Sierra’s Birth Story
Baby Sierra was finally born this week. It was beautiful. I was mentally prepared for so much pain, so much hardship, and it was none of those things. I wanted it to rip me in half to show me how hard the hardest physical thing I could experience could be. It honestly wasn’t so bad. While it was painful, yes, and the actual memory of how bad it was is quickly slipping away 3 days later, the facts still remain. I had a zero intervention unmedicated birth as a first time mother in under 10 hours, and less than 30 minutes of pushing. It was over in a flash.
Sierra Joyce Zimmerman was born on June 5th, 2023 at 10:24am.
My birth plan was to have an unmedicated “natural” birth at the UCSD Jacobs medical school birth center. This hospital-adjacent facility is a certified midwife nurse sponsored program that promises alternative birthing support for women that do not desire epidurals nor induction. The benefit of using a facility like this (if you were going to go the unmedicated route anyway), versus having a birth at home is that you can easily be sent “next door” to labor and delivery to have your baby with an epidural under the supervision of an anesthesiologist should things turn pear shaped. The additional benefits included a double bed for your partner and yourself to labor in, a hot tub bath to ease the pain of early labor and the ability to eat what ever you wanted. They also were amenable to other requests like delayed cord clamping, having your partner cut the cord, skin to skin, and saving the placenta if that’s your thing. I enjoyed that there seemed to be a general lack of urgency. They wouldn’t rush me towards chemical induction unless that’s what I wanted. This was appealing to me as someone that was generally trying to avoid the cold end of the business of being born.
Baby Sierra was running around 10 days late. Her original due date was May 25th. I was feeling impatient and frankly nervous burning so much of my work leave on being pregnant and not with the baby. Our modified plan away was to use a foley balloon induction at the week 41 and 3 day mark as an outpatient procedure, and have a picotin induction the following evening if the Foley balloon didn’t initiate spontaneous labor. Our appointment for the Foley balloon was at 6pm on Sunday evening (June 4th). For some reason this 10 minute procedure took 4 hours (most likely due to our appointment being in the middle of a nurses shift change). We weren’t expecting this time delay, and didn’t eat dinner before the appointment. We also did not walk our dog for the evening. After the Foley balloon was placed, we ate two crappy slices of Regents Pizza 5 minutes before they closed. We got home around 11:30pm, and we were in bed by midnight. I felt my water break 30 minutes after that. This sequence of events did not set me up well for the following 12 hours.
The normal procedure at this point would have been to have early labor at home. Unfortunately having a foley balloon installed required that I go back to the hospital to remove the foreign body that was now exposed directly to the baby without the protective barrier of my bag of waters. Going to the hospital probably sounds like no big deal but I was pretty bummed. I wanted to spend early labor watching TV with ice cream on my couch sitting next to my dog. I didn’t want to be at the hospital where I couldn’t turn off the lights. We arrived at the hospital around 1:30am on June 5th.
Early labor
I labored through the early morning, half asleep, with minor contraction pangs until 6am when things slowly started to intensify. The contractions radiated into my back painfully. I didn’t expect it in my back. When prompted by the nurse, I labeled the pain a 8 or 9 out of ten. She responded in term by chiding, “you aren’t even in real labor yet”, and changed my score to a 7. Around 7am I had an episode where I started shivering uncontrollably, to the point where I couldn’t speak, and recoiled into the fetal position. Robin spooned me in our double hospital bed concerned. The morning nurse, (a confident redhead named Katheryn), started moving me through spinning baby yoga positions in an effort to turn the baby from facing my back to my front. We spent perhaps 30 minutes stretching while I painfully (and sleepily) tried to play along through intense burning in my back. I was doing my best to downplay the pain trying not to lose the mental game knowing that birth at this point could easily have been 24 more hours.
My nurse suggested I sit on the toilet backwards with my face pressed against a pillow propped against a wall to make it easier to put pressure on my back. I would try anything to relieve the pain. I tried this for probably 10 before I decided that I was too tired to sit up straight and that I asked to lay back down. The nurse tsked at this. I was suffering greatly from the lack of sleep the night before.
