Masks, brain damage, forceps… and torn pants
Mama A was convinced she was going to be late. Way late. In fact, she was so convinced that on the morning of January 21st, 2021, we sauntered into our 40-week check-up at Oregon Health and Science University (OHSU) with her determined to get an induction scheduled for no later than week 42. Our due date was the following day, January 22nd.
I, on the other hand, was ready for anything. I packed our entire life into the car that very morning on the off-chance something would come up at the appointment and we’d be having the baby that very day. But a couple hours later after a relatively uneventful check-up we headed home with Mama A more convinced than ever that she’d need to be induced to get the party started.
So we settled in for the long haul. I began to think that maybe she was right. Our doula and the midwives reminded us that many first time pregnant women go past their due dates. Oh, and a quick side note on “due dates.” They’re dumb. I prefer how hypnobirthing refers to them as “guess dates.” Puts odd pressure on the mama like she has an essay due that day and she can’t graduate if she misses the deadline. Anyhow, we went about our normal day and like the party people we are, were asleep by 10pm.
Now let’s rewind a little bit. When we were in Week 24 my partner and I and a few of our friends were making guesses as to when the baby would be born. Mama A, already convinced she’d be pregnant forever, said she’d need to be induced before exploding. Other guesses were all over the place. As for me, being nearly always right of course, I made the bold call that the baby would be right on the money and smack dab on the guess date. Even if only 5% of all babies are born on their due dates. Count on it. Money in the bank. However, not even I imagined it would go down the way it did. So…
’Twas the night before due date, when all through the house
Not a creature was stirring, not even the tummy of my spouse;
The hospital bag was ready and packed with care
In hopes that Baby A would soon be there;
Soon-to-be Daddy was nestled all snug in his bed
While visions of diapers danced in his head;
And soon-to-be Mama in her robe, and I in the nude,
Had just settled our brains for they were about to be screwed;
When out from the bathroom there arose such a boom
I fell out of my bed with a feeling of doom;
Away to the bathroom I crashed with a thud,
To find that her water had broken into a flood
I kid you not the clock struck midnight on our “due date” and Mama A’s water broke like it was on an actual timer. “Josh! It’s happening! My water broke!” She yelled from the bathroom. Now I sleep on the very edge of the bed because I run really warm. So warm that I need my body not just out from underneath the covers but completely stark nude to get a good night sleep. If a burglar storms into our home in the middle of the night they are in for a very pasty surprise. In this case, the sound of her pronouncement from the bathroom struck me so suddenly that I fell out of bed and crashed unceremoniously and without any cushioned clothing on the hard floor below. Needless to say, I was awake now.
Needless to say shit gets real pretty damn fast when you know you’ve gone into labor. A wave of emotions hit me that were all over the map. I was simultaneously surging with excitement, paralyzed with fear, and laser-focused on carrying out our plan. Last time, I mentioned how my partner and I prepared for childbirth and what my strategy was as a birth partner. My philosophy for a great many things in life come from my days as a baseball pitcher and from what I have learned and honed throughout my career.
- Be as prepared as possible
- Have clear and measurable goals
- Craft a strategy that is laser-focused on achieving those goals
- Iterate where necessary
This approach is what gives me the best chance to remain calm and measured in times of great stress. In the process of preparing you think through any contingencies and if they rear their ugly heads it’s not such a big deal because you’ve already considered and planned for them. Basically, you can now trust that your instincts are well informed and can turn it over to muscle-memory.
Now sticking to that strategy is incredibly difficult in real-life. Especially during something like childbirth. My approach allowed me to stay calm on the outside. Inside, I was terrified. What if something went wrong?
This is where hypnobirthing really came in handy. One thing I loved about hypnobirthing was that while I expected it to help my partner, I didn’t foresee how much it would help me. There is this consistent theme throughout that drove home something very powerful for both of us: trust that your body, and your baby, know what they’re doing… all we have to do is breathe and let them do their thing. It made us both feel calmer and focused on our breathing. That perhaps the best approach was “less is more.” Trust your baby and your body… just get out of its way and let it do its thing.
So, it was go-time. No need to panic. Just implement the plan. We called our midwives to give them a heads up, describe the situation, and get their thoughts. They knew we had a doula and planned on laboring at home for as long as possible. Knowing this, the midwives were comfortable advising Mama A to try and get some sleep until she started experiencing more regular surges. The expectation was we’d be heading into the hospital sometime in the morning. The current time was just past midnight, approximately 12:30am.
