Induction Baby Hospital

The Birth of Arthur Avery

This mom was so calm and happy even at the end of a very long pregnancy. She trusted her body and was willing to wait as long as they could to let Art arrive on his own time. She remained calm even after an induction was needed. The entire process was not what they imagined but the peace in the room was so tangible. Not to mention Katie was so powerful and determined to have an epidural-free induction!
The Birth of Arthur Avery
By: Katie Randall
The birth story of my son Arthur starts with long days of waiting on his arrival. I never had strong feelings about how I wanted my birth experience to be until I found out I was pregnant. Early on I thought I might want to try a natural birth, and the more Jarrod and I learned about our options, the more we were convinced this was the right path for us.To prepare, I did prenatal yoga twice, sometimes three times a week, and we completed a Bradley method class, a partner coached childbirth method. We hired Merrill Durham as our doula. This was an easy choice. I’ve known Merrill for a few years, and I’ve always said she brings peace wherever she goes. She’s knowledgeable, passionate, and has done this before herself. She inspired me and she believed in me. I knew these were all qualities I needed in a doula. I had a textbook pregnancy and felt great most of the time. Even at the end of 42 weeks, I kept saying I felt too good to be about to go into labor. I expected to be miserable, and I just wasn’t. I attribute much of this to my yoga practice.
When I reached 40 weeks, I reminded myself that this is normal. First time pregnancies often go longer than 40 weeks. I wasn’t worried, but baby was still posterior and Merrill, the midwife, and I all agreed that could be why I wasn’t going into labor already. I did everything I knew to encourage him to rotate, but he didn’t, and when I hit 41 weeks, though I still wasn’t worried, I tried all of the usual natural methods for induction. I think the only thing I didn’t try was castor oil. I just knew he’d come on his own in his own time, and I wasn’t interested in forcing anything before my body and baby were totally ready. At 41.5 weeks, I had a routine biophysical profile done, and though the baby was doing well, the midwife thought my amniotic fluid levels were a little low and placenta was looking a little “tired.” At 42 weeks I talked to her about pushing induction back a few days, but she felt it was best to go ahead that night.
So on the evening of Thursday, February 5, we checked into the hospital. Checking in for your birth when you are not in labor is a bit odd, not that I’ve ever done it differently, but it was not how I imagined. We were nervous that day but excited too, and according to Merrill, who has done this part several times with moms in active labor, it was very peaceful to check in this way. Maybe that’s what set the tone for the rest of our stay. In spite of the hard work ahead, peaceful is how I would describe the whole experience.I was only dilated about 1.5 centimeters with a posterior cervix upon check in, so they started me on Cytotec, a drug to help ripen the cervix. They thought I may need a couple of doses, which would take 8 hours, so after making sure we were settled, Merrill went home to get a few hours of sleep. Jarrod and I tried to do the same, though it was difficult for me to sleep as I had monitors strapped across my belly and a blood pressure cuff that the nurse wanted on me at all times. Four hours later, the midwife checked me and decided I had progressed enough to skip the second dose of Cytotec and try a Foley bulb. The Foley bulb is essentially a balloon-like device that dilates your cervix to 4 centimeters. Needless to say, it was not comfortable. I was actually having mild contractions with it in, and I think that’s why I responded so well to it. The nurse said it can take three hours for it to work, but thankfully I made it to 4 centimeters within the hour. At this point, we started Pitocin, a drug I really hoped to avoid altogether because it can interfere with your body’s natural hormone production during labor and make contractions longer, more frequent, and/or more intense. I knew this could make my hope to avoid an epidural harder to achieve, but my body still wasn’t taking over and contracting like it needed to. It took a couple of hours for the Pitocin to kick in, but by 6:00 AM, I was in active labor.Laboring on Pitocin, I skipped early labor and jumped straight into active labor with little warm up. My body was in shock at first, causing chills, nausea, and vomiting. In fact, because of these symptoms, I thought I was farther along than I was. I was disappointed to find at my next check three and half hours later that I was only dilated 6-7 centimeters. I had hoped I was already in transition, but still, I was making progress. I can’t say enough good things about Merrill’s presence at our birth, but specifically I’m thankful she was there to work with the nurses into keeping the Pitocin as low as possible. Typically they would have upped the dosage every thirty minutes, but we asked them more than once if they could leave it where it was. I am confident had we not done this I wouldn’t have been able to tolerate the pain to come.

Throughout my labor, my contractions were irregular. They would get closer together and more intense and then space out, then they would come one on top of another and last for several minutes. They did not rise and peak like natural contractions. This was hard to work through. I remember saying over and over again that I just needed a break. I thought I would get breaks between contractions. Jarrod and Merrill kept coaching me through, providing counter pressure and heating pad as needed and reminding me to breathe, Jarrod telling me how proud he was and how beautiful I am and Merrill telling me that I was doing it when I said I couldn’t. Without their unwavering support and encouragement, I don’t think I could have held it together.

With each contraction I took long, deep breaths and vocalized in a low tone. I felt like I had to do this. If my pitch rose even slightly, I felt more pain. I never thought I would vocalize so much in labor, but it helped so much!

