In the days leading up to Natalie’s birth, I wondered constantly how I’d know when I went into labor. I’d catch myself doing labor-prep things like nesting and fussing and cooking things in the Crock-Pot, but not consistently. Despite weeks on high alert, I had yet to observe a single palpable contraction, Braxton, Hicks, or otherwise. People with relevant experience told me, not without a trace of smugness, that oh, when it happens to you, you’ll know. But I was never completely sure that I was in actual active labor, until I nearly collapsed at the admitting desk to the GW maternity ward and could deny it no longer.
This time I thought I’d know what to look for, but still had no idea what to expect. Because this pregnancy was so unlike my first, it wasn’t surprising that the signs I’d already picked up on were different. I’d been feeling painless squeezy Braxton-Hicks contractions for weeks. I’d had next to no nesting urges whatsoever. The ingredients for a Crock-Pot chicken stew had been languishing in the fridge for so long, I’d had to shunt them into the freezer, lest they spoil before I got around to making the recipe. Every day I had to dig deeper for the energy to do such trivial self-care things as color my hair, get a pedicure, or even take a shower. (My ponderous bulk barely fit in our tiny unremodeled water-closet shower stall.) The textbook signs of incipient labor, at least as I recalled them from the last time I’d gone through it, were more or less absent.
Until Sunday, December 23, when at 39 weeks 3 days I noticed something in my underwear. Not blood exactly, but something rather like it. And come to think, I had noticed strange twinges in my lower back along with the last few contractions I’d felt.
“So,” I said to & and my mother, “I think I may be passing plug.”
Two pairs of eyebrows raised.
“But,” I continued, “I’ve had exactly two Real Contractions all afternoon, and those were three hours apart.”
“Plus, look how high she still is,” I added, turning to stand in profile and cupping my hands under my bump, the better to show the distance from there to the pelvic floor.
We all agreed that I was not likely to have the baby that day. And sure enough, I didn’t.
But the next day, Monday, December 24, at 39 weeks 4 days, there was more bloody show (reddish) and then, some hours later, yet more (brownish). The baby was visibly lower than yesterday. And the contractions were definitely getting more Real. Each increasingly frequent squeeze now felt vaguely menstrual-crampy, and was accompanied each time by an unmistakable greeting from my lower back. When we clocked four of these within an hour during Christmas Eve dinner, I wondered if labor could be far off. Or if this was labor already.
No, no, I thought. I remember labor. It is hard and strong and above all FAST. I never had four contractions in an hour; I went from zero to sixty almost instantaneously. These odd contractions must be prodromal labor, something I must have experienced with Natalie but somehow never felt. This was simply my body preparing for labor. Actual labor could still be days away.
I wasn’t really bleeding, anyway. Was I? With Natalie I remembered spotting actual blood, not something that resembled the contents of a kleenex after I blew my nose (which, thanks to the dogged remnants of the Worst Cold Of All Time, I am still doing entirely too often). And I wasn’t nesting. I had no urge to clean out the fridge. I’d halfheartedly assembled a French toast casserole to throw in the oven on Christmas morning, but could summon no desire to set up the Crock-Pot or bake anything or even boil water for tea.
It was Christmas Eve. & was busy filling Natalie’s Christmas stocking with goodies from Santa, and I was useless. Why couldn’t I nest, even if I wanted to? It was all I could do to pull together even the simplest to-do list in my head. In case I do go into labor tomorrow, I need to refill the cat food dispenser. And pay the mortgage and the Visa bill. Okay, that at least I could do. The bank had recently muffed up the automatic payment settings on our mortgage, so I needed to send them a check for January. I’d been meaning to go into my closet and dig out the appropriate checkbook ever since the bank error became clear. There, I told myself, I’ll do this one thing and feel better. Then I’ll fill the cat’s dish and feel better yet. Okay, good, there was the checkbook…
…out of checks.
I lost it. I flung the empty checkbook and the bill stubs onto the hall table, threw up my hands, and started to stutter in exasperation, “I — I just — I just don’t know what to do.”
My amazing husband appeared at my side within seconds. “Tomorrow is Christmas,” he said, calmly, in his talk-you-down-off-the-ledge voice. “There’s no mail pickup anyway. I’ll go to the bank on Wednesday and get us some more checks. You’ve got plenty of time left to pay those bills anyway. You don’t have to worry about it now.”
He was right, of course, but that didn’t make me feel any better. “This is the one thing that I need to do before I go into labor,” I insisted. “Well, this, and filling up the cat food dish.”
“I’ll handle the cat food,” he said, putting his hands on my shoulders. “You need to take some Tylenol PM and drink some Bedtime Tea and just go to sleep.”
Suitably drugged, I crawled into bed and drifted. Earlier in the evening, I’d remarked to &, “I’m of two minds right now. On one hand, it’d be fine if this were really labor starting, because I’m ready, this kid could totally come any time. But on the other hand, tomorrow’s Christmas, and I feel like I should cross my legs.”
“Yes!” he replied.
“Because who wants a Christmas birthday?”
But at 2:30 am, when I’d normally be getting up anyway for the first of several midnight pee breaks, something else woke me. A contraction. A contraction that wasn’t playing around, that hurt enough to rouse me from deep sleep. I noted its passing, went to the bathroom anyway (more plug!), returned to bed, and was on my way back to sleep when another one hit me. Hard.
Less than twenty minutes had passed. But on the other hand, almost twenty minutes had passed, during which nothing had happened. This couldn’t be labor, because labor didn’t stop. This did. The interstitial delay from one contraction to the next was so long, there was actually time for me to fall asleep. Which I did, again and again.
But I woke up. Again and again. And each time, the intensity of the wake-up call surprised me. I went to the bathroom several more times (good, I thought, let’s empty the tank and zero the gauges, that’ll make for a nice clean labor like last time!) and kept going back to bed, hefting my bulk back onto the high mattress, curling around my freecycled Snoogle pillow and dipping back into REM sleep. At one point I dreamed that I was dropping my mother off at the airport, all the while weeping that she couldn’t leave now, not yet, not while I was in labor. Another contraction woke me; Mom was still asleep in the basement guest room; and I wasn’t in labor, now was I?
As the clock ticked toward 4 am I tried to reason with the process. OK, I figured, these contractions hurt. But if I did activate the launch sequence — wake my husband and my mother, get dressed, pull stuff together, trek down to GW Hospital — it would take at least an hour before we got there. Might as well just wait that hour until it got light out, so I wouldn’t ruin everyone’s night. Because even assuming we did make a beeline for the hospital, they would of course turn around and send us straight home. As far as they were concerned, it ain’t labor if a quarter hour passes and nothing happens. Which seemed to be where things were, right then.
At 5:30 the contraction hit me so hard, I moaned aloud and woke up &. “Huh?” he said.
“Oh, are you awake?” I asked.
“I could be.”
“Nah, no worries, go back to sleep.”
But by 6 we were both downstairs, watching the sky pale to gray through the sheer living room curtains, clocking the intervals between contractions with the app on &’s smartphone. By 7:30 the sun was up and so was my mother, and &’s parents, alerted via text message that Christmas was starting early, had joined us as well. I stuck my French toast casserole in the oven, figuring that if I didn’t make it to brunch at least I’d have something to eat before I officially crossed over into Real Labor.
Because (pause, breathe, owwww) it was becoming increasingly clear: labor was imminent, if it hadn’t already begun. The contractions were ten minutes apart — er, nine — make that seven. There was no further question of crossing my legs. Christmas be damned, by all appearances this kid was coming today.
The sun rose. It was time to wake up Natalie, time for her to comb delightedly through her freshly-stuffed Christmas stocking and admire all the loot that Santa had left her for being such a good girl. I ate some French toast and pretended that I still wasn’t in labor. “Another one,” I’d mutter to & through gritted teeth whenever a contraction came, while our two-year-old daughter delightedly chased wind-up toys across the living room floor and wondered what a PEZ dispenser did. (We hid the candy.) I might be halfway toward delivering a Christmas baby, but I’d be damned if my little girl was going to miss Christmas as a result.
But at about eight-thirty, a contraction hit me so hard that I threw my head back and groaned out loud. When it passed, I sat back up and noticed Natalie staring at me, wide-eyed and alarmed, not understanding why Mommy was making such strange noises. That was when I decided: this was the point of no further denial. I was in labor. “I think it’s time to go to the hospital,” I said, figuring that Natalie didn’t need to see or hear any more of this show than she already had.
“Yes!” the grown-ups in the room all agreed.
“You might even be in transition,” my mother-in-law suggested.
“I doubt that,” I said, “I’m still speaking English.”
I remained fluent in my mother tongue all the way to the hospital (a far more pleasant trip in broad daylight than it would have been at 4 am); into the lobby where my mother and I were waved on through by the wristband-distributing attendant — “Oh, are you in labor, honey? You go right on up to the third floor!” — and past the L&D check-in desk straight into triage, where & rejoined us, having perhaps set the record for Easiest Time Finding Street Parking In Foggy Bottom. (One benefit of being in labor on Christmas Day, I guess.)
And here we were at the hospital! Having this baby! On Christmas! With nothing else to do but embrace the situation, I gaily changed from my street clothes into my delivery gown (the same one I’d worn to deliver Natalie) and joked with my mother, my husband, the nurse, anyone within earshot. The contractions hurt, more and more, but in exactly the way that I expected them to. This was labor. I’d been here before. They came quicker and quicker, and that too was as it should be. This is how a baby comes. The nurse copped a quick internal feel and concluded, “You’re at seven. Actually, eight.” And I was elated. Eight! Already! Perfect. This was all going down according to Hoyle.
Even if it was taking disappointingly longer than I expected. We were in triage for over an hour, waiting for the attending OB to pay us a visit, but apparently she’d gone home at the end of her shift and the next one had yet to clock in. Meanwhile, the baby was obstinately taking her time. So much for all the research I’d done on how to deliver your own baby if you don’t make it to the hospital in time. Such hubris I’d shown in my birth plan, boastfully indicating that I was “prone to precipitous labors”! Even assuming that true labor hadn’t actually started until I said so, at 8:30, we were already nearly two hours into the process and still no —
Something shoved hard at me from the inside. I groaned, and groaned again, and then started howling. This wasn’t the proverbial Urge To Push. Something was off. The angle was wrong. It didn’t feel like the baby was coming down the birth canal — it was more like she was bearing backward, into my intestines. “I have to poop!” I concluded in a yelp, oblivious of whether this actually happened. Ugh. Gross. That never happened with Natalie.
Finally giving up on the attending, the nurse decided it was time to move me from triage into the delivery room — our lucky Room 7. This was the same room where Natalie had made her debut; I liked the karma of this, but, I realized, it was no longer possible for me to get up and walk anywhere. “But it’s literally right across the hall,” the nurse protested, by way of encouragement. I tried to respond to this and couldn’t: there went the English. All I had were insensate moans. Aha. This must be transition.
Sure enough: I started losing time, chunks of minutes at a clip, as each contraction attacked me like an electric drill to my lumbar vertebrae. Somehow, while I wasn’t looking, I made it into Room 7, gurney and all, and had an IV installed in my left wrist. And then, somehow, a midwife appeared, presumably filling in for the chief attending. “Look, Andrew, a midwife!” I joked, before I lost the thread again and the midwife was gone. (We would not see her again.)
And then, finally, the anesthesiologist arrived, and unlike last time it took, thank you Jesus, an actual effective spinal block that blunted the drilling sensation. I was elated, even though the anesthesiologist required me to swap out my delivery gown for a hospital-standard one. “Your legs should be getting numb,” he told me. “Can you feel your toes?” I could, but since the pain in my midsection was palpably diminishing, my toes were the farthest thing from my mind. Ahhh. Relief! So this was what it felt like, to be in labor and not in agony.
“See this?” the anesthesiologist said, holding up a bag of clear fluid. I saw it. “This is your epidural,” he told me. “The catheter is already in. When your spinal wears off, we can turn this on.” Yes! Wonderful! I felt even better seeing this. No failures of anesthesia this time. I might actually manage to give birth without blacking out from the pain. This time they had me covered. “But you’ll probably deliver well before that,” the anesthesiologist concluded as he left. I sighed with relief. That’d be fine too.
I blinked and it was 10:30, 11, 11:20, 11:45. & and my mother were sharing a plate of Christmas-dinner-style food from the hospital cafeteria, where they were serving free turkey and gravy and so forth to the poor sods stuck working the Christmas shift (and selling it to the other poor sods stuck visiting patients on Christmas). By this point I had completely disengaged from the passage of time. How long had we been there? And I still hadn’t had this baby. What was going on? Was it true that the mere administration of analgesia slowed labor to a crawl? Or was this just the pace of ordinary labor, the kind you’re supposed to have, the kind from which I thought I was exempt?
A doctor who introduced herself as the chief resident came in to check me, and met my gaze with a twinkle in her eye. “Would you like to have this baby now? She’s –” grope, grope — “right there. You could have her out in two pushes.”
Oh. Ah! Okay. It made perfect sense that the baby could get all the way to right there undetected, thanks to the wondrous miraculous spinal. “Sure!” I said as brightly as I could. “Let’s do it.”
On cue, I pushed.
And nothing happened.
“Hang on,” the chief resident said, reaching up the pipe again. “I feel something. It might be a nuchal hand, her hand by her face, or maybe it’s the cord, although her heart rate is fine. Hmmm. Let’s try another push –”
“–oh.” Her tone changed completely. She turned away from me and remarked under her breath to the resident at her side, “She’s OP.”
In my head, the acronym “OP” primarily stands for “on plan” — the plan in question being Medifast, my diet of choice, which I used to lose the baby weight after Natalie was born. But in the universe of childbirth the acronym had an entirely different meaning: when spoken by an obstetrician, OP is short for occiput posterior, a Latin expression which variously translates as “sunny side up,” “your baby’s in there backwards,” and “ouch.”