Obviously, childbirth is hard. It taxes Mama’s mind and body to the max. It was critical to get any sleep we could whenever we could. Unfortunately, it wasn’t to be. Just as Mama A hung up the phone and I settled back into bed, the first major surge arrived, far earlier and more intense than expected. They were so strong and often enough that sleep was out of the question. I refilled Mama’s water bottle and prepared peanut butter and banana sandwiches.
We agreed that at least one of us needed to get some sleep so she put a feel-good movie on the iPad (Tangled!) and I cuddled next to her to get some rest. But the surges were already so strong that we needed to move to our next step in the process: a mix of hypnobirthing music, massage and counter-pressure, hydration and affirmations.
It was clear at this point that the surges she was experiencing were strong and frequent enough that we needed to begin tracking them. I had researched a few apps to help me record contractions and had settled on this one. The app makes it easy to record the three key pieces of data: time of contraction; length of contraction; severity. This data then informs us which stage of labor we’re in (there are three):
1) Early (latent) labor
- Mild to moderate contractions
- Lasting 30–45 seconds
- Approximately 20 minutes apart
2) Active labor
- Increasingly intense contractions
- Lasting 40–60 seconds
- Approximately 3–4 minutes apart
3) Transitional (advanced) labor
- Very strong contractions
- Lasting 60–90 seconds
- Approximately 2–3 minutes apart
Birth Partner Pro-Tip: Time feels very different for a laboring woman. 20 minutes can feel like 20 seconds. Be aware of it and avoid pissing her off by saying things like “oh it’s just 20 seconds that’s not so bad!”
So, it was just past 12:30am and I began recording her surges (contractions) via the app. Right away we were all over the map. 25–45 seconds in length, which seemed to fit the schedule. But they were 2–7 minutes apart, far more frequent than expected. Even more odd, they were intense. Like, really intense. We knew that one way to help soothe early labor is to get in a warm bath or shower, and since we didn’t have a bath tub, shower it was. I supervised her shower to make sure she didn’t pass out and overall it slowed down the pace of the surges a bit. Got her rehydrated and back into our attempted hypnobirthing zen zone.
By 1:15am Mama A decided she needed to get audible. Before you knew it it was like a Maria Sharapova tennis match with booming grunts and foul language. Now, I love foul language so I felt right at home. And while it was a bit jarring and stressful to see my partner so animated, like she was going 15 rounds with vintage Mike Tyson, it was a different emotion that kept sweeping over me: awed wonder. I couldn’t help but smile every so often because I couldn’t believe what I was witnessing. Sheer determination. Unbelievable courage. Otherworldly sacrifice. It became clear to me that childbirth isn’t a miracle. It’s the women who give birth (or attempt to) that are the miracles. Childbirth doesn’t just happen. You have to work at it. It’s blood, sweat, and tears. Watching my partner go toe-to-toe with childbirth left me feeling like if we just turned the keys of the world over to women, they’d move mountains.
After nearly two hours of tennis grunts and Mike Tyson prizefights, it was time to call our doula. Another reason why the contraction apps are so handy is that you can just screenshot the data and shoot it right over to your doula, midwives, OBs, etc. I called her, reported what I was recording on the app, switched it to facetime so she could observe a few contractions herself, and had a discussion on next steps. We decided (see: I decided) that it would make me feel a bajillion percent better if she’d start heading our way so we could have her physically in the room to make sure all was well. She said absolutely and started heading our way. In the meantime, we continued the dance at home.
Our doula arrived at 4am, at which point my partner had been doing battle for the better part of four hours. She plopped down on the couch next to us, whipped out her phone to start her own recording of the surges, and back to battle we went. Having her in the room lifted a ten ton truck of stress off my shoulders. Mama was clearly feeling a bit relieved, herself. By 5am, the surges were so intense that I looked at our doula and said, “I mean we have to go in now, right?” I still get a lump in my throat to this day when I think back to her response. “Sure,” she said, “if we go in now we won’t be suuuuuper early… it should be fine.” I didn’t love this response when I first heard it because it made it seem like we were still in the earliest of innings… still a long way to go before the big time stuff came along. To me, this shit was insane. I didn’t think any living being of any form could take more of this without exploding. Honestly, I did feel a slight twinge of relief that I was incapable of giving birth myself. If I had been in my partner’s shoes, I’d have had a full-blown meltdown and simply asked to be knocked out and awoken the following day with a beautiful new baby and a gin and tonic.
One of the factors we loved about our hospital and why we chose to give birth there were the giant and super advanced water immersion tubs they had onsite. Even though it wouldn’t be “suuuuuuuper” early to head in, we could give the hospital a call and have them fill the tub, leave right then and by the time we arrived it would be warm and ready to roll. Mama liked the sound of this so off we went.
