(dedicated to my daughter, Autumn Nell Knox)
October 12th, 2018
Riverbend Hospital, Springfield, Oregon
For the next few hours, I am still a girl. A daughter. A grand daughter. A girlfriend. A fiancé. A young woman.
At some point after, I hear, an incredible amount of intensity or pain (whichever school of thought you prefer), I will become a mother. A guardian. A protector. A womb-an. You, child, will make sure of this. And for that, I thank you.
For the next few hours I will continue to wonder Who Are You? Are you like your father? Outwardly wild and rambunctious, inwardly steady and responsible? With big blue eyes, an easy smile? With confidence unparalleled. A thinker. A do-er. A boy. A male?
Or are you like me? A Tiny T, as your father says. A girl. Are you a female?
You are too comfortable inside of me and don’t want to come out. That’s why we’re here at the hospital for an induction instead of laboring naturally at the birth center. The midwife inserted a cervical softener about two hours ago. I feel fabulous—no change. The nurse joked she’d have me “frowning by morning.” I feel so good I was tempted to do cartwheels on our walk around the labor and delivery unit. I am only a girl for a few more hours, after all.
Your due date was ten days ago—ten days! By current standards, that’s too long. I would’ve been happy letting you gestate longer but there are these scary reports—online and in print—about the risk of still born and meconium (that’s poop) inhalation and all these things I don’t want to read about or think about but have to.
So all this brings us to the Riverbend Hospital, in one of 325 other labor and delivery rooms. Would you believe we ended up with a room with a view? It’s not the best view available (those rooms have a view of the mountains) but it is the second best view: a clock tower. Three bells hang within its open brick walls.
Like I mentioned before, you were supposed to be delivered in a freestanding birth center. In a four post bed. Once we went a week past your due date, however, it was required that we transfer to the hospital.
What I like about the hospital:
- It’s fancy and modern
- I still receive the care of the birth center midwives, including during delivery
- the view!
- the ice machine
- the bathtub (with jets!)
- when we arrived there was a live pianist in the lobby playing “The Circle of Life”—I hadn’t cried much in pregnancy but I did when I heard that song, given the circumstances
Things I don’t like about the hospital:
- Mandatory IV’s
- Hospital gowns with a cute pattern but an awful cut
We had dinner (fish for me, spaghetti for Papa). We received another dose of misoprostol to soften the cervix. Other than the miso, we’ve had no other method of induction. We took a thirty minute walk through the labor and delivery unit. As we walked, we talked and joked. It’s what we do best.
We are mainly excited because the miso is working. After our walk, I began my “bloody show.” I won’t bore you with the details of all that but we are hopeful that you will be born tomorrow.
Believe it or not, little one, things got so intense after my last entry that I wasn’t able to keep up with the journaling. I expected this, of course, I’d just wanted to get the story (your story!) started.
Luckily your papa took notes. Well, that is until he got so swept up in the labor that he couldn’t take notes anymore either.
The last entry I made was at 8:22 p.m. on Friday night. Papa and I were so excited the contractions were starting. That’s probably the last time I would describe being excited about contractions. (Remember, other than being artificially induced I was laboring naturally with no pain medication.)
We’re not sure, but the miso seemed to make the contractions come on strong and frequently. Your papa asked the nurse quietly while I was in the bathtub if they were supposed to be this frequent. “She’s hardly getting a break between them,” I overheard him say. This didn’t make me feel worse, it made me feel better. Your papa cared, and I’d rarely seen him with the opportunity to share his sensitive side. (Side note: now that you’re here, I’ve seen it a lot more.)
From a clinical standpoint, I was two and a half centimeters dilated. Your heart rate was steady, excellent even, and your head was down, doing its work of opening my cervix.
October 13th, 2018
The hospital bed bothered me. Too much light, noise, and movement, so I curled up on the bed reserved for guests. It was a flat, large, vinyl double bed tucked into a dark corner. The nurses didn’t really want me on that bed but thankfully they didn’t push it. As the contractions grew stronger and stronger, I felt best lying on that cool surface, covered in blankets, with soft music (Yoga Sanctuary on Pandora) playing in the background. I developed a song, a hum, a howl to accompany every contraction. It was all I could do to stay centered and sane through the pain I was experiencing. My songs went something like, “ho, ho, ho, ha, ha, ha,” or “ho-o-oooooo! ha-ah-ahhhhh!”
