Pain Management

I've been trying to think, lately (when I'm not busy slamming my fist onto the kitchen counter so hard it makes my arm tingle), about how I handle the stress of taking care of these two cuties, and how I could handle it better, i.e. without becoming so ridiculously impatient and angry so much of the time. Let me talk about this in a completely roundabout way:

....

After I posted Iris's birth story, Meika asked:

Was there a particular pain-control method you used? Did you do anything different than you had the first time around?

Before Ingrid was born, A and I attended Bradley Method classes, which I ended up feeling lukewarm about. The teacher was a pretty dogmatic Bradley Method believer. The right and proper way to get through a contraction was to lie on your side with your arms and legs in a specific position, relax completely, close your eyes, and stay quiet. Most of that (um, minus the "quiet" part) ended up being useful to me, but during the class it bothered me that it was presented as the only way.

The most useful part of the Bradley class, even on top of the inordinate amount of reading I did about birth, was the information about what to expect during labor and how to respond to various interventions that might be offered in the hospital. We got an earful about the untrustworthy medical profession, which I didn't exactly appreciate, but we also got a really good schooling about how x is likely to lead to y and z, so if you don't want z don't do x if you can help it. That, along with a terrific doula and a large amount of luck, is what I credit for my being able to pull off two drug-free hospital births.

What I ended up doing both times was a kind of modified Bradley pain control: as relaxed as possible, but also making a lot of noise.

I also loved the Birthing from Within book, which gives the advice: "Be curious." I tried to pay attention to the pain rather than attempt to block it out; notice where it was, how it felt, how it was changing. As labor wore on, this became more difficult impossible. But for much of labor it was a good technique for me because it matched my motivation for wanting to go drug-free in the first place: I wanted to know what it felt like to give birth.

Shortly before Ingrid was born, we watched the movie Touching the Void, and this was probably the most unusual part of my pain management plan. The film (and the book, which is awkwardly written but with such a devastating scene of manly sweetness at the end it's worth picking up) is about Joe Simpson, a mountain climber who made a three-day, five-mile trek out of a crevasse and across a glacier after being left for dead with a broken leg, no food, and practically no water. I know people do the impossible all the time in this world (i.e. give birth to babies and raise them to be well-adjusted adults), but this was such an extraordinary example of what can be endured if you're just willing to do it one step at a time, I asked A to remind me about it during labor, and he did, both times. Remember Joe Simpson, he'd breathe into my ear in the midst of a horrible contraction.

....

Answering Meika's question, I started to think that my daily "pain" (and maybe that shouldn't even be in quotes) is not so very different from the pain of labor. It's a natural part of having children. I deal with it, mostly, by the book (because, hey, books! I love them. Rules. I follow them), but with an unauthorized amount of noise (just ask A). And I would be well-advised to be more curious, to float above it more, and to remember Joe Simpson and take it one little delirious broken-legged step at a time.

When you've got a minute...

We're back. We've been back for more than a week, but since then we've had two colds (well, one cold per child), a four-hour time change, many unsynchronized naps, and zero hours for me to be awake alone and writing anything. Also, I have been grumpy. Sunshine withdrawal?

I have things I want to write about:

creative life or lack thereof
a meta-complaint about all my complaining (I bet you can hardly wait)
childcare again
Iris's name
a general Iris update, complete with mysterious blood blister

For now, I'm finally posting the story of Iris's birth. It is scandalously long, and you will only enjoy it if you really like birth stories. For ages I wanted to write a shorter, more pretty and lyrical version, but you can imagine what happened to that plan.

Re-reading it and editing it, I've gotten all wistful about pregnancy and birth. We are, as they say, "done." There is no way we should be raising a third child, nor do we really want one. But I'm ridiculously sad that the whole business of growing and pushing out babies is behind me forever. Anyone out there looking for a 33-year-old, lactating gestational surrogate?

It's...

...Iris!

Born yesterday, August 4, the first cool, rainy day here in weeks, after 10 hours of labor and 10 minutes of pushing. She is healthy and strong and doing great. She weighs 9 pounds, 2 ounces, exactly the same as Ingrid weighed. She has a spectacular face and longish gold-brown hair. She seems to be an awesome nurser and (even better) loves to suck on her hand.

We'll likely go home from the hospital tomorrow, barring any jaundice issues. The grandmas brought Ingrid here for a visit this morning and she was utterly interested and sweet: She touched her hand and said Iris has a pinky finger just like Ingrid's. She kissed her on the tummy and said I love Iris.

And time will tell, but for now I'm shocked at the extent to which I feel like I sort of know what I'm doing. I mean, I can nurse and eat pizza at the same time! And in general both my butt and my nerves are feeling far less raw than in the hours after Ingrid was born. We just passed Iris's 24-hour birthday, and it made me a little weepy. To be expected, I'm sure.

Thanks for all your good wishes for this baby's arrival. Things are sweet for now.

