When I became pregnant in early 2021, I had already accepted that my chronic sciatica was more or less permanent. For the last three years, it had prevented me from sitting down. What I didn’t know was how these factors would affect the birth.
There is no shortage of labor stories out there, and yet, I seemed to have stumbled onto a white space. I couldn’t find any accounts of women who had given birth when they were so limited in their movements, or so hampered by their sciatic nerve.
And so I decided that it was worth adding yet another birth story to an already vast literature.
When I started writing, I realized I had more to say than I expected, so I divided my story into two parts. This article covers the time from my arrival at the hospital to my daughter’s birth. The next article covers the drama of the next few hours.
Pitocin
I checked into the hospital for my induction at 11 a.m. on December 6th, 2021. The birthing center was a sleek, modern facility on the top floor of the hospital. Fargo is a horizontal city surrounded by a vast sea of prairie, so from our crow’s nest on the 10th floor, we could see the city spread out before us.
My hospital room was more spacious than I had expected. Later, I would realize that was not by accident; the last minutes of labor seem to be something of a spectator sport.
The furniture included a hospital bed with a complicated control panel, a fold-out couch, and a contraption that looked like a space-age bassinet under a heat lamp. On an earlier tour of the birthing center, I realized this contraption would be used to perform tests on the baby after birth. There was a large-screen TV that no one could figure out how to work.
Soon after my husband Alex and I settled in, the midwife, who I will call by the fake name Jessica, came by to talk about a game plan.
Since I had grudgingly agreed to an induction, I was pleased that this particular midwife was on duty. Although I had come to know and trust all five midwives in my group practice, I had secretly hoped that Jessica would be present for the birth.
During my prenatal visits, she had listened carefully to all my concerns. When I asked her about topics ranging from sleeping on my stomach to fetal monitoring during labor, her answers were both intelligent and wise. In addition, she seemed to radiate calm. I assumed her soothing presence would be a welcome balm during the chaos of labor.
Jessica had previously worked in a birthing center, and was on board with my plans for a natural delivery. She had one last suggestion that might help me avoid an IV of Pitocin, a synthetic form of oxytocin which is used to kickstart labor. I had heard that the contractions induced by Pitocin were more painful than natural ones. I didn’t know how anyone could prove this objectively, but I still wasn’t keen on getting Pitocin unless it was absolutely necessary.
So instead, Jessica gave me a tablet of misoprostol, which is supposed to help ripen the cervix and stimulate uterine contractions, to place under my tongue.
But as the hours ticked by and nothing happened, I grew impatient. I was afraid that if I waited too long, I would sap my strength before labor actually started. So in the late afternoon, I reluctantly agreed to a Pitocin drip.
The IV was administered at about 7 p.m. Jessica started me off at level 2. I still have no idea what unit of measurement this 2 referred to, but she told me that the typical dose ranged from 2–20. Most women needed to reach at least 10 before their labor started.
Although Jessica was doubtful that I’d feel anything at all with such a low dose, I sensed a drastic and immediate change. Every organ in my abdomen seemed to twist and seize up, and I kept having to run to the bathroom.
They upped my dose every 20 minutes or so. Shortly before 8 p.m., I was up to level 4.
While I was adjusting to the Pitocin, Mom stopped by my hospital room to deliver some things we’d forgotten at home – my slippers, some snacks, and Alex’s phone charger. I did my best to ignore my increasingly insistent contractions while we chatted about plans and gossip.
And then…
“BATHROOM!” I screamed, and lurched in that direction. But I hadn’t gotten the hang of maneuvering with my IV pole, and I couldn’t make it in time. I was mortified when I noticed puddles of water splashing down onto the hospital floor, until I realized this wasn’t the sort of wet I could control. My water had broken.
My Dream Birth
One of the most useful books I read when preparing for childbirth was Natural Hospital Birth: The Best of Both Worlds. The author, Cynthia Gabriel, was an experienced doula, as well as a researcher and university lecturer.
Like many people who are really into childbirth, she didn’t shy away from woo. But her book was also full of practical tips about preparing for labor and interacting with hospital staff.