The midwife, Annie, then came in around 9:30am asking for an update. We lucked out (perhaps via careful planning) that this was the same midwife that I had done all my prenatal appointments with, and we greeted eachother with a warm rapport. I told her that I was worried about how much pain was in my back, and that I was not mental prepared for how much pain would be in my back. She decided to do a pelvic exam to check how dilated I was so she could give me an estimate to my percentage-to-completion (a valuable KPI for the mental game). To our surprise, I was 6cm dilated and 90% effaced. The baby would come soon. We hadn’t even been timing the contractions at this point because we thought it was too early in the process. I may have downplayed the pain so much that no one would have guessed that I was actually this far along. In retrospect, maybe it actually wasn’t so bad at all.
Active Labor
“So you are saying that the next stage won’t take 4 hours?” I asked drowsily.
“That depends on you”, Annie said.
More people started entering the room. My nurse asked me if I would like a doula. I said yes. They sent out a page asking for a doula. We laid in bed and practiced spinning baby for a few more minutes on my side. Some of the contractions felt so painful that they shot through my body like a lightning bolt, which I responded to by shooting my legs into my chest. My midwife asked me if I felt like pushing (which may feel like pooping). I said, yes, my body seems to want to push.
They set me up on my back, and Annie discreetly made a call to cancel the doula page. I was moving along too fast for someone to come. The room was suddenly full of people. She checked my pelvis and exclaimed “the baby is right there”. She asked someone to grab a mirror on a floor stand so I could watch my progress. I grabbed my own legs and pulled them into the stirrup position, allowing myself full view of my birthing vagina. Anne alerted everyone to get gowned up, and told me to push. The baby was behind my pelvis, and she instructed me to put pressure right under her pointer finger, where she helpfully pressed (the perinium). She encouraged me, screaming “there we go!” and “yes!” every time a push advanced me forward. I felt like I was slipping in and out of consciousness.
At this point my memory gets a bit hazy. Robin helped me recall that that they were starting to notice the baby’s heart beat dropping and pulled in a crash cart for continuous monitoring.
I do remember at point she told me to slow down. I must have misheard her. “slow down?” I asked uncertainly. She said “yes”, then, “push!”. Totally confused, I did what I was told, my only guiding light being Annies voice. “Slower, slower”, then, “push, chin to chest!”. I was grabbing the back of my thighs and pushing, sweating through my hospital gowns. I felt like I was under a pin light. I heard Annie tell Robin to look at the babies head. Then she asked me for just one more big push. I gave it my all and heard Annie muttering something to Robin. I don’t remember what he said. He was happy.
Then they put a baby on my chest.
It was so quick. But then they told me to push again for the placenta. It felt like an endless amount of pushing after already delivering the baby. I was expecting relief. I saw them put the organ in butcher paper, then Tupperware, then take it away. Annie was still down there and said that I needed stitches, just minor first degree tears. This must have been why they were telling me to slow down. She said that I would need two shots if I wanted to be numbed up and it would be easier if she started stitching without, and asked me if I trusted her. I remember saying surprisingly cohesively, “I trust you”, while she stitched me up unmedicated. She was right. I felt nothing.
Annie was surprised. She didn’t have time to get gowned up. She had blood all over her arms.
Recounting this I realize how grisly a story it sounds. It wasn’t. If I’m honest I mostly remember it being very fast. Maybe too fast. I thought it would have more time to reflect and be present. I was mostly asleep for several hours in the beginning. I was only pushing for 25 minutes or so. The nurses were cooing at me afterward, telling me how easy I made it look. Apparently it is quite rare for a first time mother have a baby in less than 10 hours. If you asked me how long I was in labor, I would have said 4 hours. It was an amazingly positive experience.
I actually found the early days in the hospital much harder, while I learned how to breast feed and care for the baby all while recovering from the birth under immense sleep deprivation. But that might be a story for another time.