Iris's Birth

It started when I woke up that morning, about 7:15: contractions. I felt one, then another, then another, then turned over so I could see the clock and tell that they were pretty regularly around four minutes apart, though pretty short and not very painful. I’d been fooled the day before by an hour of that same thing, so didn’t let myself get too excited, but lay there for about a half hour before getting up and going downstairs.

It was a Saturday. Mom and A and Ingrid were up already, playing on the floor in the living room and talking about going out for breakfast. I chatted with them for a while before mentioning, well, I’ve been having a few contractions. There was some excited twittering about whether we should still go for breakfast, and the two of them got all jumpy when they saw me rock back and forth through a few contractions. Mom said, “Let’s make breakfast here,” and she whipped around the kitchen making waffles and sausages while I played with Ingrid a little and kept paying attention. I wasn’t at all sure they were regular enough to be the real thing, but we were all kind of jittery anyway. I started the kettle to make myself a cup of tea. A asked, “Are you making raspberry leaf tea?” I said, “No way—this is black tea. I don’t want to have a caffeine withdrawal headache in labor!” I think that gave him confirmation that I thought this was probably the real thing.

But at times there seemed to be long gaps between contractions, and I was worried that things would fizzle out. I spent a lot of time trying to remember what it had been like last time: How far apart were the contractions? Were there gaps like this? After breakfast, when things seemed to be keeping up, I called our doula, R, to let her know something might be going on, and A called his mom to ask her to come down to take care of Ingrid (she lives about an hour away). He brought the phone out on the front porch to call her, and I remember calling to him, “Tell her that it might be a false alarm, but to come anyway!”

I went about my usual morning: Playing with Ingrid. Organizing a few things, packing a few things in my hospital bag. Sending a few e-mails, none of them acknowledging that something big might be going on. I called my friend E, whom I’d been wanting to talk to for days, and left her a message saying to call back to chat, that in the afternoon I’d either be at the hospital giving birth or at home discouraged by the lack of progress.

It was a special day, weather-wise. For weeks—almost all of July—it had been hot and humid, so hot we could barely go outside and I certainly couldn’t do much of the brisk walking I'd wanted to do to get labor going. But that day—eight days past my due date— it was cool, cool, cool, and by mid-morning it would be raining. It felt like a huge relief.

After A's mom arrived, A and I went out for a walk. I carried an umbrella. It was so pleasant out. Just a light rain, and flowers blooming and the sound of the rain and breeze in the leaves. I remember trying to breathe that all in, knowing the last half of the birth would be in the hospital, far away from those sensations. A timed the contractions, and we talked about easy, ordinary things, about Ingrid, about how glad we were it was cool and rainy. The contractions were strong enough to make me shift my walking rhythm just a little but not really slow me down. Moving seemed to make them shorter and closer together, by about half. I really wanted to keep aware of what was going on with my body rather than trying to block it all out, and I kept thinking of my uterus as a giant muscle, trying to think about how the feeling of a contraction was similar to, say, a bicep or tricep doing its work.

We stopped at the neighborhood coffee shop. We sat outside. In my shorts and tank top, I was, for the first time in weeks, almost too cold. Sitting still in the chair, the contractions got longer, but farther apart and a little weaker.

Before we headed home we wandered through a new gift shop next door to the coffee shop. It felt so strange to be in labor in that public space—like I should tell people about it. I contemplated buying a souvenir (!) but decided things were starting to move along enough that we should head home.

Walking home, the contractions were definitely stronger than they had been on the way out ... they slowed down my walking quite a bit and even made me catch my breath.

At home I settled into sitting on the living room floor next to the birth ball, sometimes just rocking through contractions and sometimes leaning my forehead against the ball to relax through them. It was coming up on Ingrid’s nap time, and I really wanted to be able to put her down for her nap “one last time” (despite disbelieving looks from everyone else in the house). When it was time I took her upstairs and we went through our whole usual routine: tooth brushing, reading stories, nursing, hugs and kisses. I felt incredibly sentimental about it: our last time doing this, just us. At the same time, the contractions were getting harder and harder. They did slow down while I was upstairs with her (mind over matter?), but as we were looking at a book together I had a pretty hard one and it took some work to stay quiet and relaxed through it. It was a deep, hard pain at that point. An ache.

I ate some noodles for lunch and then went back to having contractions on the floor with the birth ball. We called R a number of times through this, trying to figure out, first, was this really labor, and then, when should I go to the hospital. I’d tested positive for Strep B, so the doctor wanted me there four hours before the baby was born to get IV antibiotics. I didn’t want to end up being there too long and getting messed with. And I’d found out the doctor on call was not the one I trusted the most (I’d heard she could be a little jumpy with the medical interventions). Every time I talked to R, we decided to check in again in another 20 minutes or so. Then about an hour would go by before we remembered to call her again. The contractions were pretty hard—I couldn’t talk through them, and, even between contractions, wasn’t doing much other than relax and wait for the next one—but they weren’t yet a full minute long and weren’t a consistent distance apart, so I was kind of worried I wasn’t very far along.

My friend E ended up calling back as things were heating up. I wanted so much to be able to talk to her, and we chatted between contractions and I had to just be silent through them and finally hung up sort of abruptly. She said that I should send some of the contractions her way later, so she could take one or two for me if I needed a break.

