By Calesse Smith
I was the little girl who, when asked, “What do you want to be when you grow up?” would respond, “A veterinarian or a pediatrician…and a mom.” I knew from a very early age that motherhood was something I deeply longed for. So when my husband Tyler and I found out we were pregnant with our first child in October 2020, we were thrilled.
I listened to a variety of podcasts, read many books that well-meaning friends and family suggested, and took online preparation classes on pregnancy, birth, caring for babies, and parenting. I wrote up my birth preferences with the guidance of my Hypnobirthing instructor. My plan, as I’m sure many new moms strive for, was to attempt an unmedicated birth, or at least do so for as long in the labor process as possible. In order to give myself the best chance of this happening, I decided I would labor at home for a while, and delay going to the hospital until I was truly in active labor.
I was very fortunate that I had a textbook pregnancy with no complications. I finished out the school year teaching my students, I continued running and lifting weights regularly, I saw my chiropractor as well as a pelvic floor physical therapist. Then, a few days before my due date, Tyler and I were getting ready to head out to a friend’s wedding when I felt my amniotic fluid leaking. We called my OB and my doula. We decided to wait to see if things would start progressing, as I wasn’t feeling any contractions at that point.
We went out to eat, walked around, and tried to relax and see if our little guy would start to make his presence more known. I didn’t sleep much that night, as I was too anxious and excited. I roused Tyler at about 5 am and told him it was time to go to the hospital.
We checked into INOVA Alexandria at about 6 am. By 7 they had us in a room and I was being closely monitored with a contraction monitor and a fetal heart rate monitor. I was barely dilated at all and was having very minor contractions, so my OB administered a very small dose of Cytotec orally in the hopes that it would get the contractions going and help my cervix to ripen. A few rounds of this and several hours later, the contractions were picking up. I was having to breathe through them with Tyler’s support, and they were getting pretty painful.
My OB, who I’ll refer to as Dr. B., was keeping a very close eye on me and baby because she was seeing decelerations in his heart rate in conjunction with my contractions. She was in and out of my room quite frequently.
After laboring for several hours, my contractions had become too painful for me to cope well with. We’d called our doula and she was on her way. Dr. B. checked me and I was only 5 cm. dilated. She also checked baby’s position. He was OP (occiput posterior), which some people call “sunny side up.” Basically, he was head down, but facing my front instead of my spine. This makes it more difficult for baby to descend through the pelvis. I didn’t think I would be able to continue much longer without pain relief, so I requested an epidural. I’d hoped to go longer before “giving in,” as I perceived it at that time, but it ended up being the best decision.
Soon the anesthesiologist came in. I was so glad to see him! But as he was preparing to do the spinal tap, multiple waves of rapid and very intense contractions kept washing over me. I just wanted to lay down on the bed, but he told me I had to sit up and curl over so he could get the needle in my spine. I complied as best as I could. Within minutes, the duration of the contractions shortened, and shortly afterwards my pain had all but vanished. Thankfully, I still had limited mobility in my legs, so I was able to labor on hands and knees, and on both sides, as well as leaning over the back of the bed. That anesthesiologist was my new favorite person!
Around 4 pm, my doula arrived. I felt that having her then was a bit of a waste since I’d hoped she would help me cope with the contractions longer and in order to avoid an epidural, but that ship had sailed. She came over to me and validated my negative feelings that I had somehow failed because I was now having a medicated birth, but she encouraged me, reminding me of our number one goal: healthy baby and mama. Then she got to work using the peanut ball and helping to position me in different ways to try to get baby to flip.
Dr. B. came in to check me again. I was progressing, but slower than she would have liked, considering my water had ruptured over 24 hours prior. The risk of infection was growing with every passing hour. So she administered a small dose of Pitocin. Almost immediately, my baby went into distress. All of a sudden, the room was full of nurses! Dr. B. helped me flip onto my opposite side, but baby still didn’t like that. Then they gave me a shot of terbutaline to slow the contractions and I was up draped over the back of the bed. After a few very scary and intense moments, baby’s heart rate stabilized.
“If that had gone on much longer, we would have been looking at a C-section,” Dr. B. said calmly, but intensely. “We’re going to continue to keep a cl
ose eye on your baby.” I caught my breath and remained in a semi-plank position over the back of the bed for nearly an hour before I lowered myself back onto my side.
Then, unexpectedly, a wave of nausea washed over me. I called for Tyler to get something for me. Finally a nurse came in and brought me a barf bag. Every few minutes, I became sick. Then, another unexpected sensation…I got the shakes, a side effect from the epidural. These were labor symptoms no one had told me about! A rather unpleasant surprise…but the nurses encouraged me this meant I was transitioning and would soon be ready to push.
After a while, Dr. B. started the Pitocin drip again, but this time at the absolute lowest dose possible, while closely monitoring me. After a few more hours, Dr. B. declared I was finally 10 cm. dilated and ready to push. The only problem was, now I was so numb from the epidural that I couldn’t appropriately target my pushes efficiently! So they lowered the anesthesia dose and I started pushing about 30 minutes later. At this point, it was about 1 am and I hadn’t eaten anything since 4 pm when I got the epidural. I was so hungry, but was limited to a liquid diet until baby arrived.
With every contraction, I pushed for 10 very long seconds. Tyler held my hand and counted (way too slowly in my opinion!) to 10 every time. Then a short reprieve, then we did it again…and again…and again. My doula, the nurses, and Dr. B. were so encouraging, cheering me on, affirming how well I was doing. After a while, however, I began saying things like, “I don’t know how much longer I can do this.” It was like I was running a race, which I was very used to doing, except I had no idea how far away the finish line was!
Then at last, “We can see the head!” I thought that meant I was close to meeting my baby! However, after another 30 minutes of pushing, it was clear that he might need some assistance. Baby’s heart rate was decelerating rapidly now with every push.
Dr. B. recommended she use a vacuum, which would also involve an episiotomy. No! This wasn’t part of my plan! None of this was! Not the premature rupture of membranes (my water leaking early), or the epidural, or my baby facing the wrong way, or a long labor where my body wouldn’t progress, and certainly not an instrument facilitated delivery, and definitely not an episiotomy! However, I remembered (once again) the most important objective was to end up with a healthy baby and mama, and if that’s what it took to get there, we would do it!
A few pushes later, and I finally met my beautiful baby boy, Levi Robert! Hearing his triumphant cries for the first time was incredible!
“Oh! I might have to buy some new shoes!” Dr. B. exclaimed, smiling, as Levi spewed meconium all over her! They put him right up on my chest, blood and slime and all. I held him there as he quickly calmed and attempted to nurse.
I kept looking down at him, then around at my husband the hospital staff murmuring things like, “Wow, he is finally here!” and, “I can’t believe he’s mine…”
Then nurses weighed and measured him, dried him off, and then gave him back to me. Everyone left us alone for a while to enjoy being together, now our family of three.
It was about 4:30 am. Tyler (God bless him), had ordered IHOP chocolate chip pancakes for me, since the cafeteria was closed. I swear, it was the best meal I’d ever eaten after such a long and intense labor. But boy, was it worth it!
Reflecting back, my birth experience certainly wasn’t anything like what I had anticipated and pretty much nothing went according to my “plan,” but everything worked out just fine. The hospital staff took excellent care of us, and we went home the next day with a healthy, precious baby boy, proudly wearing our new titles of “Mom” and “Dad.”
We did it!
