Well, I won't pretend I'm not a sleep deprived still recovering mess, but the truth is, I think I need to write this all down to sort through it all, and I want to do it while it's all still pretty clear in my head. So, here's the full (and I mean full, this will probably be pretty long, go grab a cup of coffee or a glass of wine and maybe a snack) story on how Speck became a newborn with a name instead of a nondescript alien living inside my abdomen. Please forgive the typos, errata, and disjointedness that I'm sure will follow as I'm not exactly at my best right now. Also, there are pictures of the new human, and details like weight name and sex, but you'll have to at least scroll past the rest of this to get there. After all, what have we been working towards for the past 42 weeks if not this moment.
To start with, things didn't go as planned/hoped for. This may not surprise you. It shouldn't surprise anyone, and in its way it didn't even surprise me. I was mentally prepared for things to turn out differently than I had hoped, and in the moments where it really mattered I was fine with how everything turned out, but there were some low points along the way.
Everything started late Saturday night (technically Sunday morning). Corey and I had enjoyed a nice Saturday and done as much as possible to induce labor naturally. Apparently, it worked, because by 2am I was having contractions that were already over one minute long every four minutes. That lasted for one hour pretty quickly and I called my doula to ask if she thought I should call the midwife as that is the time pattern one is looking for when labor goes from early to active. My doula said it wouldn't hurt to let my midwife know that things were progressing. I called the midwife and she told me that the pattern was good but that the intensity didn't seem sufficient for active labor. So I should try to sleep, keep going and let her know how things progressed the next day. Sure enough, I managed to get some sleep (with the help of tylenol and gravol). Some, in this case, meaning an hour and a half or so. When I woke up contractions resumed their earlier pace but still hadn't gotten intense enough for me to call the midwife. They continued that way until 8am when they started to get farther apart but a bit more intense. They remained farther apart for most of the day and I was becoming convinced that I would be in "early labor" for days. Did I mention yet that all of these contractions heavily involved my back? Yep, that's right. I had back labor for the entire duration of this story. For the first 24 hours I managed to breath, sway and dance my way through the sensation, though around Sunday at midnight I added the use of the TENS machine to help with the back pain. It worked. I was surprised that it did, but it really did take the edge off of that part of the sensation. $64 well spent.
(In retrospect I remember that when I was debating renting the TENS machine I said to Corey, "Well, if nothing else, it will probably be good to have it if I wind up with 36 hours of back labor." Curse me and my prophetic (albeit overly optimistic with the 36 hours part) quips.)
At 2am on Monday, I finally hit a pattern that was short, (under 4 minutes apart) long (over 1.5 minutes each) and intense (I couldn't talk or do anything else but focus on the sensation when they happened). After that had lasted an hour, I called the midwife again and she agreed to meet me at the birth center. So at 4am Corey and I met our doula in the birth center parking lot and headed inside.
So, up to this point in the story the timing is pretty clear to me because I was timing my contractions with an app on my phone and I was very aware of the time. However, as soon as we got to the birth center I stopped timing them and started focussing solely on getting through each one. My timing becomes hazy but luckily I had lots of people around me who were aware of the time and I have since gone over the story with them a bit to fill in some blanks.
We arrived at the birth center and the midwife did a check to see what my cervix was doing. I was a bit disappointed to be told that I was only two centimeters dilated, though happy to hear that I was almost fully effaced. She said that she couldn't admit me until I was 4cm. That made me very sad, not because I thought I would be further along but simply because I didn't want to labor at home any more, and I didn't want to get back in the car while having contractions. I wanted to settle in somewhere and get ready to focus on having a baby. Luckily, the midwife told me that we could stay in the birth center and walk around we just couldn't be admitted to a room. There was no one else in the birth center at that time, so we had the run of the hallways and that was fine with me. I just didn't want to go home, as that would feel like losing progress to me. So we wandered the halls of the birth center and had access to a birthing ball and an exercise mat, and I walked around and sat on the ball and leaned against chairs and got on all fours on the mat and just generally did what one does when one is in labor which is focus ways to let your body do the work it needs to do and get you closer to meeting the new human you've been growing for the past nine months or more.