Ingrid took a really short nap—only an hour. She seemed so cool with what was going on at the time, but looking back I can see she must have sensed the excitement and tension and couldn’t sleep that well. (And also, come on, Grandma and her dog were there, so who would want to nap?)

I think that after she woke up I spent about another hour in the living room. A's mom did an awesome job of keeping Ingrid busy and occupied. And clearly Ingrid noticed something was going on with Mama, but she didn’t seem worried. She’d come and talk to me between contractions, and then when another one came I’d say, “Mama needs to rest a little bit right now,” as I closed my eyes and leaned onto the birth ball, and Ingrid would go off with Grandma again. I’d been worried that having her in the house would be stressful or irritating, but it was completely the opposite. Hearing her voice in the other room as I was breathing through a contraction was really, really soothing, like its usual sweetness was magnified.

I called R again, and she seemed to think (probably because I was quite lucid and normal between contractions) that I still wasn’t very far along. She suggested I go for another walk to try to get things going. I said to her, “I don’t think I can go for a walk,” and Mom and A, listening to the conversation from the couch across the room, both shook their heads vigorously. “Everyone is saying no,” I relayed. Mom and A were starting to get antsy about getting me to the hospital, but I wanted to wait another 20 minutes and re-evaluate then.

Very soon after that phone call, the contractions got quite a bit harder. I felt uncomfortable, felt I needed to make more noise (I’d been keeping pretty much silent, for Ingrid’s sake), needed to pee, felt sort of nauseated. “Come upstairs with me,” I said to A just as a contraction ended, then I bolted up the stairs. I peed, then had a contraction that knocked my socks off, announced, “I’m going to throw up,” and threw up. A lot.

We called the doctor’s office to tell them we were on our way. I kept vomiting and trying to recover from the vomiting, and finally felt good enough to get myself down the stairs, giving instructions about what to put in the car, etc. all the way.

I still get all teary thinking of saying goodbye to Ingrid—who seemed preoccupied with Grandma and, looking back, was probably so nervous about what was going on that she was sort of ignoring it—I gave her a big hug, my big, grown up girl, and said in her ear, “Next time I see you you’ll be a big sister.”

In the car I reclined in the front seat, lying almost on my side. It felt good to lie down, like I could relax in a way I hadn’t been able to at home—and I was tired and damn uncomfortable. I’d described the contractions, a bit earlier, as “rude,” and they began to be more so.

I had a bunch of contractions as we walked through the hospital, mostly falling to my hands and knees to get through them. Someone I couldn’t see stopped and said, “Do you guys need some help?” Without looking up, I said, “No, we’re fine.” And we were. I was pretty lucid, thinking my way through contractions, and in between feeling pretty normal.

In the triage area they checked all manner of things and finally my cervix. With her hand inside me, the nurse said, “How do you like the number....six?” Six centimeters! I was thrilled. I hadn’t thought there was any way I’d be that far along yet, since things hadn’t gotten truly horrible. I remembered Ingrid’s birth, when I was admitted at six centimeters and was terrified that that was all the farther I was; I already felt like a wild animal at that point. But not this time. I put on a gown over my tank top and wrapped a drape around my bottom half to walk to the room where Iris would be born.

In the room I lay on the bed, on my side. I needed to have an IV, to get the antibiotics, and they put that in. It made me cold all over and made my arm ache. A remembered what it had felt like to have an IV as a kid and he brought me a warm washcloth to put on it. Which felt great, but the contractions were pretty harsh by then, and A had started pressing on my lower back (and R on my hip) through every single contraction, and soon I needed that much more than any relief for my arm. At one point A needed a break from doing the back pressure, and Mom did it instead. I remember saying “Push hard,” before realizing she was probably already pushing as hard as she could. I really needed super strong pressure, and apparently A was doing it in some pretty wacky positions because of the way the room was arranged—it ended up giving him a stiff neck for several days afterwards.

I had some nasty heartburn during that time, too, and I remember almost asking for some Tums before realizing it may look a little silly, me making a big deal about completely unmedicated childbirth and then asking for Tums to deal with a little heartburn. It’s funny how much it bugged me, though ... just that tiny bit of additional discomfort seemed like too much.

I lay on my side for a long time, and began to really concentrate on my breath. I remember that if I could get through eight deep breaths, then I could get to the point where the contraction was starting to ease off. I’d breathe and count and in between I was imagining floating up on a wave in the ocean, or picturing the muscle of my uterus working to open me up, picturing the baby I’d soon be holding.

The nurse was in and out of the room; the doctor came in to check on me, I think. This went on for a while and then R suggested I get up on my hands and knees and lean on the birth ball for a while. I did, and then needed to get up to pee. She suggested I hang out on the toilet for a while. I thought I’d try, but when I was standing up I realized there was no way I could get through a contraction without someone pressing on my back. So after I peed I scooted back to the bed to do another one on my hands and knees, and halfway through that contraction I knew I was about to puke. Which I announced to everyone, and a basin appeared in front of me, which I threw up into copiously.

