Like most parents say, prepare for birth to not go according to plan. 

At our 36-week growth ultrasound, they measured our baby to be small for his gestational age. His body was under the 4 percentile of average babies’ size. This was something to take action on and we were informed that a labor induction will occur by 38 weeks, so two weeks later —this means prompting the uterus to start labor early rather than waiting for it to begin on its own naturally. I was pretty surprised, upset, and worried to hear this news. I wasn’t ready to give birth in two weeks! I wanted more time off to prepare and was nervous that something is wrong with my baby. I also knew inductions can be quite intense. I had a flood of emotions.

The following week (now at 37 weeks), we were seen by a maternal specialist to verify the measurements and assess the blood flow from the placenta to our baby. He did remark blood flow concerns but informed us that an induction at 38 weeks was “probably okay”. We left the appointment disappointed that the small measurements were accurate and started to mentally prepare for an induction next week. 

Friday, February 17, 2023

The next morning, Chi gets a phone call from a doctor to induce me tonight! He was shocked and then called me right away with the news. I was equally shocked, confused, and terrified. Turns out the specialist made notes to induce between 37 weeks to 37 weeks & 6 days, despite verbally saying 38 weeks is fine. After a few clarification phone calls and discussion, the conclusion was to induce me ASAP based on medical guidelines. They rather have the baby out in a controlled environment instead of my womb, which could have a failing placenta and stress the baby. Of course, I didn’t want to risk my baby’s health, so eventually agreed to the induction despite the inconvenience. 

We did, however, advocate pushing the induction back one more day just to have a good night’s rest, finish all the prep we needed to do, and mentally take this sudden news in. I was so glad we did that.

Saturday, February 18, 2023

We had one final day with just us and finished most of everything we needed to do before coming home with a baby. That night at 6pm, we received the hospital call to come in for the induction after 8:30pm. We loaded our bags and drove to the hospital. 

After checking in, I started the first phase of the labor induction, cervix ripening. A resident doctor checked my cervix… it wasn’t painful but a nurse had to redo it deeper and verify, which was more painful. I started 1 cm dilated, 50% effaced, and +1 positive head position. I was surprised and glad for the head start towards 10cm dilation and 80% effaced —the goal that means we can start pushing. I took the first misoprostol pill around midnight and the plan was to continue every 4 hours until my cervix was “ripe” enough for Pitocin, the medication to jump-start contractions. 

Baby and my contractions were continuously monitored with wired detectors on my tummy. The hospital bed was not comfortable and made noises all night. It was hard to sleep even with a Benadryl. I probably had 1-3 hours of disrupted sleep but didn’t feel any contractions or pain. At 4am, I took my second misoprostol pill. They detected fetal stress “decelerations” a few times and made me sleep in better positions to keep my baby happy.

Sunday, February 19, 2023

At 8am in the morning, they were considering starting Pitocin instead of another pill because they were nervous about fetal stress being detected overnight. But it also sounded like my sleeping position could be the cause for the stress (i.e. I was sleeping on the umbilical cord). My cervix was checked again and after two pills, my cervix barely changed —1.5cm dilated and 55-60% effaced. I slowly started to feel faint and sporadic contractions —nothing too uncomfortable. 

My doula told me to advocate for more “miso” pills if possible because starting Pitocin when you’re not fully effaced can lead to c-sections. Because of the decelerations/stress, I was upgraded to the large birthing suite and wireless continuous monitoring! This was a blessing in disguise and the doctor gave me the good news that I could keep taking miso pills while closely monitoring if our baby responds okay, which he thankfully did!

At 10am, I took my 3rd pill. Chi and I were just hanging out and even playing some computer games throughout the day. 

At 3pm, my cervix was checked again and barely changed: 2cm dilated, 60% effaced, still in the same position. I was discouraged and this check was performed by the day shift doctor so I wonder if it was just a different opinion of progress. I took the fourth miso pill and started to worry about what would be next since I was approaching the maximum of 6 pills in 24 hours soon…

At 6pm, I started to feel regular pattern contractions about 30 seconds each, 7 mins apart. This was a good sign even though it was starting to get uncomfortable. I could still easily talk and function with these contractions. 