I had everything packed and ready to roll already so we were good to go. Our doula left a few minutes before us as mama was moving a bit slower at this point. Now, I mentioned in my last post that the drive to the hospital wasn’t my shining moment. If you missed that one, see what happened here. But in my defense, I was sweating bullets inside based on what was happening as we were trying to leave. Mama had a surge downstairs as she was about to head upstairs. Then she had another one as soon as she got upstairs and into the living room. That’s just a couple minutes apart. And they were so intense she needed to get on her knees and lean against the couch. As soon as it passed, we got out the door but she had another one before we even got to the car. I bent over so my back was basically parallel to the ground so she could lean over and put all her weight on me to get through it. That was three intense contractions in a matter of 8–10 minutes that lasted at least 35 seconds each. It didn’t feel “suuuuuper” early to me at all.
We got to the hospital after my spectacularly shitty driving and since it was the middle of the night we needed to enter through the emergency room entrance. I was dreading this as the last place you want to be during the peak of a pandemic is the emergency ward, where Covid-patients were streaming through. I had invested in some new N95 masks for us and our doula and was hellbent on getting us through the emergency area with little to no dilly dally. Fortunately, the staff was well prepared to quickly identify pregnant women and immediately usher them away from the emergency area and on our way to the birthing center. I put mama in a wheelchair and was flying through the halls like I was Lewis Freaking Hamilton.
As we reached the birthing center ward I shared the latest contraction data I had and mama relayed how she was feeling. Because of Covid, the triage staff needs to confirm that the water has broken and active labor was occurring before admitting us. This seemed super odd as it couldn’t have been more obvious that she was absolutely in labor. Apparently, it is quite common for pregnant people to show up way too early, oftentimes when they’re not yet in labor at all, and so the staff seemed to have a nonchalant and even somewhat skeptical attitude at first. Our doula arrived and helped communicate that we were certainly at the very least in early labor. Didn’t end up mattering since after observing mama for just a handful of minutes, it became abundantly clear that she was in labor and perhaps, pretty far along.
It didn’t take long for the looks on the faces of the intake staff to change from nonchalant to deadly serious. I decided right away that I preferred the nonchalant. Now that mama was hooked up to all the monitoring systems we were getting real-time data on the situation. Red flags popped up right away, most notably with our baby’s fetal heart rate being much lower than expected. There was a concern that he wasn’t getting enough oxygen. In addition, mama was showing signs that she was much further along than anyone was prepared for, as she was already feeling the urge to squat and push, telltale signs that active labor is in full swing. Given the red flags, we were immediately admitted and mama was hooked to an IV. The midwives swung into action and prepared to really get the party started.
I was nervous but didn’t want to show it. Things were getting so real so fast and I just wanted it to slow down. The cat was out of the bag, however, and there was no going back. Anyways it was the beginning of a lifetime of worrying so might as well get it started. But here’s the thing: it’s okay to be worried. It’s okay to be scared. If you’re the birth partner, don’t give in to this ridiculous societal pressure to be a super-manly robot that buries all vulnerable emotions. Childbirth is incredibly hard. Parenting is incredibly hard. We need to be honest with others and most importantly, with ourselves. Otherwise we’re going to crack. I told my partner that I was nervous. That I was scared. And that it was okay for her to be as well. It was just because we cared so much already. My instincts told me to tell a white lie and just say I was great, but it didn’t feel right. This was the birth of our child and I wanted it to be a moment of pure authenticity. Anyways, it’s a huge freaking moment and of course it’s going to be nerve-wracking. I assumed that as long as I qualified my feelings that this was the right approach. That along with being nervous and scared, I was excited and grateful. It was the most diverse mix of feelings and emotions I’d ever experienced at once. Basically, I laughed and told her “this is fucking nuts… I love you. I’m feeling all over the map. But we got this. You got this. Trust your body and our baby and the rest will take care of itself.” Thankfully, that hypnobirthing vibe was keeping me Bob Marley despite the craziness.
At this point we’d been at the hospital for only a half an hour and Mama was in the delivery room being tended to by the midwives. But she was also hitting a wall in her labor and since we’d only been at the hospital for such a short time, Mama felt discouraged. If we were just getting started, how would she be able to continue with this for several more hours? Granted, she’d been experiencing surges for upwards of 5+ hours at this point. Understandably, she requested an epidural. The epidural wouldn’t just help with the pain but it would give her an opportunity to get a little bit of sleep before pushing.
The anesthesiologists got going on the epidural and there was a sense of relief that a small bit of calm and rest was on the horizon. Alas, she wasn’t so lucky. As the anesthesiologists were still working on the epidural the midwives were wrapping up their first cervical check and to their surprise, she was already fully dilated! No friggin shitballs it was so crazy painful and she was so exhausted. She’d already gone so damn far already without any support other than hypnobirthing and the world’s okayest birth partner (me). The anesthesiologists needed to finish immediately, because it was time to push right now. Again, I felt a surge of panic and excitement.