In the middle of that the nurse came in to put the monitors back on me. After I mostly recovered from the vomiting, I lay back down again. I was still so aware in between contractions, I didn’t think I could be going through transition yet. The nurse started getting the supplies ready for the actual delivery—things for the baby, sutures, things to cut the cord with—and I joked, “Do you actually think I am going to have a baby?” It seemed very far off, but in reality it would only be a little longer before Iris was with us.

They ran the monitors for a while. R looked at the printout and said, “It looks like the baby is doing better.” It was news to me that she had been looking not so good (less reactive—not something to worry about, necessarily, but glad I didn’t know it while it was going on). The doctor came in and asked if I wanted her to check my cervix again, and I said no, I’d rather keep on going for a while longer.

She left the room, and almost immediately after that—maybe the next contraction—I started to feel like pushing—just kind of grunty at the top of the contraction. The next contraction after that I really felt like pushing, and said to R afterwards, “I really felt like pushing that time.” R was like, “Yeah, I could tell.” It seemed like it was immediately after that the nurse appeared again and checked me. As soon as she put her hand in, my water broke. It wasn’t during a contraction, so it felt very gentle—just a muffled pop, and then fluid running out of me. I said, “Oh! There’s something...” She pronounced me to be completely dilated, but the baby was still so high she needed to keep her hand inside me through a contraction to make sure the cord didn’t prolapse. She asked if it was feeling too awful for her to be doing that, and, weirdly, it wasn’t at all. It didn’t hurt, and it was actually kind of a fascinating sensation—to have my body open to the world that way. I pushed through a contraction with her hand inside me until the baby moved down far enough, and then the doctor reappeared.

Pushing was harder than I remembered. At first it was a relief: After the first contraction I pushed through, I said, “I LOVE pushing!” and everyone laughed. But as the baby moved down, it got excruciating. It felt like hell and I couldn’t wait to be done. Excruciating. The sensation of pressure, of not knowing exactly what to do with it, of needing to work, of being stretched out so fast. My body felt completely open—my cervix, but also my throat, enabling me to make sounds I have never made before.

R got right next to my face and kept talking me through it in my ear: "Just push right through whatever you’re feeling. Just keep pushing, and you can be done." I whispered to myself, finally pretty much incoherent: “You can do it. You can do it.” “Strong. Strong. Strong.”

They said I pushed for only 11 minutes. It felt like at least an hour. 11 minutes: that would be, like seven pushes or something, maybe fewer. Three while the nurse’s hand was still inside me. A handful more to move the baby down. Then one that brought her to crowning and me to total all out bellowing pain. I yelled "DO SOMETHING!" When the contraction ended I couldn’t believe I needed to wait for the next one to get that baby’s head out. To wait with her lodged there. R helped me reach down to feel the head, and I was glad to do it but was also so panicked at the level of pain that I couldn't really feel anything with my hand—I just swiped around down there, unable to tell what was me and what was baby.

The next contraction I knew I had to get her out and pushed with all my might. I think I pushed beyond the end of the contraction, not wanting to have to wait for another with her inside me. I did it. Her head was out.

A and Mom scurried to the end of the bed to see the baby’s face. The next contraction I pushed her body out and could feel her arms and legs wriggling as she emerged, like she was swimming out of me. I could sort of see or sense the baby lying perpendicular to how she’d come out as A cut the cord. He said, “Caro, we have another daughter!” and the doctor lifted her up and lay her next to me, only somehow she ended up almost throwing her, and she landed next to me in the curve of my body like a big fish splashing up onto deck, still all wet, sort of bloody, and crying. I lay on my side next to her for a long time, saying, baby, baby, hello sweetie, and she was full of healthy strong cry.

Her face looked so very unique; I think we’d been expecting an Ingrid replica, and here she was, her own perfect self: pointy chin, cheekbones, full lower lip. Yelling her head off. Sucking on her hand and making enormous slurping sounds.

A and I took turns holding her for a long time. She wanted to cry for about fifteen minutes after she was born, and our holding her didn't seem to matter; it was like she just needed to cry to get over all that smooshing and squeezing. But then she calmed down in my arms, looked around, blinking. And then I tried nursing her and she latched on as though she'd done it a million times before.

When I think of our time in the hospital with her, I think of Iris's soft, soft head. How it felt to kiss her scalp.

She was born at 5:11 p.m., about 10 hours after labor started (just a couple of hours shorter than my first labor, if you're keeping track), and two hours after our arrival at the hospital. Some parts of her birth were amazingly similar to Ingrid's: the puking at key moments, the quick dilation from six centimeters to ten. It felt very different, though. The earlier contractions were harsher, hurt more than I remembered, and pushing, as I mentioned, was far more terrible than the first time around, probably because Iris descended so quickly. But transition was somehow a breeze; I never reached a point where I felt crazed between contractions.

If you don't love birth stories, just skip this one.

Not that birth story ... not yet. This is Ingrid's. Forgive me; two years later, I still can't part with enough of it to get it down to a decent length. (This is the short version.) But here it is, for posterity and for your crazy birth-story-loving selves, if any.

