Josephine was born on Monday, August 25th, 7:50 PM. She was 40 weeks & 6 days.
I was set to be induced on that very Monday at 8 PM.
Before the Labor
After having already gone on maternity leave since week 37, I was BORED TO DEATH the weeks before. At week 39, I went in, my midwife Sharon checked me and said I was "only a fingertip dilated". Damn. That was sad news. I had already gone through a crazy number of ways you could find on the internet to induce labor: yoga, hikes, stairs, pull-ups (fine this was not on the list but I did it anyways), spicy food, sex, raspberry leaf tea, bouncing calls, squats, massages, accupressure....NOTHING. In fact, if anyone was going to provide me another "this worked for me, try it!" suggestion, I was going to strangle them.
There were three things they tell you are signs of labor: lost of mucus plug (you could still be weeks away though), water breaking (this is immediate and most dramatic, but only 10-15% women have their water break before labor), gradual increase in contractions (by far the MOST COMMON way you enter labor).
Well, I had none of those.
Starting week 38, I would go to sleep thinking: Could this be the day? Would I be waking up in the middle of the night from the increasing intensity and frequency of contraction pain, like 80% of the PTT blog posts I have read, and then wake up Ian to go to the hospital? I even downloaded an iPhone app to time contractions.
Yet, some days I would wake up from minor to persistent cramping. Not contractions because they were not rhythmnic. Just cramping. These false alarms are easy to recognize after a while: if they're real, they will not go away no matter what you do. Yet, everytime I got up to go to the bathroom, I immediately felt fine. I would walk to the bathroom feeling "OH SIGH I guess this is not it", go pee and then fall asleep like a pig.
Some days, I would have no cramping at all. I would lie down and the next thing I know, it's morning. Hella frustrating of a good night sleep!
I also noticed that many of the so-called "natural (i.e. useless)" ways to induce birth are merely methods that stimulate false labor. I would do 100 squats and feel some cramping that night, but the next day if I do another 100 squats, nothing. It's like my body got used to it immediately.
At week 40, I went in again. My midwife Sharon immediately saw my SAD PUPPY EYES.
"Would you like me to check you?"
"Yes please Q____Q"
After the exam, she said "Well, at least I could feel the baby's head now. Last week I could not. I'd say you are maybe 1-2 cm dilated? We have the antenatal scheduled tomorrow so after that they will set up a time to induce labor. We don't recommend going past 41 weeks, OK?"
I was super sad at the news. I did not want to be induced for many reasons. First, I wanted her to come out when she wanted to. Second, inductions don't always work; I could be in labor pain for a day or two and still not progress and end up getting a C-section. Out of everything I wanted to avoid, C-section was the highest on the list.
Next day (Thu, 40 week & 2 days) I had the antenatal testing. They used ultrasound to look at the baby --- good news, she's still alive, head down, kicking, and there's still sufficient amniotic fluid. Then they strapped me and tested the baby's heartrate & timed my contractions --- also good news, she's got a good heartrate and I do have contractions.
UCSF only does inductions every 3-4 days, so I had no choice but to go in for Monday evening. I was told to just show up at the hospital on Monday at 8PM.
Later that day, when I called in remotely to a meeting at work, our CTO tried to put the news in a better light. "Our kid was induced too," he said, "There was no rush, we just prepared everything and had to show up at the hospital on time. It's very Germanic." (and yup, he's German) At first I wasn't consoled, but then I realized that was probably the best way to think about the induction. I also felt a little better when I spent 2 hours final proofing a manuscript I had been collaborating on since last year. We had joked about whether the paper or the baby would come out first.
So I decided to enjoy the next three days as much as I could. I knitted a set of baby booties. I walked for 3 hours around the Marina on Saturday. I went to the Mission street day on Sunday and ate hot pot. My hospital bag had been packed weeks earlier, so there was nothing else to do but wait for Monday.
I still have time to eat lunch, right?
