While meeting with 15-year-old Kyla, who was planning an open adoption for her baby, I asked her if she would be willing to share her birth and her story for publication on my blog. She gave her permission, as did every other person involved in this story. First names are used with permission.
It was Friday, January 25, when Kyla texted me in the late evening letting me know she'd been contracting since about noon after having had her membranes swept the previous day. She was very nervous and more than anything did not want to cry wolf, but after contractions continued even through a bath, she wanted to give me the heads-up I'd asked for. After chatting for awhile, we agreed that it wasn't time for me to come over yet, but that she should carry on, try to drink as much as she could, and sleep if possible. I told her to call me when contractions were longer, stronger, and closer together. I also added that they should be intense enough to command her attention.
Kyla checked in again at 11 p.m. to let me know she was going to try to sleep. When morning came and I hadn't heard from her, I texted her to find out if her contractions had petered out over the night. It turned out that they hadn't, and she was able to sleep through some of them, but not all of them. At 10:30 a.m., she let me know that they were about 5 minutes apart and hurt more than they had before. I told her I would see her soon.
When I arrived at her home, she was sitting on the couch with her partner, Tony. She tensed her face when she had a contraction, and told me that she was feeling some back pain as well. I helped her relax, taught her how to breathe slowly in through her nose and out through her mouth, like she was blowing out a birthday candle. I also suggested that she try the hands-and-knees position over the side of her couch, since the back pain suggested to me that her baby could be posterior (sunny-side up) and this position would take some of the pressure off of her back.
As soon as we made this change, Kyla's contractions went from 5 minutes apart to 3 minutes apart, and increased in intensity. Since Kyla was planning a medicated birth, she wanted to head off to the hospital.
We arrived at the hospital at about 1 p.m., where a cervical check revealed Kyla was 3.5 cm dilated and 90 percent effaced. I told her that was great work and not to worry that they weren't immediately admitting her, but instead sending her on the one hour hospital hall walk.
We only made it about 40 minutes of walking before Kyla's legs began to hurt, and she felt more back pain. I asked her if she'd like to go back to triage until it was time for her next check, and she said yes.
When the nurse came back to perform the next cervical check, Kyla was thrilled to hear that she had made it to 4-4.5 cm and was being admitted. She was also told she could have an epidural at any time. Kyla decided to do a few more laps of walking and then told the nurse she was ready for medication. She went ahead and tried the narcotics but didn't notice any difference at all in her pain level. I helped her cope with her contractions while we waited for her IV to be placed.
Kyla benefited from counter-pressure on her hips, massage on her lower back and a lot of coaching when it came to controlling her breath and relaxing her face. We tried horse lips (blowing out the air of your breath in a raspberry sound) and a few low moans. Mostly, she tended to tense up, so I offered her my hand to hold and squeeze in exchange for doing her best to relax her face.
At approximately 5 p.m., Kyla's next check revealed that she was at 5 cm. It was around this time that the adoptive parents, Tyler and Courtnay, arrived and greeted Kyla. They asked if there was anything she wanted, anything at all. The hospital room had a TV and DVD player, and multiple people had asked Kyla if she wanted to watch a movie to help pass the time. Tyler was headed out to get some food anyway, and again told Kyla he was happy to pick up a movie from Redbox. She finally admitted she'd love to see "Pitch Perfect" again. Courtnay and Tyler hadn't seen it, so Kyla thought it would be nice if they'd like to join her and her family to watch the movie.
Of course, since Kyla had been in prodromal labor for at least 24 hours, and she'd seen the movie two times before, she didn't exactly make it through the whole thing.
I told her billions women have been doing this for all of human history and there are thousands that are out there doing it right now, right along with her. We talked about how it feels like something must be horribly wrong because how can it hurt this much, but it does and it's normal. No damage is taking place, and the shivers are from hormones and because her body is working so hard. She looked into my eyes and calmed down a touch. Once she stopped trying so hard to stop the shivering and just relaxed, it went away. Anesthesia arrived, repositioned her epidural line and increased her dosage. Pitocin was added to her IV as well, because while all of this had taken place, her next check revealed she was still at 8 cm after two hours.
Just after midnight, the doctor came in to break her water (at Kyla's request to help speed things up) and check her again. Kyla was at 9 centimeters, had no fever and baby was doing well, so the doctor told her that it was fine to just keep on keeping on.
Then, suddenly something amazing happened. I was standing between Kyla's legs and saw that during her pushes she moved the baby more than she ever had before. Maybe two to three times more per push than what she had been accomplishing with all of her previous pushes. I got very very excited and told her that this was astounding. The nurse said, "Yes, whatever you did that time, keep doing it!" I wondered if there actually was a concrete "it" to keep doing, so I asked Kyla between contractions if she knew what it was that she'd done differently. "Yes!" she said. "I didn't curl around my baby. I stayed flat."
Kyla gave another mighty push, the baby's head was out and the doctor told Kyla she need to get the baby's shoulder out ASAP. There was a lot of commotion, but Kyla remained focused and did what she knew she had to do. The doctor unwrapped the cord from the baby's neck (not a single decel! Amazing!) and pulled him out. She clamped his cord and Tony cut it, as was stated in the couple's birth plan.
As per Kyla's request, he was not put directly on her stomach, but instead taken to the warmer, weighed, wrapped and bundled up first.
Kyla chose to have only her partner and me, her doula, in the room with her while she gave birth, but it turns out that the rest of her support team was standing right outside the door of the birth room, watching the computer monitor to see as best as they could, how things were going. Once the baby was wrapped, Kyla got a chance to hold him.