This weird little work-around (back-dating the post and putting a link to it here) is the only way I can figure out to keep the whole huge thing from appearing on page one. All the official Blogger options I can find involve a stupid "read more" link at the bottom of every post, regardless of length. Is this why people switch to Typepad?

Afterbirth Stories

A friend of mine who’s pregnant with her first child wrote recently about her worries these days: At times, it scares me and I wonder if I’ll actually be able to do it without drugs and intervention. I was nodding right along until I realized she was talking about giving birth to the baby, not raising it.

I don’t blame her for focusing on the major step of getting the baby safely and happily from the inside to the outside. Birth is huge, and as we waited for Ingrid I put a lot into preparing and hoping for an unmedicated, low-intervention birth. But these days the perfect birth experience is laughably lower on my wish list.

Partly this is because Ingrid’s birth was almost dreamily good. I mean, let me be clear: It was fucking hard, and the first words out of my mouth after she was born were I’ve never been so glad to be done with something in my life. But she came out safe and healthy, and I didn’t have to have surgery, and the hospital people barely touched me, and I felt the whole thing. It was what I wanted, and for no logical reason I’m proud of how it went even though I believe that luck, circumstance, and a couple of good decisions contributed much more to the outcome than did my strength or will.

I hope this birth goes that well, and I’m doing what I can to have it go the way I want it to. But I also feel I was more than a little naive, back then, letting the big ol’ boulder of birth obscure my view of the thousand-mile, snake-infested desert* that is baby’s first year.

I think it’s a mistake a lot of us make, even those who aren’t as stunningly ignorant as I was about the specifics of life with a baby, and it’s an understandable mistake: The Birth Story genre casts a strong spell—stronger, I think, than the scores of mother memoirs on the shelves. Birth stories have beginnings and ends, and their length, when properly edited, is suited to a few minutes’ reading or a half-hour TV slot. There is room for complication and drama and emotion, but not so much that things ever stray too far from the narrative thread before the inevitable resolution: a baby appears in the world. Movies end with births.

I wrote an ultra-long account of Ingrid’s birth, which maybe I’ll even edit down sometime and post here. And no doubt I’ll do the same after this baby’s born. And I still love to read birth stories.

But now, after experiencing a good birth and a tough, tough first many months of life with baby, I’m far more interested in reading—and writing—about how we survive and thrive after the end of the birth story.


* I know, I know. But have you been in the desert in spring? It is as stiflingly hot as ever but there are cacti flowering with the most breathtaking icy pink blossoms.

Ingrid's Birth

My labor started suddenly, at about 1 p.m. on my due date, Tuesday, May 10, 2005. At first, I ignored the crampy contractions, thinking they were some weird fluke-y thing, or maybe that I’d jinx things if I got all excited. But they didn’t go away, and soon I was glancing at my watch every time one started. My watch isn’t the greatest for timing, and I kept forgetting what time the last one had been, but they seemed to come every three minutes or so right from the start, and to be about 30 seconds long.

After an hour the cramps were still mild but just as regular, and I gave A a call at work to tell him that something was probably going on, but not to come home yet. And I baked a dozen chocolate chip cookies and puttered around the house. An hour later, when the contractions were still regular and getting stronger (though I was still being imprecise about timing them), I called him again and said, “I think you should come home and help me time these.” At that point they felt about a notch worse than the worst period cramps I’ve had. Totally manageable.

A got home around 3:30 and, feeling proud of our nerdiness, set to work making an Excel spreadsheet to track the length and distance apart of each contraction.

I started out doing a lot of standing and swaying during contractions, or sitting and rocking back and forth, but by about 5 p.m. I was spending more time on my hands and knees, leaning forward on the birth ball, or lying on my side in the middle of the living room floor. A and Mom started taking turns holding a hot pack on my back. I was already pretty focused on getting through the contractions by relaxing completely both during and in between. A and Mom were also making a lot of phone calls, letting various family members know what was going on. I was aware of all this, and extremely aware of the sounds outside the house—birds singing, and, later, rain falling—but I already felt like I was in my own world, and while my senses seemed sharp, I was keeping it all at the periphery of my consciousness and focusing on relaxing and on what was going on with my body.

Things took a major turn at about 6 p.m., when I had a hard contraction and promptly afterward, threw up… into the nice pottery bowl we had on our coffee table. Mom and A scurried around cleaning up after me, bringing me a toothbrush, continuing to keep the hot pack on my back at the right times and to rub my back. I remember feeling really well taken care of, then and throughout labor.

After that, the contractions got a lot harder, and I became even more focused. I think this is when I started making low moaning sounds through each contraction—something that I continued to do throughout labor. Also at this point, A called our doula, Rita, who said she was going to take a shower and then head to our house.

I think Rita arrived at about 7 or 8. By then I was spending most of the time lying on the living room floor, switching from lying on one side to the other. I spent some time in the shower, which felt great, and lay on the bed for a while and then on the living room floor again. A, Mom, and Rita sat on the couches.