Had I read her chapter on birth plans before I wrote my own, I might have handed my pregnancy navigator a concise summary, such as, “Please help me have the most natural birth possible.” Instead, I gave the hospital a three-page document with thirteen subheadings. I cannot be sure that anyone actually read it.
Gabriel’s first step in creating a birth plan was decidedly impractical: Dream the birth. And she really meant dream. Don’t back away from the surreal. You can invite your dead grandmother, or be magically transported to the lost city of Atlantis, or dance with the elves on a mountaintop, if that’s what pushes your pram.
When I first read this suggestion, I scoffed. My dream birth, to the extent that I had one, involved skipping all the parts that actually resembled labor. I wouldn’t have to leave the house, and my baby would be transported from the womb to my arms without any pain or bother. My dream birth wasn’t spiritual so much as convenient.
Nevertheless, I decided to try the exercise, and imagine my dream birth. After all, I had already started practicing hypnobirthing visualizations, and if I was going to dip my toes into the waters of woo, I might as well wade in to my knees.
I decided that my dream birth would take place in an old-growth forest in early summer. I would hear the birds and insects singing pleasantly, but the birds wouldn’t peck and the bugs wouldn’t bite. The sticks and rocks that littered the sun-dappled floor wouldn’t scratch or cut. The air would be slightly humid and pleasantly warm, with cool spots under the trees.
I would be walking alone under the leafy canopy when my labor pains started. I would continue to walk and enjoy the scenery until it was time for me to deliver. When I felt the urge to push, I would crawl into the hollow center of a tree, and deliver my baby on the mossy forest floor.
I didn’t find this exercise particularly useful at the time, and I was relieved when Gabriel switched her focus to the practical phases of writing a birth plan.
Later, when I was laboring on my hands and knees in the hospital bathroom, with the hospital staff assailing me with questions and recommendations, I realized that this dream birth plan was exactly what I needed. I shut out the voices and hands of everyone around me, and retreated into my own mind.
I entered a sort of meditative trance. I was largely oblivious to the outside world, and had only the vaguest sense of time.
I was in the hollow center of the tree. And there, alone in the quiet, mossy space, I realized I knew exactly what to do. Some instinct had been activated. As long as I could shut out the world and listen to my body, I would know whether to squat, or stand, or get down on my hands and knees, or push, or scream, or breathe.
Alas, Jessica and the hospital staff seemed to be doing their best to break into my trance. I grew irritated and angry in turns. I didn’t want to go back to the bed, or grunt quietly, or have my Pitocin upped again. I didn’t want the nurse to adjust the fetal monitor that was strapped to my belly every five minutes. I just wanted to birth my baby. I wanted the hospital staff to stop “helping,” and give me the space I needed to do the job properly.
Scenes From a Birth
After my water broke, the contractions came fast and furious. My perception of objective reality slipped away. There were only a few brief periods when the contractions abated enough to let my thoughts surface, and lay down a few memories.
Afterwards, I compared notes with Alex and Mom to try and reconstruct some version of objective truth. I asked Jessica too, although her answers were more clinical and less detailed. The scenes that follow are taken from where our memories intersect.
###
Scene: There is a Styrofoam cup full of blueberry muffin tea (my favorite variety) on the bedside stand. I will drink it as soon as I have enough space between contractions for me to get the cup to my mouth.
The contractions return. The Styrofoam cup remains on the bedside stand, forgotten.
After labor, Mom tells me she drank it. I’m glad it didn’t go to waste.
###
Scene: “I think we can increase the Pitocin,” Jessica says.
“No!” I say, insistently. “No more Pitocin. I hate the Pitocin.”
“Are you sure? You’re still on a low dose right now. It’s perfectly safe to increase it.”
“No. No more! Do not give me any more!”
“Well, if you’re absolutely sure, we can stay at this level.”
“No! I’m done with the Pitocin! Turn it off. Take it out!”
I slip back into my labor trance. But I must have put up a sufficiently good fight, because the next time I surface, the only thing in my IV line is saline.
