Nothing As Planned: The Birth of Mihka Elisha 9/10/21

We love it when parents share their birth stories with us on our Birth Blog. Today's birth story is shared by first time mom, Bianca, supported by Mindful Birth Doula Christa. Join us in hearing her story and welcoming the arrival of baby Mihka.

“We can make our plans, but the LORD determines our steps.” Proverbs 16:9

"When I first learned that I was pregnant, I felt overwhelmed by my lack of knowledge about all things childbirth and parenting. My response was to learn as much as I could in the next nine months to prepare. As someone with a background in science and surrounded by a community pro-natural birth, I was drawn to resources like Natural Hospital Birth, Spinning Babies and Hypnobirthing. Everything I read encouraged hiring a doula, so I was so relieved when I met Tara, who shared further resources like Evidence Based Birth with me and helped me keep on track with my learning goals and birth plan.

Listening to birth stories became a favorite way to prepare. In story after story, I noticed that something unexpected always happened. Nevertheless, I was confident I would achieve my ideal labor experience. I was healthy and low risk, so why not? My only risk factor was being GBS positive, which meant antibiotics, no big deal. I imagined a textbook natural birth; my water wouldn’t break immediately, my baby would be in the right position (anterior), I would labor patiently as long as I could at home, and when I got to the hospital my doula and I would use combination of coping techniques like movement, hot water and hypnobirthing principles to have the ideal unmedicated, natural birth. By month 9 I felt confident and eager for baby to arrive, and I emailed my birth preferences to my midwives.

Of course, that idyllic vision of what my labor is not what happened. The following is an account of the 32 hour labor that defied my expectations at nearly every turn.

My mother arrived to stay with us on Wednesday September 8th. That evening around midnight, I woke up to a pulsing rush of water. Trying not to panic, I texted Tara and called the midwife group, and then remained in bed trying to rest. The midwife group told me I should go to the hospital within 6 hours, but I wanted to try to labor at home. Contractions began while in bed and I noticed they were not the cramping kind or even really in my abdomen, but instead gently radiating through my back. I stayed calm, practicing my breathing, and waited until morning to let my husband and mother know things had started. We ate breakfast and packed the car. During this prep time, all contractions had stopped. I called the midwife group and was scolded for not arriving within 6 hours of my water breaking, contractions or no, so I let Tara know I was headed to the hospital.

Last minute, through no fault of her own, Tara had a family emergency and let me know I would be receiving a backup doula. I received this news with surprising calm, and within minutes Christa, her replacement, had texted me and would meet us at the hospital.

I arrived at the hospital around 9am, where I entered triage alone due to Covid restrictions. The triage nurse was friendly but the exam was incredibly uncomfortable, and revealed that I was only 1cm dilated. Baby was posterior, which explained why I felt contractions in my back.

Once in the labor and delivery room, I met my labor nurse, Tamara, who would be a kind support person throughout my time at the hospital.

My husband and Christa soon joined me. Meeting her for the first time, I found that Christa was cheerful, compassionate and easygoing and I was grateful to have her there. Over the course of the stay, Christa truly was an advocate and supporter. She consistently talked with me about my decisions and options and also shared her own story with me, which allowed me to be compassionate with myself as my labor journey unfolded in unexpected directions.

Christa and I got to work right away. I was hooked up to an IV for fluids and antibiotics and on the bluetooth monitor, and my contractions weren’t yet regular. As soon as baby’s baseline was established, we began with movement and natural stimulation techniques.

Within minutes, the midwife on duty came in with a midwife in training and informed me that they would like to start augmenting my labor. This was not what I wanted, so after asking questions to compare my options, I requested more time to get labor started naturally.

For the next few hours, Christa guided me in different positions and movement while trying to stimulate contractions and employing coping techniques like light touch massage. I really enjoyed her support and company, and it was fun to use techniques I had been reading about and practicing. Nurse Tamara observed us and invited another nurse who was versed in Spinning Babies to come help us through some positions. I was still feeling enthusiastic and energetic.

My contractions came regularly but never increased in frequency, remaining about 6-7 minutes apart. Near the end of the shift, the midwife came in again, this time more insistent about augmenting my labor. They did an examination and I was still at 1cm dilation.

At this point, the midwife stressed again that because my water had broken there was a risk of infection and the hospital wanted me to get induced to reduce risk to the baby and myself. They had already allowed me lots of time past their recommended 6 hour timeline. At Christa’s prompting I did ask if they would put me on the clock for a C-section (which is sometimes 24 hours after water breaking), but to my relief the midwife said that was not the case.

It was now the end of the day and I was tired and discouraged by my body’s lack of progress and worried about causing complications. After asking more questions, I agreed to start on pitocin. I did get to take a shower before the pitocin was started, as using hot water was one miraculous coping mechanism I had heard about in my preparation, and it did feel really good.

Now 7pm, the shift changed and I was started on Pitocin. Before leaving, Nurse Tamara promised to get assigned to me if I was still there in the morning. Even though the pitocin started on the lowest level (2), I soon began to feel my back labor with more intensity. I was still up and about trying to use movement and breathing (while attached to the IV) and Christa and my husband were using counter-pressure to help me through the worsening sensations. However, every half an hour the new nurse came in to increase the pitocin. Soon after being at level 4 I realized the pain was no longer manageable.