I wasn’t exactly miserable, but I remember thinking how pleasant it must be to spend an evening watching someone in labor, compared to actually being the person in labor. I was still making lots and lots of moaning sounds through each contraction, and I remember being very, very relaxed in between many of them, even almost falling asleep.

Around midnight, Rita suggested that A and I go up and lie in bed and try to get some rest / sleep in between contractions. I’d been starting to wonder whether we should go to the hospital soon, but was waiting for a cue from Rita, because I didn’t want to go too soon. I was thinking Rita would somehow have a good sense of how far along I was and say something when she thought we should go. I definitely felt that contractions were getting harder and harder to deal with, and was feeling like I must be pretty far along. I didn’t say anything, but I was a little discouraged that she recommended going to bed—like she must think this was going to take a lot longer. But lying in bed had been pretty comfortable earlier, so I agreed and we went upstairs.

After a few contractions in bed, it was clear that things were getting much harder. Instead of making relaxed, low moans, a few times I felt like I was shouting, like the sound you’d make if someone stepped on your foot really hard, over and over. Then there was a super intense contraction that, like the one earlier in the evening, lasted much longer and was much harder than the ones leading up to it, and after that I got up and ran / waddled to the bathroom to puke—which I did for quite a while, while A cleaned up and continued to help me through contractions. I got back in bed after a while, and the contractions continued to be really, really hard and I started to wonder in earnest about going to the hospital. I was feeling a lot of what Rita kept calling “rectal pressure” —like I needed to shit—which was getting more and more intense.

A and I had a short discussion about when to go, and he told me that Rita had said we’d rely on my cues to time that, that I’d know when it was time. This was news to me, and I was starting to feel like we should go soon. A went downstairs to get Rita. I think it was shortly after she came up that I said, “I think we should go to the hospital pretty soon,” even though I was still afraid that this was just the beginning and that I’d end up laboring at the hospital for hours and hours. Rita suggested trying the shower again, and I thought that sounded good—that it might rejuvenate me for the trip. So I said I’d get in the shower for a while and then would want to get in the car.

The shower felt awful. The water felt like it was irritating my body and making me more tense as it hit me, and I was cold and shaking hard from the beginning, even though the water felt too hot. I did maybe one or two contractions in the shower before saying, “I think we should go to the hospital now.”

Rita came in and asked me a lot of questions about what I was feeling—the nature of the rectal pressure, did it hurt in front or in back more. I found it very hard to answer her. It seemed impossible to put what I was feeling into words, and it also seemed very petty that she was asking these things. I couldn’t for the life of me figure out what she was going to do with this information! I remember saying, “It just feels like I’m going to explode,” and then, after a few more questions of hers, “I just think we should go to the hospital now or I’m not going to be able to go.”

So we went. Rita helped me dry off and dress, and I could hear A and Mom making phone calls downstairs, telling various people that we were headed to the hospital (it was 12:45 a.m.).

I was wearing yoga pants which were totally covered in mucous / blood, and a blue tank top with vomit down the front. I’d shed my underwear and bra at different points in the evening, and I remember that putting on sandals felt excruciating—bending down to deal with them, and also the feeling of them on my feet. My walk at that point was a cross between a stagger and a waddle, and I’d gotten used to the cycle of contractions—if I wanted to do anything or get anywhere (like, say, down the stairs and into the car), I had to start it asap after the contraction ended, so I wouldn’t get trapped on the stairs when the next one started. And I wasn’t going to let anything get in my way or hold me back as I was doing this, either. So I bulldozed down the stairs and out to the car while those guys were still finishing up phone calls and gathering bags.

Rita said something like, “If you’re not comfortable sitting down, you can turn backwards and lean over the seat.” There was no question in my mind—sitting down wasn’t an option. So I leaned over the seat. It was raining a little, and I remember seeing all the streetlights shining through the drops of water on the windows, but mostly I kept my eyes closed. I couldn’t tell you which route we took to the hospital. I know that A ran one red light. I was moaning loudly, and Mom was in the back seat talking on the phone to the doctor, whom, thankfully, she had remembered to call. I could tell she was unsure what she was supposed to say, but she got across the point that we were on the way to the hospital and needed the doctor to be there soon. I think the noises I was making were probably pretty persuasive.

As we arrived at the hospital I found myself in a state of complete unwillingness to be interfered with. Bureaucratic procedures and social conventions seemed absolutely trivial, and although I still felt extraordinarily aware of everything going on around me, I pretty much did not do anything but what I needed to to get through each contraction. This meant that I was on my hands and knees moaning and bellowing in the hospital hallway for about four or five contractions on the way to the elevator. A security guy appeared and escorted us to the elevator. He kept offering me a wheelchair, and I kept saying “NO.” So the guy would walk along with us and then loiter about 15 feet ahead when he realized I’d dropped to the ground again.

