Miles James Koch was born at 12:32pm on Sunday, October 25, 2015 after spending exactly 41 weeks getting ready for the outside world.
I started having contractions at around midnight on Friday night/Saturday morning. If you’re quick at math, you probably just realized that I was in labor for almost exactly 36 hours. Yep.
I woke up around midnight on Friday night with what felt like an intense gas cramp. However, after about two hours of cramping, I started to think that my wildest dreams were coming true and that I was finally going into labor.
I woke Brandon up at around 2:30am and told him that I thought I might be having some contractions and that I was going to go walk down to the creek. He got up and came with me, and we ended up walking for about two hours. I had texted my doula and close friend, Alex, at this point and we decided that these were likely not gas cramps, so I started to time them–about 1 minute long and 10-12 minutes apart. I could keep walking through most of them, but they were distinct and already starting to get a little more intense. Off to a good start.
By 5:30am we had returned to our apartment, Brandon went back to bed, and I called my mom to come pick up our dog. She answered the phone with, “Is it happening!?” “I think so,” I said.
Throughout the morning my contractions continued to increase slightly in intensity, and by 10am they were about 6-7 minutes apart. We decided to go for another walk, but during our walk, things seemed to stall out–I suddenly dropped from 6-7 minutes apart back to 10-12 minutes apart. We headed back to the house and once I settled back in they picked up again, but we took another walk around 3pm and the same thing happened. Ok, no more walks.
We ordered pizza around 6pm and by now my contractions were much more intense–I could no longer talk or move through them, but would just flop myself over the arm of the couch and try to groan through them. But they were still anywhere from 5-7 minutes apart, and I knew I should wait until they were consistently 4-5 minutes apart before they would want me to come into the hospital. But by 8pm I was starting to get so exhausted that I called my midwife anyway. I told her that I had been in labor for over 18 hours and even though my contractions weren’t that close together, I was starting to run out of steam. She sounded a little hesitant but told me to go ahead and come in to get checked and we would make a plan from there.
I got to the hospital with my mom and Brandon and we were taken to a triage room. And that was the beginning of the phase that I call “the black hole of labor.”
I had been checked at a midwife appointment on Friday morning and was 1cm and 80% effaced, so I was expecting to at least be at 3cm or so after having been in labor for so long. But when the nurse checked me, nothing had changed–I was still 1cm and 80 percent. The nurse said something along the lines of, “Maybe you’re not really in labor, we could send you home and you could just come back in the morning if your contractions don’t stop by then,” and I broke down crying. I knew that this was the real deal, but I was so frustrated that after all the work I’d been doing, nothing had changed whatsoever. The nurse assured me that this was normal for a first pregnancy, that she herself had been in labor for 24 hours before anything started to change, but I was starting to feel pretty helpless at this point. The midwife came in and told me that they could give me an Ambien and send me home, or I could walk the hallways for two hours and see if anything progressed. If I progressed, we would go from there. If I didn’t, I could either take the Ambien and go home, or stay and be given some morphine. The morphine would either put me to sleep and my body would stop this “false” labor, or if I was really in labor, I would wake up 2 or 3 hours later with stronger contractions. I told her that I wasn’t going home without a baby to show for it, and Brandon and I took to walking the halls.
The next two hours were some of the most painful hours of my life. I was so exhausted that I was having a hard time balancing, and baby (who was still unnamed at this point) was kicking and jabbing my pelvis like crazy between contractions. Though he had been a super active baby my whole pregnancy, it had never hurt when he moved before–but now it HURT. I felt like I wasn’t getting any break between contractions because of how much it hurt when he moved, and it took me almost a full hour to take a single lap around the labor and delivery unit.
When they finally re-checked me, nothing had changed. I opted for the morphine and they led me to the farthest room at the end of the hall. Once I got settled in, they gave me the morphine with a needle that Brandon would later describe as a harpoon (luckily I didn’t see it before they gave it to me), and I passed out right away.
However, the glorious effects of the morphine wore off almost as quickly as they’d set in. My contractions woke me up about an hour later, and when we called in the nurse, she basically told me that we were out of options. She explained that they couldn’t give me an epidural because I wasn’t progressing, but they also couldn’t give me more morphine. This was definitely the hardest moment of labor for me. I was totally physically, mentally, and emotionally exhausted. I felt like I had been told so many times that “your body will know what to do,” but my body just couldn’t get with the program. And on top of that I was being told that I was going to just have to deal with it until I started “real” labor–which also seemed like an impossible thought. I had already been in labor for over 24 hours and was a total mess, how was I going to go through “real” labor if this wasn’t it?
The nurse sent in my midwife, who was a lot more reassuring but still didn’t offer a ton of options. We decided that I would try to stick it out for a few more hours, and finally decided to call my doula, Alex.