At 6am the midwife did another check and reported that I was now 3cm dilated. The good news was, my body was making natural progress, the bad news was, I still wasn't at the magical 4cm and she couldn't admit me. I forget what my reaction was, but disappointment would have been an understatement. I can't remember if I cried or not, I might have, as I didn't want to be told that I would have to go home and that's what I was dreading. She surprised me though, by saying, "there's no one else here and you did make steady progress, so I can admit you anyway, but you won't be allowed to use the tub until you've progressed farther."
I almost laughed. Certainly I had originally been drawn to the birth center because I wanted to use a birthing tub, but at that moment I didn't care about anything but having a place to settle into and focus. I didn't want to be told I'd have to leave again. I wanted to have the options that those rooms provided (which included an amazing hot shower) and I wanted to feel like I was being taken seriously. Admitting me to a room took care of all of that. Fuck the tub. It would be there when I needed it. I just didn't want to be moaning in the halls anymore like a stranded cow.
So I was admitted and allowed use of everything the room had to offer aside from the tub. I went right back to what I had been doing before and continued with no sense of time, living from one contraction to the next. They had, of course, been getting progressively more intense and the back labor was getting particularly more noticeable the longer I had it and the TENS machine was becoming less and less of a balm.
At around 8am my primary midwife came on call and the midwife who had admitted me (who was part of my team but not my primary) went home. My primary midwife is awesome. The other midwife was lovely, she's very professional, has a good bedside manner and is very matter of fact. I like her. But my primary midwife is a freaking rock star, and when she finally came to check me (not until 10am) I felt like everything shifted into high gear. At 10am I was finally at 4cm, but that meant that I'd only gained 2cm in six hours. You have to get to 10cm to push a baby out, you can do math on that one yourself, but if things progressed as they were I was looking at a very long time before pushing was going to even start let alone finish (first time moms often push for at least 2 hours before baby arrives). So, my primary midwife decided we were going to try every trick in the book to speed things up. Her theory was that Speck was posterior (Speck's spine lined up with mine and facing the same way) and that was what was slowing everything down. The answer was to make Speck rotate if possible. So we started doing everything we could to get Speck to rotate. That meant weird positions on furniture, raising my ass above my head, bouncing on a ball in the shower, having people pull on me and push on me during contractions and all kinds of other stuff. It meant doing even more work between and through each contraction and it was exhausting both mentally and physically. When left to my own devices all I wanted to do was try to position myself and breathe in a way that minimized the intensity of what I was feeling with every contraction. Trying to convince myself that it wasn't pain, but only pressure that I was feeling. I remain convinced that I would have been able to do that if it hadn't involved back labor, but I was personally unable to overcome the sensation of back labor and separate it from pain. It fucking hurt, and the more it hurt the more I was told that was good, that's what was making progress on my cervix. I tried to remind myself of that and was successful at times, but that was only so helpful. Part of me kept thinking, this isn't even the worst of it and I'm already close to the edge.
Of course by that time it was already 6 or 7pm. Maybe later. I don't know. I had no clear idea of time and certain thoughts can't be pinned down. I remember it was still light out when I was allowed to get into the tub for the first time. I remember that it was dark out when I understood I wouldn't be allowed back into the tub until it was time to push because my body wasn't progressing well enough in the tub and we needed me to make more progress.
I'm sure that in my midwife's head there was a timer ticking down on how much longer I could go before things fell apart, but she never let that show. I really appreciate that.
Labor is a very inward focused process, focusing on me and on the unborn human, I felt I had virtually no attention to put anywhere else, hence the lack of time. But I have to take a moment to point out how amazing my support people were during the whole thing. Corey was amazing, doing everything everyone asked of him. My doula was also a rock star, and she and Corey worked together to do everything they could to help me make from one contraction to the next and through each one. They helped provide pressure for my hips (something that takes a lot of energy from them especially over time and that works to greatly reduce some of the more negative sensations of back labor) they offered me drinks and snacks, they reminded me to breathe, they reminded me why we were doing this, they told me I was doing great and they never ever ever mentioned how long it was taking or that they were tired, or let a single negative stray thought so much as show in their eyes let alone slip their tongues. In other words those three people (midwife, doula and husband) kept me going in ways that were critical and I truly don't know what I would have done without them.
