror was amazing, something I'll never forget. And the mirror was immensely helpful for me to see Ash's head come out alongside the doctor's orders to push at various percentages.
- Other than the epidural, I didn't need any more drugs. Usually an epidural is combined with Pitocin, which induces contractions, since an epidural decreases muscular control. Functional workouts like climbing, squatting, and working out the transverse abdominals are key to maintaining muscular tone.
- Recovery was fairly fast, as much as I can tell being a first-time mom. My theory is that if your body's used to being worked out, broken down, and rebuilt, it's used to "snapping back" to its norm. Recovering from labor is an extreme case, but your body's got to be used to rebuilding after trauma.
Aside from the physical aspects, I strongly believe we as a society don't value the importance of maternal well-being and emotional state. The medical profession pushes to minimize any complications at the expense of the positive effects of emotional happiness. If getting your blood flowing throughout pregnancy reduces cortisol and increases endorphins, thumbs-up to you!