Monday morning came. I woke up leisurely around 9AM, ate breakfast, checked emails, and thought about what I would do until I had to go to the hospital. I decided that I would eat ramen for lunch. I had been craving ramen since my diet control forbade it.
Around 11AM, I asked my mom & Ian if we could go have ramen for lunch. They had no objection.
I went in the room to fold laundry. Then as I stood up, I felt a small gush of fluid --- kinda like the feeling you get when you stand up after sitting during a menstrual period.
I went into the bathroom. I had a sanitary pad that was soaked by...I'd say 1/3 shotglass of clear fluids. Not enough evidence for leaking water. So I waited a little more. 20-30 minutes later, I felt another gush. Also about the same amount. I called UCSF's labor & delivery, "I think I am leaking water," I said, "But can I go eat lunch first? I'll be there in about an hour."
They knew I was set for induction later in the day and said it was absolutely fine. So we set off towards ramen, which is on Irving & 21st. UCSF Parnassus is at Irving/Parnassus & 3rd.
When we got to Irving & 16th, I felt a little uneasy. The ramen place had made me wait a lot in the past. What if I suddenly progressed? Or worse, had a major water leakage during lunch?
So we agreed that my mom & I would be dropped off at UCSF first and Ian would go get ramen. When we did the birthing center tour, they recommended using a wheelchair for the woman-in-labor to avoid running into people in the narrow hallways to get to the 15th floor. Since I was still very much in a normal state, I walked past the security room to get to the elevator to the 15th floor.
The guard told my mom, "You will need a guest pass. How much in a hurry are you?"
"Well, I think my water broke." I said.
The guard stared at me, "Oh! In that case go up now!"
We got there and was admitted to the triage room. There, they swabbed me to test if I was indeed leaking amniotic fluid. This was around 2PM.
Either way, I knew they weren't going to let me home since I was going to be induced. So I initiated my labor ritual: celebrate by eating my favorite flavor of Doritos. Specifically, spicy sweet chili.
As you can see, I was pretty excited to eat the doritos. Doritos was also banned since I went on glucose control. Man did I miss them!
So there I was, sitting on the hospital bed, chatting with my mom, eating doritos.
And then as I shifted forward, I felt a small "pop", and a HUGE GUSH of fluid uncontrollably coming out of me.
OHHHHH THIS IS IT!!! The dramatic pop! This is what they always show in the movies and I got it!!
We frantically called the nurse in so I wouldn't mess up the bed any further. I sat on a new sheet on padding with more fluids gushing out of me.
The doctor came back and had an amusing look on her face. Turns out I was NOT leaking amniotic fluid. They think it was just part of the mucus plug coming off. And while she was there pondering what to do with me --- should they send me home wait a few more hours or just start inducing me anyway? --- my real water broke. So there. Problem solved. I am officially admitted!! Yay!!
But there's still the question of induction.
"Are you feeling contractions yet?" Doctor asked, "You look too comfortable to me right now."
"Hmmmm.......no......but....." Crap. I forgot that if your water breaks, they will induce you if you don't start progressing in labor, "Can we wait a few hours? I think I will begin to have contractions."
The doctor agreed. We waited for the labor room to be set up. Now my mom had to feed me the doritos.
Labor with a view
The UCSF labor rooms are AMAZING. I don't know what it's like elsewhere, but it's like a freaking hotel suite! You have your own private labor room (no such thing in Taiwan!) with your own TV, bathroom, and this amazing view.
It was almost 4PM I think when we were officially admitted. We all ate the delicious ramen Ian brought and chatted with the nurse Heather. Heather later turned out to be the best nurse I could possibly imagine having.
After ramen, I was starting to feel contractions. Still very manageable, since I was still walking around the room and asking Ian to put on Parks & Recreation.
At around 5PM, the contractions were starting to get intense. I remember telling my mom: this was about how much it hurt when I suffered the miscarriage and had to walk down the streets of Osaka the next day. I can't believe it's been more than a year since then.