When we got to the right floor, I remembered exactly where the triage area was. Someone sitting behind a desk said, “Can I help you?” I said, “I hope so,” and promptly dropped to my knees leaning on a chair to moan through another contraction. They got us into an exam room in short order. Later Rita told us that they'd been unusually flexible with the admission procedure, not making us do a ton of paperwork right away and not even making me be on the fetal monitor for 20 minutes. Who knows why this was. My theory is that it was clear to them that I wasn’t going to put up with anything. Another possibility is that I was making so much noise they wanted to get me the hell out of the triage area and into the farthest possible labor room so I wouldn’t disturb the other patients.

I don’t have a great memory of what happened in the exam room. I know that they monitored the baby for a while, but I don’t remember thinking about it or worrying at all whether it was ok. The baby’s well-being, in my mind, seemed like a given, and the monitoring seemed like a hoop to jump through.

She checked my cervix and announced that I was about 6 or 7 centimeters. Six or seven! I was afraid when I heard this. I had heard and read over and over that you should not count on progress being consistent, or try to calculate how long labor will last based on how long it’s taken you to dilate this far. But the contractions were so intense, and the pressure—which felt more and more like the fabled “urge to push” —was so great, I didn’t see how I could continue to get through it for even a few more minutes, let alone the minimum time I assumed it would take to get to 10 centimeters. I mean, what’s the fastest you’d think a person could pull off four centimeters of dilation?

We weren’t in the exam room very long before they told us we could go to a labor / delivery room. I believe I was wearing only the pukey tank top at this point, and, like I said, I wanted to act quickly between contractions. Mom tried to get me to take off the tank top and put on a hospital gown, and I not only thought that sounded itchy and hot and horrible, but also had no patience for the whole ridiculous convention of clothing. I was fully ready to walk to the labor/delivery room wearing only the tank top, and I think I was even partway out the door before the nurse forced me (in the most gentle way possible) to put on a robe. I did not put on my sandals – the thought of those things touching my feet was completely abhorrent.

So, somewhat suitably dressed, we made our way to the room where Ingrid would be born. My memory of what order things happened there is foggy, and my visual memory of it is alarmingly sparse. I could hardly tell you what anything looked like, let alone who was in the room at any given point, or who was doing what.

I remember using the bathroom and then climbing onto the bed. I was more or less out of my mind, yet surprisingly able to think clearly about certain things that you’d think I would have overlooked. Knowing the way to the triage area is one example; I also reminded Rita to tell the nurse I wanted to use the hydrotherapy tub, though I could not see how I was going to survive long enough for a tub to be wheeled into the room and filled up.

I don’t know how many contractions I went through on the bed—not many—before I blurted out something (between bellows that I’m sure were getting increasingly horrifying) that I’d been feeling for a while without thinking it could be right: “I wish I could push!” This seemed to kick people into action. I heard Rita or the nurse murmur something that included “…push…” and the nurse checked my cervix again—and said I was basically fully dilated, “just a lip left.” I think I almost cried with relief when I heard this. This was only about 20 minutes after they’d said I was six or seven centimeters.

That was the good news. The bad news? They didn’t want me to push until the doctor arrived. I said something like, “Where IS she?” It felt like it had been ages since we arrived at the hospital, and I was wondering if she was driving down from Canada or something.

Not pushing (or trying not to push) was the hardest physical task I’ve ever done. I can’t describe the feeling of it … pain is one thing, but this was like pain that wants to make you do something, and not doing that thing is like—well, it’s bad. It’s like going against the forces of nature.

Here is where Rita was worth about three times her weight in gold. After the nurse left the room, she said, “You know, on the next contraction, try to put a little of that sound [I was still bellowing like a stabbed moose] into pushing, just to relieve some of the pressure.” Was I ever glad to hear that! Pushing even a little bit was an immense relief. I didn’t realize at the time that Rita had told me behind the nurse’s back to do this, but I’m so glad she did. Then when the nurse came back in and noticed I was pushing, Rita said something very calm and diplomatic like, “The baby is not going to fall out onto the floor before the doctor gets here,” and she let me be.

It wasn’t long before the doctor got there anyway. It was a doctor I hadn't met before, and she introduced herself to me. I remember thinking, can we cool it with the niceties and just get the baby out? She gave me the ok to push hard. And I did. It took a while to get the hang of it, I think, but not that long. It was like each contraction was making me push in a certain way, and I had to follow what the pain was telling me to do. It seemed when I was doing it right it just felt better.

Even though pushing felt a lot better than not pushing, it was very, very intense and hard. I wish I had better words to describe it. Calling it pain doesn’t seem adequate. It did hurt. But more remarkable than the pain was the pressure, and the feeling of being possessed—or being an animal. I remember thinking it is amazing that so many people have managed to get born in the world so far. I remember thinking (completely irrationally since I was so close to the end) that in fact I would need to get an epidural, or perhaps have a C-section, right then. I remember thinking—and saying— “I can’t do it,” which was met with instant encouragement from everyone in the room. Rita, a couple of times, gave me some gentle but stern talks about how I needed to focus on my breathing, and that helped.