When Alex showed up, everything changed. She filled the bathtub in my hospital room, added some essential oils, and put little electric candles around it. We put on some white noise, she and Brandon started using pressure points to help me get through my contractions, and more than anything, I felt like I had options again. The black hole of labor was officially over.
I labored in the tub for about 3 hours, with pretty strong contractions about 2-3 minutes apart. I thought that if I wasn’t in “real” labor before, this must finally be it. But I was relaxed, optimistic, and full-on in the middle of my second wind. When my midwife came in at 6am to check me, I was so sure that I would at least be at a 3 or 4… But, I was 1.5cm. Womp womp.
Somehow I was more prepared to hear the news this time, because I knew I was at a point where I at least had some options. And by this point I knew that I couldn’t keep going on my own. I had gotten about two hours of sleep in the last 3o hours, and if I still had 8.5 cm of dilating ahead of me, I would have to let go of my plan to have an unmedicated birth. We decided it was time for an epidural and some Pitocin. So we snagged the anesthesiologist right as the shift change was about to happen at 7am. When he came into the room I was in the bathroom, and he walked in and said, “Is she in here? Does she still want the epidural?” I heard him through the door and shouted, “YES!” If I was going to get this show on the road, I didn’t want to have to wait for the next doctor to clock in.
The epidural took effect almost immediately, and I (and everyone else in the room) knew right away that I had made the right choice. Part of me started thinking I should have gone for the epidural/Pitocin combo earlier, but I also knew that I had needed to give myself every opportunity to have the labor and delivery that I was “expecting” (seems like such a silly concept now, but what can you do). I felt like I had done everything I could and given it everything I had, but at the end of the day this was why I had chosen to go with midwife care in a hospital setting. In fact throughout my whole pregnancy I had always joked that I wasn’t going to be “that girl” who got to hour 30 of labor and still refused drugs. I just didn’t think I would ever really have to face that scenario. But here I was.
Brandon, my mom, and I finally got to nap (oh yeah–did I mention they had both been awake the entire night, too?), and Alex went to her house a few blocks away to get some sleep as well. Around 10:30 I woke up with the urge to push, and my mom went out and grabbed my midwife. She checked me and I was so sure she was going to say I was still at 1.5cm… But I was at 8cm! “But your bag of water is HUGE!” she said. And right as she said it, my water broke! She checked me again and said, “Well… now you’re at a 10… Give me a few minutes to get everything together and I think you can start pushing!”
I was SO relieved that something had finally changed, I could have cried again. I had gone from 1.5 to 10cm in about 3.5 hours, which meant I really had been in “real” labor that whole time… my body just wasn’t quite as dialed in as it needed to be.
Brandon called Alex, who I’m pretty sure literally ran to the hospital from her house. I started pushing at around 11:30, and at 12:32, Miles James was born.
However, while I was pushing I started to spike a fever and both my heart rate and baby’s heart rate were spiking. As the hour of pushing went by (which felt like about 10 minutes from my perspective), the midwife started getting more and more worried that I had developed an infection in my placenta due to my long labor and that the longer I pushed, the more chance the baby would have of picking the infection up. I was totally unaware of how tense things were starting to get, but Brandon later told me that every break in pushing the midwife would call in more people, starting with more nurses, then NICU nurses, and by the time Miles was born there were at least 15 people in the room.
They handed him to me right away, but after about a minute the nurses took him to the little warming table because he was having a hard time breathing. Brandon stood with him and after a few minutes, came over and just said, “Miles.” “Ok, Miles it is,” I said.
I don’t really remember much from the next few minutes, but after a little while the decision was made to take Miles to the NICU. Brandon went with him while I stayed behind to get cleaned up, but I was finally able to join them about two hours later. He was put on oxygen and given a few rounds of antibiotics, but he was released the next afternoon after just over 24 hours.
We came to find out that my placenta had an unusual extra “bubble” at the bottom, a double wall that had formed a water balloon under Miles’ head which kept him from dropping and putting pressure on my cervix, which kept my labor from progressing. Eventually I was in labor for so long that I started to develop an infection in my placenta called chorioamnionitis, which weakened my uterus and kept me from progressing even more. By the time I had reached hour 30 of labor, I was unknowingly in the middle of a perfect storm of labor-stalling factors.
I hope I never have to go through anything like 36 hours of labor ever again, but in a way I am grateful for the experience. More than anything I am grateful that Miles is healthy–spending even one night in the NICU really put things into perspective for how much worse everything could have turned out.
In the next few days (weeks?), I’ll be writing about things I learned in my 3rd trimester and things I’m learning in my first few weeks postpartum, but for now, Mr. Miles: