James's Birth Story

Unlike the birth stories of my first two, this third one was a long time coming. I’ve just never really felt comfortable sharing it until now. There was a lot for me to process after James was born and even now, a year later, I still haven’t quite digested it yet. The wake of his birth, moving into our first home, the emergency appendectomy two months later, the drawn-out healing, the year of sleepless nights and the echoes of trauma, fear, mistrust, and postpartum-depression have really done a number on me. It’s been the most difficult year of my life, so far, and I am amazed we all made it through. I’ve never once felt that holding James in my arms has been anything less than a privilege and a blessing—I have truly enjoyed him and feel more deeply attached to him than any baby before—yet everything else seemed to consume me. It was such an exhausting dichotomy to live in. This birthday is not only a celebration of an absolutely beloved baby boy who exudes sunshine and joy, but also a triumph of the human will, and testament to the power of a village. It feels like such a feat to get here and I am grateful to be moving on toward brighter days.

James’s birth story echoes some of Liam’s birth story, and I had a feeling that it would. You see, if you don’t know already, I have a uterine abnormality called a “uterus didelphys” which means my reproductive system formed two separate uteruses with their own cervixes. So far, I’ve had three pregnancies (only two full term) in my right uterus and James is the first pregnancy in my left uterus. Throughout my pregnancy my midwives referred to James’s pregnancy as “primigravida” which means “first pregnancy” because it technically was for that uterus. We didn’t know whether James would come quickly like Lily or slowly like Liam, but I guessed it would be the latter. Labor with James did end up being just like my first labor—very late and very long. And it also began on a Thursday. 

I woke up Thursday morning, August 30th, to the familiar feeling of a contraction. I lay in bed feeling them come and go about every ten minutes. I was so relieved labor was finally beginning and on its own. I was 41 weeks and 6 days along in my pregnancy and had been begging for contractions for days. I didn’t tell anyone what I was feeling because I didn’t want to feel any more pressure or give anyone false hope. 

I went to my appointment that afternoon at the midwives’ office for my third NST (non-stress test) and second biophysical profile. The baby was absolutely fine, as I figured, since women in my family usually go late and it has never negatively affected the baby. Our babies just need a little extra time to cook and we should not be held so strictly to the arbitrary “due date” calculations. Just don’t even get me started on that…

I had consistently been feeling contractions every ten minutes but realized if they hadn’t picked up by now then I would not be experiencing a short labor like Lily’s. So I just prayed I was dilating. The midwife checked my cervix and announced, “You’re dilated to 3 cm!” I was over-the-moon. After about 30 hours of labor with Liam I was only dilated to 1 cm. My left cervix may be new to this, but it was dilating on its own—hooray!

 Later that day I told Joel and my mom the good news. Contractions were still ten minutes apart, but we figured that once they picked up then it wouldn’t take too long to fully dilate. I went to bed that night hoping to get as much rest as possible, but as soon as I lay down the contractions felt more intense and closer together. I slept between contractions for a couple of hours, but jumped out of bed after a contraction that made me feel like I was going to throw up. I ran to the bathroom in a cold-sweat feeling nauseous and panicked and thought, “Uh oh…I felt just like this right before Lily was born…did I wait too long? Did I underestimate things again?” I felt an intense contraction and then quickly yelled to Joel, “It’s time to go!” He and my mom quickly pulled things together, called our friends over to watch the kids and we were out the door in about twenty minutes. We left our apartment around 11pm and got the birth center in about 45 minutes. By the time we got there my contractions were back to ten minutes apart. I wanted to cry. I felt so dumb for rushing out the door when I was probably about to be sent right back home. The first mistake of many, but this one was entirely my own.