I decided to ask for nitrous oxide, or laughing gas. This helped initially, but then in half an hour the pitocin was turned up to 6 and I was loopy on the nitrous but experiencing worse pain than before. With more and more difficulty I tried to breathe through the back labor while clinging to my husband while Christa applied counter pressure, switching from breathing techniques to praying the Lord’s Prayer in desperation. I was also starting to feel the need to push (and a couple of times I let out some truly terrifying sounding howls), which scared me because I was nowhere enough dilated, and had learned that pushing early can lead to a swollen cervix which could necessitate a C-section.

I had called the nurse and let them know I felt like pushing, to which the response was “just breathe through it”, and when I tried to describe the pain I was told, both by the new nurse and midwife, “it’s going to hurt.” I don’t know if this was the standard response but it was one of the things that I would later mourn as a severe lack of compassion.

By the time the nurse came in to increase pitocin from 6 to 8, I begged her to stop. I felt like I was breaking in two. I asked to talk to the midwife on call about other pain management options, and agreed to get an epidural, but not before throwing up from the nitrous just as the midwife entered the room. They examined me and I was only at 3cm dilation. Fortunately the epidural was delivered relatively quickly after watching a 10 minute video on its risks. I had to sit through a contraction while the epidural was inserted but fortunately the relief was quick in coming.

After that everything calmed down. I couldn’t feel my contractions and I didn’t need to push anymore. I became sleepy immediately and could no longer feel my lower half except for tingling in my legs. This made the process of a catheter being inserted and every examination to follow painless. It was now very late at night and I was allowed to sleep, which meant both Christa and my husband could rest as well. Christa went above and beyond, not knowing how long it would take me to progress, and stayed with me overnight.

In the morning, after getting some sleep, I was examined again and told I was now at 9.5cm dilation. I sent an update to my friends to ask for prayer, excited to begin pushing soon. They left me for a while longer for that last .5cm. In “Labor Land” time passes quickly even though it was probably a long time for everyone else. I was soon woken up for another examination after another shift change at 7am on Friday and told that I was at 10cm by Cristal, the midwife on call. She asked if I’d like to try pushing, also giving me an out, “You probably don’t feel like pushing yet”, but I jumped at the chance.

After pushing for a brief time, it was noted I was a bit swollen and baby was still OP. The midwife left, saying we would continue after a while. Nurse Tamara had come back, and soon she, the midwife in training, and some other nurses came in to help me push. We tried different positions briefly, like side lying. My epidural was still effective but I could wriggle my toes and the midwife in training asked if I could get on my hands and knees, and I complied. For the next hour (although it felt shorter in Labor Land), she had me lean on a peanut ball and used the “Shake the Apple Tree” Spinning Babies technique with a rebozo cloth.

I was then directed to try pushing again. With all the whole team still there, and Christa at my side, they began coaching me to push. Finally, I began to progress. As baby crowned, Cristal the midwife joined us to deliver the baby. She later noted that the baby had turned from OP during pushing to a more favorable anterior position. I believe the midwife in training's efforts really helped that happen. I was told that I pushed for 5 hours total, although for me it felt like 1, tops. I was so happy to make progress and that baby was almost there. The epidural, which by then was praised by everyone in the room as “A really good epidural” spared me from feeling anything other than pressure the entire time. Finally the last pushes were upon me, and my son was born. I couldn’t see from where I was but he had his cord wrapped around his head, which the midwife skillfully removed as he entered the world. He was born Friday September 10th at 9:22am.

The midwife called my husband over to quickly cut the cord. My son was placed on my chest but was in shock. I heard the call for baby nurses. He wasn’t crying but he was moving and I reached out to touch him, one hand amongst the many cleansing and prodding him. Within seconds he was taken to the corner of the room and thoroughly suctioned and cleaned by a team of nurses. For about five minutes I waited quietly and helplessly as I trusted God and the medical staff with my baby, Christa holding my hand the whole time. His cries became clearer and more frequent and after an endless wait he was brought back to me to be placed on my chest again, skin to skin. Finally, my baby was here, safe and sound.

While processing my experience, which included its share of trauma, I have also noted with humor that almost every “preference” listed on my birth plan was not met. And yet, I am grateful that the most important goals were; my son was born strong and healthy, scoring a 9 on the Apgar at 5 minutes, and I was able to avoid a C-section against the odds of having a nearly 33 hour labor after my water broke.

I am grateful for the wonderful companionship of Christa, who performed thousands of small and large acts of service and encouragement through an intensely long shift for her. I am grateful for the compassion of the nurse Tamara, who attended me for two shifts and was the one who gently helped me use the bathroom for the first time after delivery. I am grateful for the midwife in training, who I later learned rallied to help me push after learning I might be scheduled for a C-section. I am also grateful for the skillful hands of the delivering midwife, Cristal, who ensured my son’s safe arrival, as I am for the nurses who cleared his lungs and helped him transition to post-womb life. Though mentioned very little in this story, I am also grateful for my husband, who stayed by my side and assisted Christa when he could, and also recorded the birthing process and even played some ukulele during labor and postpartum. And finally, I’m so thankful for Tara’s gentle guidance throughout as my pregnancy progressed.”

-Authored by Bianca Basch, mother of baby Mihka Elisha