At 7pm, it was time for the fifth miso pill. The same morning doctor asked me if I wanted another cervix check and I volunteered “Yes” because I wanted consistency with the doctor whose checking. I was hoping for more progress since contractions were starting but I was disappointed to hear that I did not change at all —still 2cm dilated and 60% effaced. The doctor did say it was a good sign that I was getting regular contractions because this means dilation will progress. 

I took the fifth pill and suddenly, everything was picking up at full speed. Contractions were getting more noticeable but still manageable enough to eat a large dinner and take a shower in case things got more intense overnight. 

These contractions felt like period cramps but usually only lasted for 30 secs. After that, you feel completely normal and comfortable again but for that 30 seconds, you worry if you can do this. You doubt yourself and feel pretty miserable. You need to pause and focus on relaxing and breathing out the pain like you learned in the birthing classes —Inhale for 3 secs, Exhale for 6 secs through your mouth. It got harder as the breaks get shorter and it just feels like non-stop waves of intense cramps. 

By 9:30pm, my contractions were hard to ignore and my night nurse was massaging me to get the baby in the right position. He was anterior at the last ultrasound (i.e facing outwards rather than my spine “sunny side”). Our nurse was jiggling my hips, then side-lying me, and also positioned a peanut ball between my legs. It was a nice massage but my contractions were getting more painful. At this time, my breath out was a deep groan —I sounded pretty miserable. I was already thinking about how I won’t be able to sleep through this and how long I could last. I swear the contractions felt like every 3-4 minutes now. 

Around 10:30pm, while lying on my side with the peanut ball between my legs, one of my contractions had a huge dropping / popping feeling. It was painful and I thought it was my baby’s head “dropping lower” but as soon after I felt liquid, I knew my water broke. I yelled to my husband sleeping next to me to call the nurse. I started to shake and shiver like crazy. The wetness underneath was uncomfortable. 

I knew that once your water breaks, the contractions pain worsens. I was already worried about how much worst can it get and how I can’t do this for hours at this current pain level. The thought of epidural relief started to be very appealing but I kept wondering how far dilated I am. I was open to the epidural but liked some of the benefits of natural birth (like moving around during labor). 

It was close to 11pm and both my husband and I were expecting another 12-24 hours of labor before pushing. My husband asked me if I wanted my doula. I debated if it was too early but told him yes because I knew it would take her an hour to arrive.

At 11:30pm, contractions were getting worse and more frequent. The night doctor was checking in and ready for a cervix check as per my pill schedule. I did not want this check because the contractions were tough as is without someone reaching inside. My nurse kept asking me if I wanted the epidural before the cervix check but I wasn’t sure yet. My husband said I didn’t say the code word yet even though I kept mumbling “epidural… should I get it?” 

My exhale breaths were now a loud groan/scream. I remember I kept saying “I need to take a shit! I never went poop this morning” but my nurse told me not to push because that pressure is the baby’s head.

From this point on, things became a blur and I was focusing on each contraction that felt like every 1-2 minutes apart. I tried different positions for relief like standing and bent over, sitting on a birth ball, and side-lying down on the bed. My husband was coaching my breath and added pressure to my lower back. Nothing helped or reduce the pain.

So many things running through my mind like how much longer can I continue this. 

“I was only 2 cm dilated at the last check…”
“…I might be 4-5cm dilated? Maybe 6cm if I’m lucky or 3cm if I’m not”
“If I can’t even last for a cervix check, how can I last for the rest of labor and the pushing?”
“Even when the doula arrives and helps, it won’t be the same relief as the epidural.”