 The midwife on call, Jenna, met us at the door of the birth center. I explained the situation to her. She said she would check my cervix and and go from there. I was now 4 cm dilated, but obviously not progressing very quickly. She said that with my history (Lily) she didn’t feel comfortable sending me home, but she also didn’t want to admit me and put a time limit on my labor (the birth center usually gives you 12 hours to get into active labor, otherwise you are admitted to the hospital). She graciously asked if we wanted to make ourselves at home in the lobby and see if contractions picked up. I just wanted to have my baby so going back home felt like a huge step backwards. I should have gone home, but I was thrilled to be able to stay and relax. The lobby had a few comfortable couches for us to sleep on so we spent the night there. As soon as I lay down on the couch, contractions picked up again. They were every five minutes. I ate and slept for the next several hours until about 5 am when my contractions slowed down again. I got up and walked up and down the stairs of the birth center for about an hour. I skipped a step as I walked up the stairs and did squats when I got to the bottom of the stairs. I was so determined to will myself back into labor. An hour later Jenna checked me again and I was dilated to 6 cm. It was slow progress, but it was progress! Unfortunately, time was against me. I had until midnight that night (which would officially put me over 42 weeks) to give birth at the birth center or I would have to give birth in the hospital. Jenna sent us outside to walk around until shift change at 8pm. We walked and walked and walked around the cemetery across the street. It was a cool, beautiful morning and the fresh air felt good…too good, though. My contractions stopped. I had maybe two during our walk. 

When we got back to the birth center Jenna and I sat down to talk. We discussed breaking my water to get things moving and give me a better chance of staying at the birth center. I figured that breaking my water at 6 cm seemed like a good idea, so I told her to go for it. After several very painful attempts, Jenna vaguely said, “I can’t seem to do it. Let me get the next midwife on-call. She’s here now.” Lindsey came into the room with Jenna and she attempted to break my waters, too. But she couldn’t seem to do it either. Her attempt was terribly painful for me, too. At one point I told her it was enough. Although she was respectful, I felt injured and almost violated. She suggested we go across the street to the hospital and have one of the OBs they work with try to break it. We walked over to triage and met with the OB, Dr. Miller. I wasn’t happy to be there because I really do not like hospitals, but if Dr. Miller was successful then I could go right on back to the birth center. 

Dr. Miller checked me and then said to Lindsay, “Yeah, I feel it too.” She turned to me and said, “We are feeling some sort of thin membrane that seems to be covering the opening of your cervix. The baby might not be able to even get out that way.” They double-checked their findings by doing a transvaginal ultrasound and then gave me two options: a c-section or an epidural so they could cut out the membrane. Awesome. They said that they might be able to push the membrane out of the way if I got to the point of pushing. It was then that I proposed a third option: put me on pitocin in hopes that I fully dilate and can push. If I was fully dilated then the baby’s head might apply enough pressure to break the membrane or push it to the side. I didn’t want to jump straight to a c-section nor slow down labor even more with an epidural. They were on board with pitocin. They cant administer pitocin during labor at the birth center which meant I would be admitted to the hospital after all. Joel and I went up to Labor & Delivery while my mom grabbed our stuff from the birth center. I asked them to start me “low and slow” on the pitocin and they got me hooked up and ready to go. This was at about 11:30 AM. I was tired, but felt like I had enough energy in me to make it through a few hours of pitocin. After only about 4ish hours of pitocin during Liam’s labor my body dilated from 1 cm to 10 cm, so I was hoping to dilate quickly. 

The next six hours on pitocin were awful. The nurse kept coming in and turning up the dosage. She didn’t say a word to me—she just walked in, pressed a few buttons and walked out. I was annoyed but not in my right mind to talk to her about it. I felt the most intense pressure in my back on the left side. I figured the baby was posterior and had my mom and Joel alternate applying pressure to my back through each contraction. I don’t think I could have handled the contractions without the counter pressure. They were about 1-3 minutes apart and extremely intense back labor. I had specifically told the midwife, Lindsay, when they admitted me to the hospital that I needed her there to help with pain management, but she was nowhere to be found while I was on pitocin. She didn’t help with pain or try to get the baby in the right position. Looking back on this, it really bothers me. Changing the baby’s position could have made all of the difference, as you’ll see later on. She seemed to just check out and let the OB take over even though the midwives are supposed to be the primary care givers whether you are at the hospital or birth center. I’m disappointed in how that turned out. After six hours of laboring through pitocin—walking around, sitting in the bath tub, and laying in bed—I couldn’t take it anymore. It was the most unnatural, unnerving pain. While I was laying in bed I felt my water break. I needed someone to check my progress and tell me the baby was crowning—now! But he wasn’t. I was checked and had not progressed at all. I felt defeated. I told Dr. Miller that I was ready to move onto option #2: administer the epidural and cut out the membrane.