Yet still, by 10pm, after twelve hours of official "active labor" at more than 4cm (though more than nineteen hours if we go by intensity and frequency alone) and around 43 hours of labor total starting with "established early labor" I was still only at 8cm. After some discussion we decided the midwife would break my water for me and we would hope that would trigger a big jump in progress. The other choice was to head to the hospital for an oxytocin drip in hopes that it would speed things up. Wanting to put off changing locations for as long as possible (that was seriously my main motivation at that point, anything not to have to sit in the car while going through contractions) I decided to have the midwife break my water. Which is something we would have done as soon as we'd gotten to the hospital anyway.
A quick lesson on birthing, and birthing in Manitoba specifically. Meconium is a baby's first fecal matter, it has been built up and stored since months before a baby is born and it generally isn't released before birth unless the baby is in distress. Though it could be released for no reason, the chance of distress is high enough that if you are in Manitoba under the care of a midwife and laboring at home or in the birth center finding meconium in the amniotic fluid when your water breaks (or is broken) means heading to the hospital. It doesn't mean that your midwife is no longer your care provider, or that you've reached an emergency (it's a non urgent transfer, you drive yourself) it just means that they want you to have hospital access in case anything escalates and so you can no longer birth in the birth center or at home. I knew all of this in advance, so the second the mid-wife said, "Oh no," after breaking my water. I asked, "is it meconium?" She said, "yes." And I said, "Well let's get to the hospital then."
So, she left to call the hospitals in Winnipeg and find us a room. It took longer than I would have thought for her to do this and it turned out that was because the first hospital that she called was completely full and they were no longer admitting births. So we headed to the other main hospital in Winnipeg which is actually much closer to where we live as well as closer to the birth center, so that worked out in terms of shortening the car ride, at least. It was also where Speck was going to be born if we hadn't gotten midwifery care. All in all, we weren't too upset to wind up there.
On the way to the hospital I decided quietly that I would be asking for an epidural as soon as we arrived. I had honestly been thinking about asking for one ever since we started talking about going to the hospital at all. I was so exhausted, the TENS machine was doing nothing for my back labor anymore and hadn't been for a while, and I knew that if I was ever going to have the energy to actually push Speck out I needed to rest. I had simply been at it for too long. I was mentally and physically spent in a way that I had never been before. The car ride, in the meantime, was short but full of all the same pain and desperation of the previous hours. And I no longer had the energy to channel the pain into something else, it was simply pain. I had lost my hold on it and it was consuming me.
We checked in and I was barely aware of my surroundings, I remember quick flashes of hallways, reception desks and the room I was wheeled into. I do remember being thankful for the wheelchair. Walking wasn't impossible but it was slow and much interrupted by contractions and would have been far worse than being wheeled around. As soon as we stood up in the room I remember clinging to Corey I was vaguely aware of the nurses in the background giving my midwife a hard time about checking in properly. She had gone to triage to check in and they had told her to head straight to L&D and then when she got there they were giving her crap about not going through triage. It's odd but I remember hearing all of this and I remember it pissing me off. I'm sure they were just very busy and having a bad night, but I was angered on my midwife's behalf. In addition it seems that they were making it take as long as possible for us to be admitted which was not what my pain wracked body and mind were in the mood for. I wanted to rest so desperately.
I can't remember when I announced to the room that I wanted an epidural, but it was not long after we'd walked in. I was sure my midwife would be disappointed but I think I was probably projecting. I was NOT disappointed in myself. I had come to terms with it on the car ride over or even before that. I had worked so hard for so long, and I was going to wind up doing damage to myself if I didn't let myself rest. I knew that resting without medication would be impossible. I knew that even narcotics alone wouldn't do the job, I needed to be disconnected from the sensation of my lower half. It was the only way I would be able to rest. I had done enough. I deserved to rest. (Not that anyone has to earn the right to rest, or to need/want an epidural, just that for the particular mindset I brought to this birth I would have felt differently if I hadn't gone through what I already had first.) I knew It was the right choice and I was sure of that.