Nurse Heather showed Ian how to massage my lower back to ease off the pain. It was really helpful. I love massages. At 5:16PM, I sent out an email to a few folks at work to tell them I am in labor.
Then there are no more pictures between 5:16PM and the birth. Because then things got real.
I don't remember when the anethesiologist came in. I'm pretty sure by the time he came in I was contracting because it was hard to focus on what he was saying. He said things I already knew. Three pain options: epidural, IV, and nitrous oxide (laughing gas). I told them I prefer to go as long as I can without pain control, but I understand that I could easily give in. If that does happen, I told them, out of all three of them, I was most interested in the nitrous because it was the most flexible. Nitrous would not take the pain away, only "take the edge off", and is only effective when inhaled, and I would be one holding the mask.
The contractions became stronger and the massages could no longer soothe them. I went from being able to laugh at Ron Swanson from listening to Parks & Recreation, to starting to moan in pain when the contractions came. At some point, I started sobbing when the pain came.
"It goes down, just remember that." Nurse Heather looked at my contraction charting, "Just remember it gets worse and then it goes down. The pain is sometimes caused by the fear of it never going away."
Nurse Heather suggested getting into the tub that had jets, which I guess you can call a jacuzzi. I remember glancing at the clock before I walked in. It was a little before 6PM. I did not look at anything after that.
The tub felt amazing, esp. with the jets massaging my sore waist. Now the contractions were full-on. The long ones were lasting a minute or longer, and there were hardly spaces in between them. I started screaming when the contractions came. Again Nurse Heather came to help: she told me to not scream at the top of my lungs cuz I would quickly destroy my voice; instead I should try to moan at a low-to-mid tone. So I would squeeze onto Ian or the nurse's hands and say, "...It's coming!" and then let out a very very long "aaaaaaahhhhhhh" that I tried to keep at as low a tone as possible. I wanted the aaahhs to last as long as each contraction. I remember at some point marveling how long I could produce a continuous note, thinking "Damn I got some good lungs today!"
I also started talking incoherently. I would sway my head violently to the left and right and mumble in a mixture of English & Chinese (Chinglish?) I remember saying a few things like: "I could feel her going down!!! AAAAHHHH~~~!!! (cont. long note)" and lots of invocations of god. Everytime the contractions go down, I would be dead silent. My eyes would be closed, I would not make any noise. It felt so good to be not in pain. But then I was deprived on that rest. I remember there was a set of three contractions that came back to back while I was in the tub that initiated me into another stage of screaming. I started shouting things like "I want to dieeeee!", "Kill me please!"
Nurse Heather and Ian continued to encourage me. They got me out of the tub. I had to be carried back to the bed. The tub and the floor was dripping with blood, as according to the nurse I had a bloody show (which is strange? I thought that was related to loss of mucus plug...)
The nurse called for the doctors to come in to examine my progress. I did not open my eyes once I was in bed. With Ian on one side and my mom on the other, I would scratch and squeeze the heck out of them (my mom had the scars to prove it) when the contractions came.
In my mind, with what little sanity I had left, I was thinking: How long can I endure this? What if I am barely dilated? Can I stand this for another 4 hours? 6 hours? And would I still fail at the end?
In between the pain and confusion and delirium, I saw my midwife Sharon who was about to go off duty. She had a beautiful SPARKLE in her eyes when she saw how miserable I looked. Her beaming expression echoed what Nurse Heather told me earlier: this is the only place in the hospital where the more pain you are in, the happier everyone else is.
Sharon came to me and told me to look into her eyes. Breathe in, in short sips of quick draws of breath, she said. I followed as much as I could.
I can't remember the exact order of things. But at some point the doctors finally came. They checked me. "7 cm dilated!" They marveled. That was the best news I could hear.