This went on for hours. At one a.m., my water broke. I cannot tell you the relief and excitement of this happening. It was what I’d been wishing and hoping would happen since October 2nd, your due date.
Earlier in the night the nurse said they would wipe the smile off my face and replace it with a frown. We’d laughed about it then. See, that was the goal. Well, now we were winning.
The midwife, Kanya, responded when my water broke. She confirmed that it was brown with meconium, common in post-date babies. There was a fear that you’d have inhaled this meconium and would need immediate attention from the NICU. I had also read that babies exposed to meconium could come out green-tinged. Your hair. Your skin. And that it would take a while to go away. Compounding these nagging thoughts were the ever frequent and incredibly painful contractions. There, I said it: painful. You see, I’d read every book by Ina May Gaskin, and within it’s pages were testimonies by women describing childbirth as intense but not painful, their contractions as waves or rushes, and the whole experience as psychedelic.
Look, I’m all for positive imagery. I’d come to your birth armed with a Himalayan salt lamp, a handmade sculpture of a mother and child, a book on childbirth by Deepak Chopra, and at least six essential oils. I had lavender, the calming herb, on speed dial.
Your papa and I submitted our birth plan, prepared weeks in advance, heeding the advice of the nation’s most beloved midwife, Ina May. Hell, I even had a vision board, “I am doing a fantastic job!” it read on onside, and, “I accept this pain to bring my baby into the world” on the other. Your father had my favorite soothing music dubbed on his cell phone, only by this time I didn’t want to hear it. I didn’t want to hear a thing. I even asked the nurses to turn down your heartbeat on the monitor, it was reassuring, yes, but it was static-y and loud. I had them turn the monitors away, facing the wall (too bright).
By this stage I requested that your father not touch me (I would recoil), he could not talk to me (what did he know about birthing babies, anyway?) but he needed to be there. It was just he and I, with the occasional visits from Kanya and the PeaceHealth nurses (who only wanted to adjust your heartbeat monitor). I was vomiting profusely. I was still wrapped in blankets, lying on my side on the guest bed. I continued my chant of “ho-o-ooooo! ha-ah-ahhhh!” and every time I wanted to moan “noooooo!” I moaned “yeeaaaa!” instead.
Kanya was scheduled to leave at six a.m. When it became apparent that she would not be delivering you that Saturday morning, I brought up pain management. That’s what they call schedule I drugs in a clinical setting.
Kanya had wanted me to sleep through the night but the only rest I’d gotten were strange little blips between contractions. One to two minute naps as my womb rocked and rolled in anticipation for your arrival. I experienced the lightning bolts and thunder of labor. In retrospect, I’d needed a little guidance. I never felt better during labor than when a midwife was talking me through a contraction, but that only happened once or twice.
“Somethings gotta change,” I explained to Kanya between contractions. Her response was Fentanyl, which I understood was synthetic heroine. Was there no in-between? No extra-strength Tylenol? “It won’t take the pain away. And it will make you feel funny,” she told me.
I declined the Fentanyl.
I retreated, naked, back to my dark corner on the guest bed. My limbs were shaking like leaves. Kanya checked my dilation, which was stalled at 5 centimeters. Though the contractions were regular, I’d somehow stopped progressing. I continued my chanting and moaning. When it felt right, I squatted, walked, and used the yoga ball. Your head, dear child, was not dilating my cervix like it should. The positioning needs to be just right to be effective. Despite my walking and forward positioning over the past night, days and weeks…the midwives kept saying that progress was stalled.
The sun rose and I barely acknowledged it. I was writhing in pain in my dark corner. The concept of an orgasmic birth (see the documentary titled Orgasmic Birth) was laughable now.
“I would not recommend this to ANYONE,” I told your father. I even had the fleeting thought that he should, effective immediately, hit the streets and start warning women, “No, really, DON’T DO IT! Child birth. Don’t do it!”
Six a.m. to 10:30 a.m. went by incredibly fast. In fact I don’t remember much except the hoo-ing and haa-ing. The new midwife Pauline, an elder, came in to check my dilation. No progress. I was in such intense pain I could hardly navigate the room or a conversation. Pauline wanted to try a different position and asked me to get on my hands and knees on the hospital bed. But once I did, your heart rate dropped below 60—a dangerous low.
“Get her back up, get her back up!” Pauline pleaded, and your papa and a nurse helped turn me back over. “Whatever you do, stay on your back or side. Absolutely do not get on all fours,” she told me.
