Mona's Story: A hospital transfer gone right

Mona's Story
July 18, 2007
Submitted by Jillian


My water broke the first night. It was unmistakeable; I had been sitting on the couch and when I stood up, the collected fluid spilled out of me, soaking through my underwear and dripping down my leg. This was not pee. It was a week and a half before my due date, my baby hadn't even dropped into my pelvis, and we were not prepared. As a first-time mom and the daughter of a woman who had always had long pregnancies, I had expected to go another 3 weeks or so. We had the basics, though, and it was clear that the basics would have to be enough.

That night and the following day, I tried to prepare myself. Despite all the tricks, pre-labor refused to advance to active labor. I ate and drank, walked and rested, and waited. That evening we met the midwife at her office. We were closing in on 24 hours with ruptured membranes, and one way or another, labor would have to start soon.

The three of us (the midwife, my husband, and I) decided to try a catheter trick. Foley catheters are usually used to empty bladders, but my midwife would insert one with the tip just inside my cervix, and inflate it with a little bubble of saline to put pressure on my cervix and stimulate labor. It was an easy procedure, and we went home afterwards to wait -- and returned to the birth center within 2 hours, in active labor. What we didn't know at the time was that my daughter was in the occiput posterior (OP) position, with her back along my back, instead of the easier anterior position with the baby facing backwards. My cervix was straining against the top of her head instead of the pointier crown, and despite a night and a day of good active labor, I could not dilate the way I needed to.

My husband would later describe this as the worst day of his life. I couldn't eat or drink (although I would sip juice and later throw it up). I was having double and triple contractions without breaks in between, hard back labor. I would spend hours standing and leaning against a wall, with someone behind me to rub my back during contractions, and it felt like minutes. My midwife did painful cervical massage a few times to encourage dilation, but eventually that was only causing swelling and irritation. I was getting IV antibiotics every few hours, but still, as we neared 48 hours with ruptured membranes, I knew that the baby was going to have to come out. What we were doing was not going to meet that deadline. If I was going to transfer to the hospital, I would need to do it while I still had time to have a vaginal birth.

My body had given me a break of a few minutes without contractions to have this discussion with my husband and midwife. In fact, it was the first and only break I got. Once the decision was made to transfer, labor started again, and I contracted while dressing, in the car, in the waiting room at the hospital, while changing into a gown, trying to talk to the nurse, getting into the bed. I was sure the whole hospital heard my labor roars. (I credit my classical voice training for giving me the skills to roar like that for 24 hours straight without losing my voice!) I gratefully accepted a shot of Fentanyl while I settled and, a bit later, an epidural and a small Pitocin drip. I knew that these interventions could raise the risk of a surgical birth, but I also knew that I had very little time to start making progress before the hospital would insist I have surgery, and I needed to do whatever I could to make that progress.

I was lucky to get a nurse who was an advocate of midwives and vaginal birth. She pushed and pressured and bent the rules for me to have a chance to labor, and it worked. I started dilating immediately, and within 2 hours of my transfer, I was ready to push. Forty-eight hours after my water had broken, Mona emerged, utterly perfect. Her heart rate had been rock-solid through the whole labor, and her lips were cranberry pink when I first saw her.

I had wanted to avoid giving birth in the hospital, but I was lucky to have such a good hospital to give birth in. The hospitalist that delivered Mona allowed me to lie partly on my left side while I labored, and he even let my midwife (who had stayed with us in an unofficial capacity) show him how to delay clamping the umbilical cord until it had stopped pulsing. The nurses encouraged me to bedshare and breastfeed, and Mona was barely out of our arms for the 24 hours that we stayed. I had an easy physical recovery, too, with no tearing or rawness. I do sometimes wonder if the chronic headaches I've suffered since my daughter was born might be related to the epidural, but that's unlikely, and in any case the epidural couldn't be avoided. All in all, I'm happy with my birth story. It's a good memory, and there's nothing I regret about it.