Well, that explained why it was taking so long. And why it felt like the baby was drilling her way down into the small of my back. Babies at this point in the birth process are supposed to be head down and facing the mother’s spine; mine had decided to do things differently and was facing my navel instead. The narrow crown of her head, which should have been leading the way down the birth canal, was instead bumping into my intestines (hence the pooping, of which there had apparently been more). What was emerging through the birth canal, or trying to, was actually her (significantly broader) forehead. And it was taking awhile. “We’re going to let you labor her down for a bit longer, maybe 45 minutes or an hour,” the chief resident told me.
This was not a problem, until it became one. As the clock crept toward 1 pm, the spinal began to wear off. “I think we need to turn on the epidural now,” I told whoever came within earshot of the delivery table. “I’m feeling things again. Owww. I can feel these contractions again. Seriously? I need the epidural now.”
“No,” someone responded. “We don’t want to turn it on now, because we need you to be able to push.”
“I assure you, I will be able to push,” I attempted to say, but the contractions had recovered their unblunted intensity and all I managed to articulate was “Whaaaaa.”
Here I was once again in Room 7 of the GW hospital maternity ward, with my mother and a nurse holding up my knees, a resident urging me to push, and a catheter in my spine doing absolutely nothing to mitigate the excruciating sensation of a human being battling her way out of my nethers. I’d done this before, too, but it hadn’t hurt nearly so badly last time. Natalie hadn’t been OP. Her sister, meanwhile, wasn’t going to come out without a fight.
Here is how labor with an OP baby differs, in my experience, from labor with a right-side-up baby:
1. It takes at least twice as long.
2. It redefines the “back pain” element of conventional labor.
3. Poop. Just let go of it. You can’t make it stop.
4. If pushing in conventional labor feels like bad constipation, pushing in back labor feels like laying an egg. An ostrich egg. Made of diamond.
The spinal had worn off almost completely, and the “sensation” of a largeish baby brute-forcing her way backward down the birth canal had returned to unmitigated full strength. Fortunately, my body did the best it could to approximate “precipitous labor” with my sunny-side-up diamond egg. Finally urged to push by the resident, I gave it all I could. Oh dear God. (“It hurts all over,” I wailed, in a rare articulate moment in medias res. “You would not believe the shade of purple you turned,” & reported to me afterward.)
Time stopped, then backed up like a blocked drain. I could have sworn that I’d been pushing at least twenty minutes or half an hour. But the clock told a different truth: it actually took less than five excruciating minutes for my second daughter’s face to emerge from my loins.
(And be caught on illicit video by her father, to whom I will forever be grateful for bootlegging the event. There is no money shot on earth quite like your girl parts stretching wide over the face of your child, not yet alive, frozen in a beatific otherworldly expression of total peace. I’ve watched it several times since and will never get over the sheer awe.)
It was 1:24 pm on Christmas Day, 2012, and our second daughter had arrived at 39 weeks 5 days, 8 pounds 6 ounces, and 20 1/4 inches long. She was a week earlier than her sister and a pound heavier, and her water was clear and meconium-free. The resident handed her straight up to me, dripping and still connected to me through that amazing umbilical cord, and she found her voice — that wonderful, unequaled newborn shrill — before they’d even finished suctioning out her airways with the little blue bulb.
“You would not believe,” the chief resident told me, “how many people can’t do what you just did. They push and push and push, and the baby just won’t come, and they wind up having a C-section.” She paused, then added, “But I wasn’t going to tell you that while you were pushing.”
It hadn’t been an ordinary labor after all; it had been an impossible one, and we’d hacked it anyway, she and I. My mother cried. My husband cried, then cut the umbilical cord. I didn’t cry, but met the baby’s amazing gaze, and spoke my first words to my second daughter: “You hurt!”
And then: “She doesn’t look like Natalie at all!”
She didn’t. She looked like me. I’d managed to produce a child who resembled her mother. Two years earlier in this exact same room, when they’d handed me a fresh-squeezed Natalie, I’d been dumbfounded by the strangeness of her, those unprecedented eyes and that odd square brow and the alien peeling skin on her hands. This kid, meanwhile, had a round head and visible eyelashes and gorgeous fingernails, and was familiar in a way that her sister had not been. For all that she’d been a stranger to me in utero, everything suddenly became clear upon beholding her, and it was exactly as I’d wished. You were the one I was hoping for, I told her silently, and then murmured aloud in her ear, “Your name is Genevieve Amelia Martin.”
And a half hour later, I stood up and walked to the recovery room on my own two feet. Because my legs never had gone numb, and it was Christmas, and if anyone could do the impossible right this minute, I could. “Look at you!” the nurses cheered as I walked by. I raised my fists in the air in response, the boxer’s gesture of victory. I’d torn again, had stitches again, moved slowly and awkwardly thanks to the giant absorbent ice pack in my hospital-issue mesh underwear. But I’d had another baby. The hard way. On Christmas. And there is no victory quite like it.