Elizabeth's Tips for a Med-Free, Joyful Labor

This crazy person is writing this for other crazy people who want a pain-medication-free labor and delivery. I wanted to make sure to offer my experience and tips for how I managed the pain so that others might know that THEY CAN DO IT, too! I wrote about the birth of my first baby, which turned out to be many hundreds of words longer than I expected. Separate post, it is!  

I have read and watched dozens of tips and labor experiences from other women. Please be sure to look into others' experiences! I'm just going to list them in an annotated bullet list and I'd be happy to answer any questions left in the comments.

Mindset

• Start positive and know your reasons for wanting a pain-med-free labor and delivery. Write it down.
• Know that fear of pain is useless. You will be on the other side of the pain within 24 hours (most likely) of whenever you feel like you're hitting rock bottom. You'll survive!
• Fear of pain makes pain worse. Start working on eradicating your fear of the pain right now. It's not in charge, God is.
• Tell your support system what is important to you and be prepared to chuck them out if they aren't showing the support you need (for example, I forbade anyone from saying the word "epidural" while in the room with me)
• Know that you only have to get through the first half of the contraction, then it's downhill. Don't panic.
• Relax in the breaks. They really are breaks. You feel no pain during them (except during transition).
• Know your limits. Leaving the door cracked to the possibility of pain meds may eventually empower you when you CHOOSE not to take them rather than refuse them.
• Pace yourself. One of the hardest mental battles is that you will not know how long your labor is going to be. You will be tempted to ask someone how long you'll be feeling that pain and no one can tell you. For this reason, it's essential that you control that part of your brain and pace yourself as if you're going to have the longest labor on record. If you're an athlete, imagine what it's like to begin a workout when someone else is in control. You don't know how long they're going to make you swim, run, lift, play, etc. Control your pace.
• Yes, it's possible to go pain-med-free on Pitocin. Yes, it's wicked, but mine was even faster than it's supposed to be (meaning, no chance for endorphin or natural Oxytocin to build up) and I managed.

Plan and research

• Have a plan and give it to your husband with options. I suggest putting the faith in him, even if you're a little nervous about how he'll handle the medical stuff. It's unbearable for a husband to watch his wife go through the kind of pain you're facing, but having a task can help that.
• Have a breathing plan with options. I drew a little bell curve representing a contraction, plotting out how to breathe through it. I had to consult this when the simple slow breathing wasn't working as well anymore.
• Study. YouTube, blogs, friends, articles, anything you can get your hands on to help you understand what the whole process is going to look like. Ask your physician everything you can think of to help yourself get acquainted with that future day. Surprises are better when they're few and far between.
• Create a list of tools. Mine were a list of affirmations that Kevin read to me at appropriate times, music (didn't work for me by the time I got to it, but I'm glad I had it), massage (at some point, you want exactly NO ONE touching you), warm water tub (I had one in my room, but in trying to pace myself--I had no idea how quickly my labor was going--I never used it), watching a movie in early active labor.

Physical

• Water. All the time. Husbands, this is your job.
• Focus on relaxing everything but your uterus. That's the only place where the contraction happens, so let it do what it's doing and prevent contractions in other muscles.
• Watch videos of a flower opening beginning 2 or 3 days before your due date. I watched the same video during labor, right before I pushed. I was visualizing my body opening to help prevent tearing (and I didn't tear).-
• Use every contraction to visualize moving that baby down. Imagine the movement and imagine that your body is working to open up. Let it do that.
• Pace yourself. Again, this is physical, too. Don't start out using every tool you have to manage pain because you want to save some (like the tub) for later. However, DO walk in the early part of labor. Don't lay around.
• Use multiple positions during labor and for pushing (if your physician will allow it). Hands and knees and a sit/squat position, using the bed as a chair, were helpful for me mentally and in a gravitational sense. 

Last, but certainly not least...

Spiritual

• Give it to God. He's blessed you with this little person(s) and He will help you. I brought a crucifix on which to focus and prayed a lot during labor.
• Offer it up for others or your baby. Suffering is redemptive. Cash in on that.
• Look at the ultrasound pictures to focus on that little one!

Rita Marie's Birth Story

Birth story time! I am currently reminding myself that you, dear reader, choose to read this. I'm not forcing you, therefore, I can be as detailed as I darn well please!

Trigger warnings: those with fertility struggles, I would beg you to first visit some of my other posts about what we have in common before reading this. Also, I will probably talk about poop, blood, pain, and midwives. Fair warning.

A good friend recently pointed out that in college I made it clear I wanted a natural pain medicine-free birth. It has always been a goal, probably steeped in pride, but a goal nonetheless. My two major fears about childbirth were Pitocin (more painful and higher risk factor for a C-Section), and tearing. One happened, the other didn't, but I realize now that the fear of those was just as futile as the fear of pain that I scoffed at for so many years.