I heard my midwife tell the same nurse who was in the process of giving us a hard time checking in that I wanted an epidural and I remember that woman laughing. I wanted to punch her. It was probably a good thing she wasn't standing anywhere near me. I'm sure she only laughed because they were so over booked and everyone probably wanted an epidural. I'm sure the anesthesiologists were being run ragged in a totally booked labor ward. I remember my midwife saying "she's been in back labor for 46 hours" and I didn't hear the reply of the nurse, because I was too distracted with the next contraction.
It took the anesthesiologist about an hour to arrive. I don't remember how much time it took at all, but that's what Corey told me. I had gone back to focussing on each contraction as it happened and trying to turn it into something other than pain, I wasn't having much success. I was just fighting to make it through to the next contraction and kept telling myself that soon I would get to stop fighting.
Of course, epidurals aren't immediate things. The anesthesiologist had to deliver his spiel about epidurals, risks, and consent. Then he had to set up an IV for me...
Oh the IV struggles. I failed to mention this earlier but as I tested positive for GBS in the week leading up to my due date I was given an antibiotic as soon as I reached active labor. Of course, as soon as, is an exaggeration because apparently I have very valvey veins, which means they are difficult to run an IV tube into. It took the midwives three tries to get my port in and then, when we got to the hospital, because the port had been exposed to air for the duration of the car ride the hospital decided they had to remove it and start over, and then none of the nurses in L&D could do it. Three more tries (all while I was going through contractions) and no one succeeded. They finally waited for the anesthesiologist to do it. One, because anesthesiologists are quite good at putting in IVs and two because they have extra special tools for doing so. Meanwhile I had been without fluids while we waited for the anesthesiologist. So first he got my basic port in, and then he got my back prepared for the epidural. He warned me about the pain of the numbing agent etc. and all the attempts at getting the IV port into me had been painful too, but none of that touched what I was going through otherwise, unless it coincided well enough to magnify things, which only happened with one of the IV port attempts.
Finally the epidural was up and running, of course, it takes about 20 minutes to set in properly. I was happy though, as I could feel it slowly starting to work. Then I was worried, as after what I thought was 20 minutes had passed and I could still feel enough of my contractions to keep me from sleeping. Then I was told I had a top up button that I could hit at will and had a maximum safe dosage that I couldn't exceed. I hit the button a few times and then I started to drift off to sleep.
Except I kept getting woken up because of... well lots of things. For one thing I was getting a dose of oxytocin in order to get my cervix to finish doing its job. That was happening through the IV so it's not as though it was distracting, but I was getting checked every hour to see what my cervix was doing in response and... well cervical checks are not things one can sleep through. I remember commenting as a brand new person performed a check that the number of people who had shoved their hand into my vagina without introducing themselves had grown exponentially in the past 24 hours. (Of course they actually did introduce themselves first, I just thought it was funnier without that part.) One of the nurses laughed at my joke most everyone else ignored it.
The news wasn't great. My cervix was responding but slowly and somehow between leaving the birth center and arriving at the hospital my cervix had closed a bit and swollen. The midwives had described it as very soft and thin for the entire time I'd been with them, but something about breaking my water had changed things and it was now swollen and was only at 6cm when we arrived. The oxytocin was working but slowly. More bad news, Speck's heart rate was dropping and rising in a disconcerting pattern and the staff were concerned that Speck wouldn't react well to pushing when we finally got there and that was still hours away.
All of this developed over a spread of time that I was unaware of, I would fall asleep between each announcement and to me they almost seemed to happen back to back. But we had arrived at the hospital at close to 11pm and by 5am things weren't looking great. Then we had our panic movie moment.
As soon as we arrived Speck and I had both been put on heart rate monitors. That's standard procedure for showing up with meconium in your amniotic fluid. But once Speck's heart rate started dropping unexpectedly they suggested putting Speck on a scalp clip heart rate monitor. It's exactly what it sounds like, they run a cord up to Speck's head via my vagina and clip it to Speck's scalp and it monitors Speck's heart rate. We consented because we wanted to be damned sure that Speck was ok.