I was weighing the pros and cons of getting the epidural now in my head… Each contraction led me to want the epidural relief but the break between led me to believe that maybe I could do this unmedicated for the next contraction. The breaks got shorter and shorter. I felt they were almost 1 minute apart and I was trying to process in my mind what stage of labor I was in… “Is this active or transition labor?” “I was just 2cm dilated at 7pm… this is can’t be the final labor stage… could it?”. 

I debated between getting the cervix check to determine how far dilated I was, which would help me determine if I should get the epidural. On the other hand, I felt like giving in to the odds that I’m far from 10 cm dilation and should get the relief now without suffering through the cervix check. 

All odds pointed to “get the relief” so I caved for the epidural. I wasn’t strongly inclined to natural birth in the first place and the epidural was knocking at my door… literally, the anesthesiologist was knocking at the door. Odds were I was just starting active labor and had hours to go so I might as well get the epidural now while I could keep still between the contractions, then go to sleep and have the baby the next morning. Hah, I’m still a planner during labor.

Chi was motivating me to wait until the doula came (another 30 mins) but it was getting harder and harder to wait. The anesthesiologist was setting up and ready to go and I honestly wanted relief. I said our code word “tequila” three times for the epidural and I couldn’t wait for the doula anymore.

It was now close to midnight. I stayed still for the epidural. I lean forward looking at my husband and he helped me visualize the day after our wedding. The epidural was painless and slowly started to work. Contractions felt like they were ramping down instead of up. My doula arrived and shortly after I did the cervix check. I heard the resident doctor say I was 9cm dilated! I thought I heard wrong… (this is the same doctor who first did my check and had to get a nurse to verify). The nurse checked again, confirmed 9cm, and called the delivery doctor. 

The doctor arrived 5-10 minutes after and checked my cervix. She said I was now 10cm dilated and ready to push!!! It was go time and I felt relieved as the toughest part was complete. Both Chi and I couldn’t believe it. 

I felt some pressure and contractions but when it came time to push, I lost all feeling below the waist. The epidural was now fully in effect. I couldn’t feel myself pushing but the nurse and doctors paced my pushes to my contractions. Chi was holding my hand by my side encouraging me to push like it was the biggest poop of my life. I tried and wasn’t sure if it was working. After the first three pushes at the first contraction, I was asked if they can monitor the baby via a tiny detector on his head. I asked if there are any risks or long-term issues and then agreed because it allowed them to better monitor his wellbeing.

At the end of three more pushes during the second contraction, the doctor informed me that they wanted to do an assisted delivery using a vacuum or forceps (like metal tongs). The other option is an emergency c-section. I was woozy but not in any pain so was able to make pretty conscious decisions. I read the difference in assisted delivery procedures but couldn’t remember how the risks compared. I asked about the risks between the two options and consulted my husband and doula. I wanted the forceps instead of the vacuum. The vacuum had more risks to the baby’s head (eg. cone shape) but the forceps risked 3rd or 4th-degree tears to my perineum. While my husband wanted the vacuum, I rather risk damage to myself than our newborn’s head.  

Pretty glad I had no feeling down there while this was happening but I was getting nervous about my progress. No one was really telling me how far out my baby was and I didn’t want a c-section. With the forceps and the “spoon doctor”, I was told to push three times at my third contraction. I pushed as hard as I could without any feeling. Suddenly, I was handed my crying son for skin-to-skin and breastfeeding. I cried and my husband cried —labor was just about done and our son is with us.

Chi reluctantly cut his umbilical cord. I didn’t notice the birth of my placenta and then I was stitched up with a very common 2nd-degree tear. It was over… labor was done. It was tough as expected but like other moms, I survived.

So with three total contractions and three pushes each, my baby boy, Maxwell was born on Feb 20 2023 at 2:07am. He was a small baby for his gestational age just under 5lbs. It must have been less than an hour of pushing and we were thankful for very fast labor —a total of 8 hours, pattern contractions starting at 6pm to his birth at 2am. I was happy with all the decisions I made including the epidural. Labor is now just a blur as I graduate into the newborn care stage… Man, what did we get ourselves into?