Liam Patrick Riehm
7 lbs. 12 oz. / 18.75 inches
As my due date approached, finally came, and the days following it started ticking… two, three, four, five… I started prepping myself for labor. Not the physical effort itself, but the emotional impact it would have on me if things did not go as planned.
What would I do if I needed to have an emergency cesarean, for example? Would I still see Liam’s birth as a fulfilling one? How would I feel if it affected everything else I had in mind, like immediate skin to skin after delivery and breastfeeding? What would I do if my body needed the extra help (aka drugs) to progress from early to active labor? Would I be okay with that?
My water broke (well, trickled) at 9 A.M. on Thursday morning, two hours before my scheduled ultrasound appointment. My husband, Joe, and I decided to stop at the hospital to check if it was really amniotic fluid.
The nurses at Phelps Memorial Hospital confirmed that it was.
Later that day, I felt my first real contractions, about 5-7 minutes apart and mild. As a first time mom, I wondered how intense they would get (I was handling them really well, I thought, at the time.) I called my midwife and let her know that they hadn’t stopped and were slowly building in intensity. She asked that I eat dinner at home and meet her at the hospital that night around 9 P.M.
My mom, Joe, and I packed our hospital bags in the car and went right away.
When Robin, my midwife, came in, checked me, and told me the plan, I wasn’t thrilled. First, she said that the contractions I’d been having all day weren’t “true” labor contractions. They were close together but not intense enough. She recommended that we use a gel called Cervidil to soften my cervix overnight at the hospital. We would check me the following morning and decide what the plan would be if things didn’t progress. This would mean breaking the rest of my water and starting me on a light Pitocin drip.
Surprisingly, Joe was the one with the doubts. “Two weeks ago, you would never have agreed to do this,” he told me, when she left the room. “Are you sure you’re okay with it?”
He was right, but deep down, I trusted Robin’s advice. She knew how I felt about unnecessary interventions, but also knew, with her experience, how long I could potentially be in labor without the extra help.
Early the next morning, Robin said the Cervidil had done its job: my cervix had softened and the baby’s head was a lot lower in my pelvis. The intense contractions I’d had the whole night, though, still weren’t strong enough to move things along. This surprised me because the pain I’d experienced all night was definitely real — I couldn’t lie down for more than a minute and spent the night in a rocking chair, breathing through the contractions, watching them on the monitor. My mom and Joe slept for a few hours on their two small cots beside me.
Robin said that if it was okay with me, she would break the rest of my water and start me on a Pitocin drip. I had chills as I agreed, wondering if it was a big mistake. After all the research I’d done on inductions, I knew there was a greater likelihood of a domino effect eventually leading to a cesarean birth. Robin reassured me and said they would only use a small amount of Pitocin to trigger my own body’s contractions. They would then stop it when I reached 4 cm and let me labor in the tub naturally. I became nervous about how intense the pain would become after that. I was already very uncomfortable.
My mother reassured me as soon as Robin left the room: this was exactly the same thing she’d gone through for my birth. The Pitocin had helped her enormously and I was born quickly and above all, healthy.
Before the Pitocin even kicked in, the contractions became longer, more intense. I started getting very focused, unable to sit still. I focused on my breathing and luckily, had a wide array of positions to choose from thanks to Robin. She had me lean on Joe’s arms, letting go of my lower body, which helped a lot. She laid down pillows on the raised hospital bed and had me rock my hips back and forth. When I told her, in between contractions, that the pain was getting intense, she checked me.
Sure enough, I was at 4-5 cm and ready to hop in the tub.
The relief I felt in the warm water was immediate: my body loosened and relaxed as the water enveloped me. At this point, I had to focus all of my energy on my breaths: long intakes of air and strong exhales. Joe held my hand as I entered the most difficult stage of labor: transition.