The fluctuations continued even with the better monitor attached, and then, at one terrifying moment, they dropped dangerously low and then stopped. The nursing staff performed the incredibly professional calm panic that is their job and ran us (me still in bed and Corey and the doula running behind) down the hall to high risk section of Labor and Delivery where we were right next door to the OR. As we arrived it became apparent that somehow the heart rate clip had come undone. Speck had not flatlined. As soon as the monitors were reattached Speck had a normal heart rate. For a while. Then it continued to dip and raise disconcertingly.
The resident who had been monitoring us under the care of an OB since I asked for the epidural (epidurals require transfer of care away from midwifery care and into OB care, and my midwife had gone home in order to rest before we called her in for pushing whenever the time came) came in to talk to us about a cesarean section.
When we first arrived at the hospital this moment had occurred to me as a possibility and I had dreaded it. Then we had been there for so long, and we'd run down the hall because we'd been worried Speck was flatlining and suddenly all I wanted was to be safely holding a child in my arms. I didn't care that it was major abdominal surgery anymore, I didn't care that it had its own risks, I didn't care that I had really wanted a vaginal delivery back before all of this started. I wanted a healthy baby, and honestly, when I really thought about the prospect of pushing for two hours after everything else, I wasn't sure I could do it. And the doctors were telling me that they weren't sure that Speck could do it.
I agreed to the emergency c-section with a feeling of relief and sudden calm. We now knew exactly what was happening and the waiting would be over shortly. There were risks, of course there were risks, but we had a very competent surgical team, a functioning epidural already in place, and I am a very good prospect for recovering well from major abdominal surgery. Once again it was the right choice, and by the time it came down to making it I had no reservations.
What would I have said if you'd told that would happen three days prior to going into labor? Well to be honest if you could tell me all the details as I am telling them to you now I think the me of three days prior would have said, GET THE FUCKING C-SECTION! And that's why I am at peace with the situation. There is no iteration of me, who, given all the information, would have made a different choice.
So, now the anesthesiologist returns to talk to me about how things will go with the epidural during surgery and to test how established it is at the moment and make sure it's distributed evenly. I am lucky and it seems to have taken effect in all the right places. He leaves and some nurses show up to disconnect me from all the machines in my room switch beds and wheel me to the OR, Corey is taken to a place to put on scrubs and told he'll be shown to the OR in about 20 minutes when they're ready to start.
The OR is a smaller room than I expect it to be, but otherwise it looks exactly as I would have imagined. I am placed on the operating table, but actually I'm still mobile enough to help with the upper half of my body. I'm given an A by the nurses for being able to help move myself. A screen is placed so that I can't see past my chest. The anesthesiologist comes in again and does a lot to make sure that my epidural is topped way up and that I'm truly numb from the chest down. It's a much different sensation to how I felt up until I helped transfer myself to the operating table and I'm glad it has been put off until the last second. I don't enjoy not feeling this much of my body, it makes me feel like I'm entombed in my own flesh. I'm pleased to see that the anesthesiologist is same one from before. This guy has been wonderful the whole time. He has a great bedside manner, is friendly and just the right amount of talkative. I know that it's part of his job to make sure that I'm responsive and thus chatting to me is probably an easy way to do that, but he does it naturally and in such a way that I feel like he's just being friendly not clinically checking boxes for my LOR. I find out he and his wife just had a baby seven months ago, and the baby is a girl. I decide I like him. Also, he's there to tell me what's happening on the other side of the curtain without giving me too much information. Things like, "they're starting now." Then he's kind enough to remind everyone that my husband isn't in the room. I like him more. Someone must have been sent to get Corey because he arrives shortly after. He's dressed in scrubs and I have time to think it's a good look on him before I go back to focussing on the incredibly strange sensation of feeling a surgery happen without feeling any of the pain attached to it. I can feel tugging and pulling, things being moved, but no pain, and no direct sensation. The whole thing is surreal. It's also very fast. Corey keeps eye contact with me and we say silly things to each other. We also say nothing at all. I expected to be terrified the whole time but I feel surprisingly confident in the team that's working on me and their ability to do this well. I feel like I'm in good hands. I do worry about Speck though. Speck's heart rate was really freaking everyone out before we started and I'm scared that we waited to long or didn't do the right thing or... one large pull. "They've got him, they're pulling him out," says the anesthesiologist. Instantly a strong baby cry fills the air and I feel immense relief. "He's crying." "He is a she," someone corrects. "It's a girl."