The anesthesiologist came in to give me the epidural and I pretty much wanted to punch everyone in the room. I was still on pitocin, the contractions were too much and it seemed impossible to “hold completely still” as they kept telling me to do. When I was all numbed up, Dr. Miller came in to cut the membrane. She checked me and then said, with surprise in her voice, “Well, I have good news and bad news. Good news is that there isn’t actually a membrane covering your cervix. The bad news is, we have been checking the wrong cervix this whole time.” Did your jaw just drop reading that? Yep, over 30 hours of labor and they had been checking the wrong cervix. Remember how they even double-checked with an ultrasound? The membrane they “saw” did not exist!

I  felt a mix of emotions—shocked, relieved and on the verge of crying. It turns out that my right (non-pregnant side) cervix had been dilating this whole time and that’s what they were feeling. They would reach up through my right cervix and feel the baby’s head against the uterine wall, which they thought was the mysterious membrane. When the midwives were trying to break my water, they were essentially trying to rupture a uterine wall. No wonder it was so painful and, praise the Lord, they weren’t successful. 

 So my right cervix (non-pregnant) was dilated to about 6/7cm and the left cervix (pregnant side) was only dilated to 3 cm at this point. Dr. Miller said this was fine, we will treat it like a first labor and just give it time to dilate completely. With time, she was sure I would deliver this baby vaginally. 

Now, Dr. Miller is a fine doctor and I am grateful I had her there. I don’t blame her for not knowing her way around my unique reproductive system. This was the day we met! She was great at explaining everything to me, showed respect by offering options and listening to my concerns. She was motherly, but not condescending. She felt very familiar to me and I’ve learned over time that strangers who feel familiar to me have been specifically placed in my life by God. My midwife on-call, on the other hand, I am extremely disappointed with. It’s interesting because in my experience that has usually been the other way around. I digress…moving on…

At this point I had been in labor for 36 hours. I was off of pitocin because my cervix was dilating and I was contracting regularly on my own. I lay in bed feeling exhausted and unwell. I felt like I couldn’t breathe. I was nauseous and my body was weak. I was happy to wait for my body to dilate but it felt like it would never happen. I would never see my baby. I would never be on the other side of this. Unfortunately, the baby seemed to be feeling similarly. During the next couple of hours his heart rate kept dropping. He had always been a strong, happy baby with a steady heart rate. About a month before this I was hospitalized due to abdominal pain “attacks” I’ve been having over the past ten years. This specific “attack” ended up putting me into the hospital and early labor. Throughout my stay the nurses kept commenting on how happy the baby was and how much he was moving through everything. So when his heart rate started to drop at this point I knew it wasn’t good. His heart rate would drop and the doctor and nurses had me rolling around, up on my hands and knees, and hanging over the head of the bed. Each time it took longer to get his heart rate back to normal. They screwed an internal monitor into the baby’s head (which really upset me—like if I were in my right mind that would not have happened). I was dilated to 6 cm now, but he was posterior and his face was presenting which really slowed down the progress. He needed help getting into the right position, but nobody did anything about it. I was so out of it that I didn’t even know how to communicate the need. After about the sixth time his heart rate dropped Dr. Miller sat down and calmly discussed our options. We could wait it out or go in for a c-section. It was so clear to me, Joel and my mom what my next step would be. It was the right decision but a decision I never thought I would have to make. We agreed to go ahead with the c-section. I made it very clear how much I wanted to avoid it, why I wanted to avoid it and the anxiety I felt about the surgery. Dr. Miller talked me through every thing and promised me a few things to make me feel more comfortable throughout the surgery. They wheeled me into the blindingly bright operating room and I felt at peace, anxious, relieved and terrified all at once. 