At one point, I thought my water had broken, but it had not, at least not completely. I was already feeling the urge to bear down with contractions, but 2.5 hours since my last check, I hadn’t progressed much more than half a centimeter. I was stuck at 7.5 centimeters. This was discouraging. I was doubting myself and getting so tired. Merrill asked if I wanted to try nitrous oxide. I was so glad she asked! I had been thinking about it but couldn’t verbalize my request. I know nitrous doesn’t work well for everyone, but it helped me so much. Just like I’d heard, it didn’t take the pain away, but it helped me not care as much. I was already in another place mentally, and the nitrous helped me stay in “labor land.”

Shortly after, Robin, my midwife, suggested letting her break my water. I was hesitant at first, afraid it would increase my pain, but eventually I let her and was so glad I did! I went from 7.5 to 9.75 centimeters in no time! When she told me I was 9.75 and could bear down with the contractions if I wanted, hoping a little pressure would help get me to 10, I cried tears of relief. I remember looking at Merrill, and she teared up with me. It was such happy news. We were nearing the end!

Within half an hour, I was at 10 and pushing with each contraction. At this point my body had taken over and the nurse was able to turn the Pitocin off. I know this was a totally different part of labor, but my contractions without Pitocin felt so different. They were spaced more evenly and peaked naturally. This was a huge relief! And pushing made them easier to work through as well. I would say the pushing part was the least painful yet hardest thing I’ve ever had to do. Mamas have to work so hard to push their babies into this world!

Unfortunately, as soon as I started pushing, Arthur’s heart rate started to drop. They gave me oxygen and fluids, which seemed to help, and kept me on my left side, which seemed best for baby. Robin checked me again to confirm he was in a good position for birth, and he was! At some point during labor he had turned into a direct OA position. This was an answer to prayer! He was still behind the pubic bone however, which seemed to slow things down some. At this point, my contractions spaced again, and after an hour and a half of pushing, the room was suddenly very crowded. I felt a little out of it and wasn’t totally sure what all happening. All I remember is meeting the OBs on call, talking about options like forceps and C-section, saying they were concerned about the baby’s heart rate. They had been monitoring my progress over the last two hours and felt it was taking too long. They wanted to check on the baby’s positioning themselves. I assumed this would be similar to the cervical checks I had had thus far. I was very wrong. This was by far the most painful part of my entire experience and the most difficult for Jarrod and I both to process since. If I’m being totally honest and vulnerable here, I felt violated. I know the OBs were only doing their job and what they felt was best for my baby. I in no way believe they are bad doctors or people, but this check was very deep and extremely painful, they did not wait to check me between contractions as my midwife had, and they did not stop when I asked them to. It took me awhile to reconcile this part of my birth experience and not allow it to overshadow how wonderful the rest of it was.

After this excruciating check, they confirmed baby’s positioning was good after all, he was not too big for me to deliver naturally and safely, and I could continue pushing. Thank goodness! I think maybe it was the fear of another check like that or a forceps delivery that motivated me to push even harder than I had before, because just a few pushes later with Jarrod right by my side and the entire room cheering us on, Arthur Avery was born at 3:46 pm. He weighed 8 lbs 1 oz and was 21 inches long. That moment when they placed him on my belly was pure joy. He was so squishy and warm and so perfect. I kept saying, “You worked so hard, baby. I’m so proud of you.” One of the nurses heard me and said, “YOU worked so hard, mama! Good job!” I know these doctors, nurses, and midwives do this everyday, but they sure did a great job making me feel special that day.

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Newborn baby

I delivered the placenta shortly thereafter, Jarrod got to cut the cord and had skin to skin time with Art while the OBs worked on me. I had a 3rd degree tear, so it took a little while. I opted not to go to the OR for the repair because I didn’t want to be separated from my new little family and thought if I’d avoided an epidural so far, why get one now. Merrill and Robin stayed with me throughout the surgery, holding my hands and keeping me distracted.

I didn’t pay attention to what song on my playlist was playing when Art was actually born, but at one point during my surgery, I looked over to Jarrod holding our son, and John Mark McMillan’s How He Loves was on. I started to laugh and cry all at once, and Merrill asked what was so funny. I just said, “This song. He really does love us!” One of the OBs commented that he loves this song too, and the mood in the room was so light, so full of joy and light and love. I know there was a lot of oxytocin floating around in the room that day, but I truly believe the Holy Spirit was with us, anointing us with peace during the labor and joy at Art’s birth. I’ve never felt the veil between Heaven and Earth so thin before. I’ve never felt more brave, more strong, more alive, more confident and beautiful than I did that day. It was an amazing experience that has forever changed me. Every laboring woman deserves this type of birth experience.

I’m so thankful my body responded so well to the induction methods used. Although we wanted to avoid as many interventions and medications as possible, I’m thankful for modern medicine and made my peace with the decision to induce when we did. When I look back on it all, I only really remember the good stuff. I remember certain songs on my playlist, the aromatherapy Merrill had going in her diffuser, the encouraging words spoken over me, and the love. I am so incredibly thankful for my birth team and all of our friends and family praying over us that day. We felt their prayers with us, and I know I would not have had the same experience without them.

Woman baby and husband
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