Shortly after I started pushing hard, my water broke. This was astounding, because I’d forgotten that that was going to happen at some point, and because it felt like it was shooting out of me with the strength of an ocean wave, and it kept coming and coming and coming—I could hear it splattering onto the floor. And because, as it emptied out the feeling of the contraction changed, got more intense, like the baby was pressing down on me harder and harder. After it was all over I asked A if it’d gotten him wet, because it felt like the fluid must have shot about five feet into the room. Apparently it didn’t, it just flowed out onto the bed and from there to the floor. But boy was it strong.

Rita very calmly said, “It looks like there is meconium in the fluid, so there will be extra people in the room for delivery, and they’ll need to take the baby right away to suction the airways.” I remember letting out a whimper at the thought of someone taking the baby, but another contraction started then and this too began to seem like a superficial concern.

And I kept pushing. With each contraction I was pushing three or four times, holding my breath for longer than I thought possible. I pushed all the way through the end of each contraction, because the contractions felt so much worse when I wasn’t pushing. And then it would keep hurting in between contractions, too.

At one point, Rita said, “Soon you’ll be able to reach down and feel the baby’s head,” and I think I almost cried then. It was a joy I’d forgotten was coming, and a sign that I was almost done. Up until then I’d had no sense of making progress, and no sense that I could even start thinking about labor ending soon or about the reality that a baby was coming out of this. Hearing this from Rita made it feel like running the last leg of a race—the end was in sight, and I could put everything I had into getting there.

I have no memory of how long each step of this took, or of who was in the room, or who was doing what, but I continued to feel so well taken care of. I know that a couple of people were holding up my leg, and that someone was wiping my face with a cool wet cloth.

I remember almost wanting to suck on the cool cloth because my mouth was so dry and my throat was getting so sore from all the bellowing.

They were also continually monitoring the baby’s heart rate, but the whoosh-whoosh sound was pure background noise to me. Mom told me later that it made her incredibly anxious to hear the heart rate drop with each contraction, or to hear it stop when the monitor slipped away from the right spot on my belly. If I’d been in my right mind, I’d probably have been out of my mind with worry about that as well … but as it was, I was operating on the assumption that the baby was and would be fine. I could hardly tell you what the monitor looked like, or how they had it attached to me, or what motions of mine would make it slip off of me.

When the baby’s head was emerging, the doctor said something like, “You can reach down and feel the head now,” and then, “Do you want to feel it?” For some reason I assumed she was talking to A. I think she wasn’t calling me by name, and I didn’t know her or know her voice, so the things she was saying seemed like part of the background noise to me. Finally Rita took my hand and guided it down there—the head felt kind of soft, almost spongy, and wet and warm, and a little hairy. I felt this delirious joy that there was a real baby there, and that it would be out of me soon! It was a remarkable sensation, and if Rita hadn’t intervened I don’t think I’d have broken out of my little labor world to reach down and feel it.

After that it was the homestretch…it must not have taken many more pushes before the head was (painfully) out…then a little break, and then the shoulders, which were unexpectedly painful to push out. (Rita told me later that the baby had her arm up by her shoulder, which probably explains this.)

The first moments after the baby was out are blurry in my memory. I don’t remember seeing the baby right away. I remember craning around and trying to see it, and getting weird glimpses of a baby that seemed far too large to have lived inside me. But for the most part, for the first minute or so, I was totally overtaken by an immense sense of relief. I’ve never been so glad to be done with anything, ever. It was luscious to think that from that moment on I could go through life without a contraction coming every three minutes.

After what seemed like quite a long time after the baby was born (but it was probably only a minute or two), the doctor said, “Well, does anyone want to know if it’s a boy or a girl?” A and I had both forgotten to care about this—we were so overwhelmed by the very existence of a baby and the intensity of what had just happened. It seemed like it took a long time for A to walk around the bed and get into a position where he could see, before he said, “It’s a girl!”

A girl! I was thrilled. And then I got to see her face, which looked so much like my dad and brother, and like me. And she was so big. I couldn’t believe she had been inside me, and come out of me.

It wasn’t long before they lay her on my chest. She’d been fussing and crying a little, and when she came in contact with my skin she became quiet immediately. Her skin was so soft. And she was alert and looking around. It was hard to see her, because I was lying down, but A and Mom could see her big blue eyes open up. I’d been waiting for so long to hold her, and she seemed so content, I could believe she had been waiting and looking forward to this moment as long as we had.

She was 9 lbs., 2 oz., and was born at 2:40 a.m.

When I was all through being stitched up and cleaned up, we were moved to a recovery room. I rode over in a wheelchair holding Ingrid in my arms, all wrapped in blankets and with a little stocking cap on that made her look like a munchkin. I was talking to her in a string of baby talk and pet names that I’d never known I was capable of. Her eyes were open as we wheeled down the hall, and it was amazing to see her looking up at me.

In the recovery room I fell asleep holding her. Sometime in the wee hours of the morning I lay her in the bassinet while I went to use the bathroom, and then fell back asleep. A bit later she woke up fussy, and when I picked her up, lay her on her side on my chest, and jiggled her a little, she fell right back asleep, all calm and snuggly. I think I will always remember just how her little face looked as the room got lighter and lighter that morning.