Although the tub was a lot better than being on solid ground at this point, the contractions I felt were beyond anything I had ever experienced. My body caved and arched itself as I tried desperately to breathe through them as I had done for the past seven or eight hours. Exhausted from the night before, I took 30 second naps in between each contraction. When they started again, I tried to let go of everything and breathe, tell myself that with each contraction there was a build up, a peak, and then a decline, but the pain became more and more difficult to control.
During my final contraction, I said I couldn’t do it. Funny that I uttered those words out loud because I had a strong feeling we were nearing the end.
The echo of voices — Robin, my mom, and Joe — all reassured me.
“You’re doing amazing.”
“Yes you can. You are so strong.”
“ You are so close now. This is it.”
Seconds after that, I felt the overpowering urge to push and sure enough, I let out a strong groan as my belly dropped. Joe couldn’t help shouting in unison with me.
This was it — the final stretch.
Robin checked me immediately. She looked me in the eye, a grin spreading across her face.
“You’re done,” she said, smiling.
I got out of the tub, she dried me off, and I made my way back to the hospital bed for the final stage of labor.
Pushing was almost a relief. After such intense contractions, I enjoyed the way my body took over and almost did the work for me. I pushed with every last bit of grit and energy I had in me. I felt Liam’s head pressing down on my first push but when the contraction went away, Robin told me to stop pushing, breathe, and let her know when the next one came. Two, three, four pushes, the head was out.
Robin gave Joe a pair of gloves and told him to help her with the birth. With tears in his eyes, he told me he could see his dark brown hair.
The “pain” wasn’t anything close to what I had experienced during transition. I didn’t feel delusional and out of control, but powerful and empowered. A warrior. The most difficult part was behind me and I was about to cross the finish line. No episiotomy, only Robin’s expert hands and arnica oil to do the job.
During the fifth and final push, I felt everything drop and the rest of Liam’s body followed. I stared in amazement at our son, our creation, right there between my thighs. He cried immediately and even urinated on Robin (which is apparently good luck!)
The rest is a blur: the few first degree stitches, the placenta, the blood… I had my son in my arms. My beautiful baby boy. All I remember is Robin telling me what an amazing job I had done.
“You do good work, Mama,” she said. “That was incredible.”
In the background, I heard Joe ask her about the blood. “Is that the normal amount?”
She told him it was a little more than expected but I didn’t care, my nose buried in Liam’s hair, his little warm body against mine.
Later, Robin told me that Liam had started his descent in a posterior position. I hadn’t felt any contractions in my back, luckily, but Robin explained that it was probably why I was stuck at 4 cm for what felt like so long.
When the room was cleaned up, Robin left us in the room to bond with our son, who latched on to my right breast right away: the most incredible feeling in the world. I had been blessed with a natural, vaginal birth with no epidural, episiotomy, and/or unnecessary interventions. Pitocin took me from 2 cm to pushing in less than three hours. My son and I were both alert and ready to breastfeed and it showed instantly. Everything was as perfect as could be. An hour later, I was out of bed, feeling like myself again. I felt this high, this adrenaline, for the next 72 hours: no exhaustion and not even the slightest amount of pain.
Bottom line is this: Over and over again, I was told to be open minded about birth. I had a plan in my mind and despite worrying about the way things would go (the baby’s position, my fear of a cesarean birth, the worry that I wouldn’t have a say in my birth), I always had faith in my body and ability to labor naturally. The fact that my water broke early was beyond my control but I am 100% happy with the choices I made: Switching from an OB/GYN to a midwifery practice at 32 weeks of pregnancy and a gentle induction of labor to get things going.
I got the midwife-assisted, vaginal, epidural-free birth I wanted. I didn’t need an episiotomy. It was a personal journey I had to take on my own and I’ve never been more proud of myself for anything I’ve ever done. No one could take the pain of labor away from me, but I did it anyway, and I did it well. I can truly say that I fully experienced childbirth in all of its intensity and power. What a victory.
I did it all for you, Liam, and will forever consider myself the luckiest woman in the world. Now on to the next chapter in my life… as your mom.