My blood pressure has always been somewhere around 90 / 60, yet my 39 week appointment found my blood pressure to be 135 over 80. Being that it was high for me, my midwife decided to test my blood, my urine, and have me collect my urine for a full 24 hours or to test that. Blood and quick urine test came back fine, so I thought I was in the clear. We were facing the Labor Day weekend and the first day of school on Tuesday: I felt relieved. I desired to spend some time with my kids at school before this baby arrived. 

Tuesday morning came around and I got an email notification reporting my 24 hour urine collection results: two times higher than the highest allowable amount of protein in the urine. I charged off to school upset that I could expect a call about needing to be induced. Around 10 a.m., after much scurrying and getting ready for my substitute, my Midwife called and told me to come in. Always the rebel, I didn't actually leave school until 12:30, going home to have lunch with my husband by ourselves for the last time.

I had adrenalin pumping through my veins, my hands shifting too quickly and my breath harder to catch. We drove, rather too quickly, to the hospital to meet the midwife and check "my situation," suitcase in hand.

First picture of Rita.

At this point I was only three days away from my due date, so I bowed my head to the knowledge that they would follow through with the threat of induction. The midwife checked, saw that I was one centimeter dilated and began the most painful procedure of the whole ordeal: stripping the membranes. I say it was most painful because the pain was unexpected. You know labor is supposed to hurt, but I never imagined what that would be like. In a word, #$&+$*¥€. However, I did not scream out in pain and I started practicing my breathing in anticipation of what I was facing the next 24 hours. I made it.

Next, we had to go to the health food store to get the yucky castor oil birth cocktail, which I mixed into a crazy juice solution to accompany our last dinner together pre-hospital. My husband, Kevin, was so calm during this entire ordeal, something I desperately needed as I was facing the potential of both my biggest fears. I repeat, the fear of childbirth had nothing to do with the pain of normal childbirth. I knew I could handle normal pain, and I really think that kind of attitude is necessary when entering labor. It was the introduction of Pitocin or tearing that I stressed over.

We had this to look forward to.

Kevin and I checked into the hospital, which is really more like a hotel at this point, where the midwife planned to insert a Foley balloon to mechanically dilate me overnight. Fortunately or unfortunately, during the procedure of putting the Foley balloon in, my water broke. The sweet Midwife said she was nowhere near the actual water membrane, so it must have been ready to go anyway. Yay! Not officially an induction! I might be able to go without this stupid Pitocin after all.

The running theme that I should say every other sentence is that the nurses at this hospital were to die for! They were friendly, kind, not shy about nasty bodily functions, and always helpful. Just imagine I inserted that comment after every paragraph and we might approach the necessary amount of praise for these fine women.

I woke up around midnight with contractions that prevented me from sleeping and waited until 1:30 before waking up Kevin. We walked around the hallways, and indulged my intense urge to watch Prince of Egypt. These contractions were definitely active labor, and I could finally feel pain after what felt like months of painless Braxton Hicks. We were getting somewhere and I was going to get to meet my little one! 

Around 4 in the morning, I felt as if either I had gotten used to the pain or the pain has lessened because I was able to lay down and fall asleep until about 6:30. The Midwife returned at that point and had to have The Conversation with us. It was time for Pitocin. Downtrodden, I agreed, ate my breakfast, and we hooked me up at 8 a.m.

In order to prevent babies' hearts from freaking out, the procedure with Pitocin is to administer two units to start and increase it by two units every half an hour as long as the baby is healthy. This pattern worked for me and we got to eight units after about an hour. The contractions were much more intense, but my breathing, ball sitting, walking, and dancing with Kevin was helping me hold off more fear of pain. It's the fear that will get you, ladies. 

I'll soon post my tips for accomplishing natural labor, so I'll hold off on sharing that here. 

At some point I stopped being quite so conscious of what was going on. I know my sister visited around 10, I know my parents arrived around that time also, I remember getting really irritated at everything at some point as well. They eventually bumped the Pitocin up to 10 and later 12 (the maximum dose), because I wasn't "at the huffing and puffing stage," like they wanted me to be. It turns out I was in the "huffing and puffing" stage, I just didn't look like it. 

My amazing husband was with me the entire time, asking my mom for a quick break at some point after several hours of me leaning on him with all my body weight. I am so proud of his amazing feat of being with me during this whole interlude, as he has vasovagal nerve issues. He's such a champion! 

I further slipped into an subconscious (?) state, and I had to move to the bed because of the exhaustion. I literally fell asleep in between contractions from about 1 until Rita Marie arrived. Who knew it was possible to take multiple ninety second naps during labor? That should be proof that you get breaks between the painful contractions.