Nurse Heather talked to Sharon a bit. In between my contractions, Sharon expressed concern about my screaming "I want to die". According to Ian, I replied something like, "No, I don't really want to die. I just want to say I want to die." And that made everyone in the room laugh.
"Do you want to try nitrous?" I think it was Sharon who asked. I said yes.
I went through 2-3 more contractions until the nitrous came. It felt weird to hold the mask myself and inhale it. The first time the contractions came, I did the opposite of what I was supposed to do --- I dropped the mask and screamed. I was quickly coached that the mask should always be on since it has oxygen flowing. I should be inhaling when contractions come, and exhaling through the mask as well. I tried a few more times. It was the opposite of what I was doing earlier (exhaling during contractions), but once I got it, I started to feel the effects. It made me drowsy.
My mom noticed my mask-holding hand dropping. "I am falling...asleep..." I tried to talk through the mask. At this point, I think Nurse Heather left and it's the night shift nurse (unfortunately I could not remember her name) who said it's a good thing the nitrous is making me sleepy during the contraction downtime.
So for I don't know how long, probably the next 15 - 30 min, I would still hold on to my mom or Ian's hand on one side, but breathe through the mask when pain comes. I remember Ian telling the nurses that it had an obvious effect on me. I was still in pain when contractions came, but they felt more distant, like everything is coming through a thin layer of something. The sounds of others talking, the pain, is all there, but a little further away than it used to be. And that was enough to keep me going.
I was starting to get delirious, but I remembered that many people said the feeling of giving birth is akin to wanting to poop a giant poop. And I was starting to feel it.
"I want to poop!" I shouted in Chinese to my mom. I probably said that twice before the nurses came back in. I waited frantically for the doctors to come in. They have to be there before I can be allowed to push. And I could not wait for it to be over.
Then I finally heard lots of noises around me (I did not open my eyes since the nitrous came), ones that told me that I could push. I felt the huge pressure and more interesting, that something wanted to go out. It's different from when you go to the bathroom, where you are doing all the pushing. In this case, I felt like I did have to push but the thing was going to do that anyway on its own. I inhaled deeply, then exhaled and allowed myself to scream at the top of my lungs while I pushed. I did that three times, and on the third I could feel the relief. Yes, a GIANT POOP leaving me that kind of awesomeness. There were happy voices around me, and after some commotion, I felt a warm thing being tossed on my chest. At first I didn't realize what it was. Then I realized it was the baby.
I opened my eyes, finally. And I saw the baby. I think I said some things to the baby, but it wasn't too dramatic so I don't remember what they were. I still had to deliver the placenta and be sewed up, so while they were measuring the baby, I put the mask back on and quietly suffered through the remaining portion.
It was really really strange to hear Ian and my mom talking to the nurses while they cleaned the baby. Since I had never been on drugs, I had guessed that even laughing gas would have a pretty strong effect on me and I guess it did. I finally kinda know what those weird montage or camera effects in movies were trying to show when the characters are high.
They cleaned the baby, gave it a quick bath, and sent her back to me for skin to skin.
I remember the breastfeeding class teaching us about letting baby do some of the initiating. It's in their instinct to go toward the nipple. It's in their instinct to suck. I watched her wriggle on my chest. The nurses helped nudged her towards the nipple. Her eyes were open, and she was very alert (something I had no expected). Then she got there and latched on. And I was both relieved and amazed (wow babies do have instincts!)
Baby Josephine was born 6 lb 12 oz, about 18 inches. She was born at 7:50PM. Clearly, she understood what a deadline of 8PM meant.
My mom thought was a relatively unwrinkled for a baby. I kinda agree. But that's because she was overripe, I argued.
I think that's all for now (geez this is SOOOOO LONG and I don't even think I wrote all the things that went through my head during the last few weeks). We came home on Wednesday and it's been a lot of craziness since then. But I want to write this down while I still can remember.
Anyway, baby delivered. Mission achieved.