Pauline also indicated that my pelvic bone was uniquely shaped, a particularly narrow V. She thought this oddity might be preventing your head from descending properly. She said something about a c-section, almost under her breath, maybe it was to a nurse.
I touched Pauline’s arm, demanding her attention and croaked out, “If this is going to end in a c-section anyway, I request that we do it now.”
Then I told her what I’d told Kanya, “Something’s gotta change. This is too intense,” I told her, keeping with the Gaskin language but not the Gaskin morals.
The sun was gaining on noon, I could tell from the picture window behind Pauline. It had been twenty some hours since we came in for the induction. I was a woman who popped an Ibuprofin at the onset of a headache (then again I was prone to migraines) and here I was in the throes of a medication free labor. Pauline swiftly responded, “I’d like to try all the tools in my belt before opting for a cesarean. I’d recommend an epidural for pain relief followed by Pitocin to get things really rolling again.”
She was the midwife, an experienced one, and I trusted her.
“Okay,” I managed to say. “Let’s do it.”
What happened next was not at all what I expected. What happened next was neither an orgasmic, natural birth like I had hoped for nor was it a series of invasive interventions from a menacing male doctor, like so many of my natural-leaning mama friends had warned. What happened next is that Pauline got the anesthesiologist in the room in a snap (in less than five minutes). He was a kind, pleasant man whom I felt reassured being in the care of. What happened next is that through the cries and moans I could hear the anesthesiologist telling me I would soon experience complete relief from the pain.
Your papa gave me reassuring nod as I felt no more than a pin prick at the center of my low back. Ten minutes later, as promised, I felt pain-free, like new, and I was downright chipper. I could sense a collective sigh in the room. The nurses gained a pep in their step as if to say, “Thank god we don’t have to deal with that whole natural childbirth thing anymore!”
Your papa sunk into the guest recliner pulled close to my hospital bed and we both, per the midwife’s recommendation, fell into a deep, much needed sleep. When we woke it was more than two hours later.
Pauline and I shared a knowing smile as I roused to wake from my epidural-induced slumber. Unlike Fentanyl, the epidural only affected my lower body—most importantly it didn’t affect my headspace at all. I felt clear as the bell outside the window.
The only struggle was the weight of my legs. It took all the nurses and your papa to lift them into the stirrups so Pauline could check my dilation. “Time to start pushing,” Pauline said. I was fully dilated at ten centimeters!
Your papa and I looked at one another with amazement. I was thinking, “All that walking up and down the gravel lane, all that walking the corridors of the hospital, all that Evening Primrose Oil and spicy food, all that time on the yoga ball and all that active imagery—the lotus flower opening up—only to konk out for two hours, completely not conscious, and it’s then that my body works its magic…or was it the Pitocin?
Nonetheless, Pauline said it was time to push.
I held your fathers hand, a nurse rolled a full length mirror to the foot of the bed, and the midwife called for the NICU team should we need backup in the event of, well, any number of things. As it turned out, the NICU didn’t come in time.
I looked into the full length mirror. The sun was shining bright behind Pauline’s head as you began crowning. A sliver the size of a mango pit revealed my child, you, cocooned between my legs.
Every time I pushed through a contraction your papa yelled “Yeah babe! Go babe! You’re getting so close!” I’d rarely seen him so enthralled and excited. Well, once, river rafting. And who could blame him?
In my mind I was only warming up. In the births I’d witnessed (two), the “pushing phase” lasted for one and a half hours, maybe two. Later your papa said my face was so red and puffy it looked as if I would explode.
After just a handful of contractions, Pauline pushed the mirror aside and replaced it with a tray of stainless steel instruments, scissors and who knows what else. Then she said something to the effect of “this baby’s coming now.”
We all did a double take, though I couldn’t see anything now that the mirror was gone.
“Push,” she instructed when I sensed the next contraction. And when I did she said, “Here come the ears!”
I felt the warmth of your skin coming through my labia. I felt the weight of your body, a helpless, delicate thing but full of life and spirit. I scanned your face for reassurance that you were breathing and well.
“Well, what’s the gender?” Pauline nudged at your papa, who was just as amazed as I was that you were here.
“It’s…it’s a girl!” He stuttered.
I held your liquid warm, just-birthed body to my chest and kissed your head. There was no reason to whisk you away to the NICU. You were not green-tinged or chord-wrapped. You were, and still are, a perfect baby girl; earthside.
You were born at 3:44 p.m. on October 13th, your great great grandmother’s birthday.
We named you Autumn, after the season.