Fortunately, the epidural was very light so mama was able to try pushing in different positions, including on her hands and knees and using the squat bar. Unfortunately, the baby’s heart rate continued to fall. The midwives tried a few last gasp positions to speed up the labor and increase the heart rate, to no avail. The heart rate fell below 60 BPM (normal is 110–160 BPM) and the OBs were immediately called in and decided that an emergency cesarean was necessary.
Dads and birth partners everywhere! This is an enormously important moment. Most women (but not all) are trying to avoid a cesarean. Needing to have one can feel like a failure or at least a massive deviation from a birth plan. Remind them that there is only one outcome that truly matters: a healthy baby and a healthy mama. Everything else is immaterial. You’re incredibly proud of them, incredibly grateful, and incredibly excited. You’ll deal with any deviations from the plan together, as a family. Mama A and I had talked about this potential and had even put together a birth plan in the event of a C-section. Mostly so we could be mentally and emotionally prepared for it. We’d reiterated over and over that the only thing that mattered was a healthy baby and a healthy mama. I can’t underestimate the dividends this paid as we entered this moment.
I told her I was proud of her and that this was an amazing moment. It meant we were about to meet our baby. It was time to trust that her body and our baby knew what they were doing and what they needed. The courage she showed and the enthusiasm in which she approached this was remarkable. I’ve never seen anything like it. It made me feel that there was nothing she couldn’t do and that we were all going to be fine.
That lasted about one minute for me. As she was being moved to the OR and everyone shuttled out after her, the lead OB remained behind for one second to deliver me a message. “Look, as you’ve been hearing the heart rate has fallen really low and we don’t know exactly how long this has been happening. We need to get the baby out now.” Okay, makes sense, I said. Then she dropped a bomb. “But we have to be prepared for the possibility that the baby has gone too long with too little oxygen to his brain… and that he could have permanent brain damage.” And then she left. The room was completely empty. It was just me and my thoughts. At first I felt a mix of desperation, fear, and even anger. Then I realized that mama was still fighting like hell. This wasn’t over. It would be selfish and defeatist to lose my shit now. But I needed to see her. I needed to be in there with her. We were a team and whatever happened, I’d be damned if we weren’t going to face it together.
At this moment our doula came back in and I told her I don’t care what you have to do, please go tell them I have to be in the room. Covid had limited the amount of people that could be in the OR and there were already too many in the room. As if the universe was listening, a nurse popped back into the room and said I could come in, just needed to get me in the correct attire. I dressed into the OR garb so quickly I tore a hole through the pants. They took pity on me and let me in anyways. And what I saw just blew my mind… There were at least 20 doctors, nurses, and midwives in the room. It was freaking packed. And in the middle of it all was Mama A, refusing to give in. I was expecting to come into a scene of worry, sadness, and silence. Instead, it was determination. The lead OB turned to me and said the heart rate had rebounded a bit, and while she’d have had 99% of other mothers having a C-section already, our mama had convinced her that she could keep trying. She was exhausted, but determined. And while labor had stalled due to the baby having his hand up near his mouth and the umbilical cord wrapped around his neck, we had one more option: forceps.
We had read all about forceps and knew the drawbacks, but this was our last option before C-section. The OB wouldn’t have even offered if it hadn’t been for mama’s resilien. ce and desire to keep pushing. So out popped the forceps, and it is a peculiar and slightly scary looking device (see photo above). After a couple failed attempts, the OB got the forceps secured on the baby’s head and it was time to push again. Mama pushed with all her might, and the OB pulled. It was terrifying. We still didn’t know if the heart rate had fallen for too long and brain damage was done. There wasn’t anything we could do about that so we needed to stay focused on the task at hand. It was like a battle going back and forth between forceps and a baby. After what seemed like an eternity, our baby Aidan emerged into the world. There was then a moment of silence that lasted what felt like an eternity. And then, out came the most beautiful sound I’d ever heard: loud, thunderous cries. Everyone in the room let out a collective gasp and then bursts of celebration, laughter, clapped hands, and smiles.
Aidan didn’t come late, like Mama was convinced. She didn’t get to soak in the birth tub, like she had long imagined. We didn’t avoid the interventions and strayed far from our birth plan. Aidan had scrapes on his head from the forceps that throbbed and drew blood. And yet, we got everything we ever wanted. A happy, healthy baby and a happy, truly transformed and healthy mama. It was the greatest day of my life.
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