 We were told the surgery would take about an hour—including prep time. After they prepped me they brought Joel into the room. He held my hand and kept me calm. He also held the cup I kept vomiting into. Poor guy. Dr. Miller did the “pinch test” where she would pinch parts of my abdomen to see if I was numbed completely. She pinched above my belly button and I said, “Yep, I felt that one,” to which she replied, “Well…I’m really sorry Sara but I have to start because the baby has been off of the monitor for too long.” It totally freaked me out that I was about to be cut open and possibly feel it. I didn’t, thank goodness. Although c-sections are actually pretty intense. I was surprised at how much I did feel. I even cried out in pain a few times at the end. You’re not just feeling “pressure”.  

At 11:34pm on Friday August 31st, 2018, ten minutes after they began surgery, I felt them pull the baby out of me. I looked up and saw my healthy, crying baby. He looked very familiar to me and I said to Joel, “Yeah, that is definitely our baby!” They announced we had a boy and we both cried. I didn’t cry when my other babies came out, but the relief in this moment was palpable and we were so grateful for our healthy baby to be OUTSIDE of my body. And it was a boy! How wonderful! He had swallowed some meconium so he had to be suctioned and put on CPAP, but he was fine otherwise. James was born weighing 7 lbs. 7 oz. and measuring 20 inches long. Joel followed him to the nursery about 45 minutes later, but not before he saw that things with me were taking a turn for the worse.

 I had asked for someone to be talking me through the surgery. I just wanted updates to help keep me calm, but after the baby was taken care of things got quiet. Joel said he would look over the curtain at Dr. Miller’s face and she kept shaking her head. Dr. Miller eventually said, “Sara, I’m very sorry but I cut your bladder. I’m stitching it up now.” And that was it. She told the anesthesiologist to give me shots of something in my arm a few times. I spent the next hour and 45 minutes on the operating table unsure what was going on and calling out over the curtain, “Am I going to be okay?” I was exhausted and out of it and couldn’t keep my eyes open with the bright lights above me. Nobody was telling me anything so my thoughts went wild. Joel was in the Nursery with the baby during that hour and 45 minutes planning my funeral. It all felt very dramatic. The midwife, Lindsey, had taken Joel’s place holding my hand by my side. Now I can’t remember if this happened while she was next to me or while Joel was next to me, but at one point I felt someone else holding my hand on the opposite side. The anesthesiologist was over there and I thought, “Oh that’s nice of him to do that.” I turned my head to see him and there was no one there. It was crystal clear that someone on the other side was watching over and comforting me. In fact, before I could even imagine who it could be I immediately thought of Joel’s dad. I believe it was him, and I was so grateful for that tender moment.

Once they took me out to the recovery area, Dr. Miller came in to talk to me. She explained that due to my uterine abnormality my bladder isn’t in the normal spot. It’s higher than usual, kind of peeking out between my two uteruses. She said that at one point during surgery my bladder and my two uteruses were completely outside of my body. I sincerely hope they made it back to their usual place. I was told later that the surgery was much longer than anticipated because the bladder was difficult to repair. I wish that would’ve been communicated at the time because Joel and I were very shaken up by the unknown. The thoughts we had then still haunt us now. 

 Due to the incision on my bladder, I would have to have a catheter in for ten days. Let me tell you, those ten days drove me absolutely crazy. An infection, a 6 hour trip to the ER with my newborn in tow, and four rounds of antibiotics later and I was finally done with the bladder ordeal (two months later I had an emergency appendectomy and two more rounds of antibiotics…but that is another story).

Out of this long, complicated labor came a perfect, beautiful baby boy. When Joel brought him to me in recovery James latched on right away and started nursing like a pro. In that first month, he ate well, slept well, was so sweet and happy and glowed just like an angel. I couldn’t be more grateful for and in love with him. He was my pal and my source of joy throughout a painful recovery. And even after all we’ve been through—when I look at him it makes me want a million more babies. 

I’ve accepted that labor will never be “normal” for me (I mean c’mon, my three labors have been VASTLY different), but he is proof that it is all worth it in the end. After all is said and done, I feel a much deeper sense of pride and honor to be a mother. Thank you, and happy birthday, my sweet baby James.