The Midwife told us at 8 a.m. that this labor would probably be between 12 and 20 hours, so I preserved my energy. Little did we know, I was almost fully dilated. Our daughter's head head plugged up the previously broken water spot, creating a new water balloon that the midwife busted. As soon as she took care of that, transition hit. Mamas, this is when you know you have made it, this is when you know you're facing as much physical pain as you will ever face in this season. You're almost there!

I was so delirious. The woman who gave us the tour of the hospital many months ago, a head nurse of some sort, walked in. I immediately associated her with the suggestion she made in the tour of using nitrous. I said hello to her and, "I might not be opposed to nitrous right now." The midwife suggested we wait for two more contractions before talking about nitrous, so she could check me again. Apparently she took him outside and asked him what he thought I would really want at this stage. He said that he knew I really wanted an all natural labor, but that he'd check with me. 

The Midwife checked my dilation and it was time to begin pushing. Per my over-researching about how not to tear, I got in the hands and knees position on the bed. Imagine being on your knees facing a Sleep Number bed that has been jacked up into the L position. I had my chin and my forearms resting on the top of the mattress between contractions. While in that position, again completely delirious but ready to meet our daughter, Kevin asked me about the nitrous. I told him I had gotten this far without any pain meds and that I would do the rest of it without them as well.

I pushed like that for at least a half an hour, not being able to see or feel any progress, but hearing multiple lamentations of praise for the great job I was doing. I started to disbelieve my supporters. My mom had pushed for 4 hours with me, so I was assuming it might take somewhere close to that for little Rita Marie.

That's when they turned me around and I got in a seated position. Someone suggested the mirror, which kind of grossed me out, but I said yes. Best decision of the day! It allowed me to see my progress. It allowed my athletic mentality to start to see the Finish Line. I could watch my progress, and feel my daughter's head (so squishy). This position is also where I started to feel that overwhelming pushing urge. You will never believe it until you feel it yourself, but it is as if someone else is making you push. And this is crazy and gross, but it feels so good!

I must have known she was coming soon because some of the few words I spared energy for were, "I need to get this bra and dress off because I want to do skin to skin with her." They cut the dress off of me and a new contraction began. I had my eyes closed. My second push of that contraction brought Rita Marie into the room. The Midwife called out to me to reach down and grab my daughter. The most clear memory of joy is associated with how warm and wet her tiny little fragile body was on my chest.

The eight hours of labor we're far shorter than the medical team expected them to be. Again, as I said they kept increasing the Pitocin because I wasn't showing enough pain. It turns out I was hiding too much of it. However I would do it again like that in a heartbeat, going through as much pain as I did, just to be able to meet her as quickly as I did. I did not tear and I turned out to actually like the Pitocin because of that shorter labor time. Perspective is everything.

As soon as I pulled her up onto my chest I emerged from my subconsciousness and yelled out, "oh my gosh! Happy birthday! I love you, my darling!" Kevin said the whole room laughed and cried at my outburst, because I hadn't really said anything for several hours. It was as if a new woman was there on the bed. That's how I felt, also.

Finally, I looked over at Kevin and said, "we did it!" We thanked God, kissed each other, and thanked each other. My dad has always said God is in the room for a few moments during a child's birth. My mom suggests it's much longer than a few moments. I say I still haven't felt His Presence leave us. 

Beget Some Joy

I made it through 3 hours of the first day of school before driving to the hospital.

While awaiting our tiny blessing, my husband and I made many predictions about whence she would arrive. I assumed she would arrive in mid-September, partially out of the hopes that I would spend more time with my school kiddos before holding my personal, biological kiddo. My husband, as he often does, guessed it spot on. September 6, 2017, Rita Marie joined us on the outside!

One must spend only a few moments with most women on the topic of labor, delivery, and general motherhood before one hears the battle stories. Parents are the modern warriors, it seems, traversing parts unknown to raise their children and facing all number of dragons and scars.

Labor and delivery seems to be the focus of several women as the first prolonged peak of suffering on the path to parenthood. However, I’ve learned differently. Wanting, praying for, waiting for, and hoping for a child that I didn’t know would arrive was far more stinging than labor.

Who among us would disagree that suffering begets joy? The harder we work to reach that one student, the more cheer when we see the spark in their understanding. The more often we sweat it out at the gym or on the trails, the more confidence we build in the fruit of our actions. And the more a student struggles to learn, the greater the reward when their perseverance pays off.

I found that paradox to be true throughout my time growing my daughter on the inside: every pregnancy ailment was a step toward meeting her. I offered it up for her and my husband as we prepared to be her parents, just as I did during labor. Afterall, once I met her and held her in my arms, how could I complain of pain or suffering. The joy had come, as it always does on the other side of struggle. I choose to attend to that.