I still don't know who announced it and I don't really care, but I remember being happy. She is whisked under the lamp and massaged and wiped and checked for all the responsiveness tests they run babies through. She passes with flying colors. "Would you like her on your chest?" someone asks. YES! They bring her over and push my gown out of the way and lay her on me. I can move one of my arms well enough to hold her. The name Cedar pops into my head. It was one at the top of our list. Corey is there and we get to be a family for a few minutes while I feel them put everything back together on the other side of the curtain. Then they tell me it's time to head to post op, I'm told Corey will go with Cedar and we'll all meet in the recovery room. They disappear and I am left under the lights with my friend the anesthesiologist who is explaining how long it will take the epidural to wear off and what my pain options will be, also the nursing staff are cleaning up and putting things away and then they're all moving me in a dead lift to the gurney and wheeling me to post op.
I think it was in post op that Corey and I made a decision about the name. He had thought of one of our other top picks when he'd seen her come out, but when I told him Cedar he said he liked it just as much. The more he thought about it the more he liked it until he finally decided he liked it better. So we decided on Cedar. Ashmead as a middle name had pretty much been decided on when Speck was still Speck, so that was an easy choice. Then it was just a question of how the last names were to flow. Which sounded better? McClain Ticknor or Ticknor McClain? In the case of Cedar Ashmead we thought McClain Ticknor sounded best.
There are many other details, but none of them seem that important now. Cedar was waiting for us in post op and was given to us as soon as she'd been weighed and measured and had her foot poked etc. She cried plenty, but also had moments of quiet. The nurses all said she was beautiful, but I think they say that to everyone. I thought she was beautiful, but I also thought she looked like the weird squished beings that all newborns are, only slightly less squished for having been pulled out by cesarean instead of being pushed through the birth canal. Our nurses were all lovely. There was one largish snafu. Our midwife hadn't been called by the nursing staff and told to come to the OR. I had told our doula to call her and tell her to meet us in post op. The nurses had told us she didn't have OR privileges. I thought I remembered her saying she did have them, but that had been weeks ago and I was in no state of mind to argue about it. When my midwife arrived and asked about why she hadn't been called the nurse repeated what she'd told me, that she didn't have OR privileges. That's not true, apparently and it's kind of a big deal that they messed that up. Luckily, I had Corey with me, and felt like I was in good hands, but imagine if I hadn't liked the anesthesiologist or they'd forgot to bring Corey in at all... Anyway, that was the only thing that was wrong. Everything else was great. Our staff was wonderful, knowledgeable and helpful. We felt very well taken care of, and we were too busy falling in love with our daughter to be bothered by anything else anyway.
My midwife asked if I wanted to try breast feeding and I said yes, but told her I had no idea what I was doing. She gave me a lesson, helped me position Cedar properly and we were away. Lucky again, Cedar had a good natural latch that only needed a bit of help on my part. Yay! I felt like it was the first thing that had gone right in three days.
For the next 48 hours we were poked and prodded at various intervals and moved to a couple different rooms. The staff was always kind and helpful. The hospital food was half decent, and eventually we got a private room where we felt we could get some kind of rest. The three of us were all exhausted, and Corey and I were both pretty emotional after everything we'd gone through, but the prevailing emotion was love.
We were discharged on Thursday afternoon and finally got to take our girl home. It was sad to come back to a house without Artemis, but Corey's parents had very kindly been watching her since the night before and a neighbor of ours had come by to take her out a few times on Monday.
We're slowly figuring out our normal, a process made more challenging due to recovering from major abdominal surgery, but so far we've been managing and Cedar is still alive. That's five days now that we've managed not to kill the new human, and I'm feeling carefully optimistic.
So now, I present to you, the light at the end of our tunnel:
Cedar Ashmead McClain Ticknor
Born on September 27th at 7:10am via emergency c-section
weighing in at 6lbs 5.5 oz
20.4 inches long