###
Scene: I refuse to leave the bathroom. There is a giant tub in the corner, and I still hope to make it there for a steaming hot shower. But for now, I stay close to the toilet. Something about the squatting position just feels right.
###
Scene: I am kneeling on the cold tile floors of the bathroom, pulling with all my might against the brushed nickel grab bar. I am blocking the door to the bathroom. I am pleased that this is a great inconvenience for Jessica and the nurses, who are trying to slip pillows under my knees and clean up my considerable mess.
Jessica asks me something. Some medical question that I can’t understand, let alone answer. I scream at the medical staff, over and over again, to, “GET THE FUCK AWAY FROM ME!!!”
###
Scene: I have been transported to the bed, and am carefully sitting on the edge of it. I do not want to sit, but there is no other way to get the epidural. I need the epidural so that I can understand what the medical people are saying. Someone – the anesthesiologist? His assistant? – is reading me a long list of conditions and asking if I consent. I do not know what the conditions are, but I know I have to say yes if I want the epidural. Part of me thinks, only a lawyer would think my consent right now matters.
They tell me to lean forward. The part of me that is protecting myself from sciatica thinks, oh no. Oh no oh no oh no. My insides twist again. I feel like a wet rag that’s being wrung out.
“Just wait until she has a break between contractions,” Alex says. I am grateful, although I do not say so. The part of my brain that translates thoughts into words is broken.
Another contraction comes. And another and another and another and they are all one long contraction and I am a contraction living inside a bigger contraction in an expanding universe of contractions.
“You’re at 10,” Jessica says, soothingly. This means my cervix is fully dilated. “If you want, you can go ahead and have this baby.”
I want this very much. The epidural people go away. Although I was the one screaming for an epidural minutes earlier, I am secretly relieved that it failed.
###
Scene: I am squatting beside the bed, hanging on to Alex’s neck for support. I am pulling very, very hard.
Alex goes away. He is tired. I have been doing this for a long time. Mom takes a shift. Part of me feels bad for her. She was just dropping off our stuff. She was on her way to pick up supper. She never intended to stay for the entire labor.
She is not as solid as Alex. I am afraid I will hurt her. I want a human version of my brushed nickel grab bar.
###
Scene: “She has hair,” Jessica announces. She is standing behind me, staring up my cervix. “Now I just need one more big push.”
I am now squatting beside the bed so I can lean over and rest my torso on it. I want to straighten my legs, but something big is stuck in my pelvis. I know the something big is my baby’s head.
Alex is on the other side of the bed. I pull on his hands as he pulls on mine, and I try to push my baby out.
“Good mama. Strong mama,” Jessica purrs. “Now I want you to give me one more giant push.”
I have lost track of how many times Jessica has asked me for one more big push, one more giant push. I am pretty sure it will take more than one push to get my baby out.
I have no more energy to push. I need to rest, if only for a minute. I breathe into the space between contractions. My mind escapes. I dream of strange faces and a colorful array of lights.
###
Scene: I am standing as well as I can. I ask for juice. “What kind?” Someone asks. “Any kind,” I say, surprised at the idea that I might have a preference.
Someone brings me a cranberry juice. It is good. I ask for another. The sugar gives me a slight jolt of energy. It will have to be enough.
###
Scene: I am leaning across the bed again. There is an explosion of pain at the opening of my vagina. With each push, I am tearing myself apart. Ring of Fire, I think, recalling the informal term for the pain a woman experiences as the baby slips through this final collar.
My instincts tell me to slow down and relax, but I am impatient. I want Jessica to stop asking for one last push. I want to put my legs together. I want to sleep.
There is a ripping, and more pain, and then the stuck thing comes unstuck, and I can hear my baby cry. Someone – I don’t know who – must have gotten down on the floor to catch her.
My baby is born at 12:36 a.m. on December 7th, 2021. After labor, Mom tells me that I have been pushing since 11 p.m.
Photo courtesy of the Wellcome Collection.
How Childbirth Affected My Sciatica
Before labor, I was concerned about how childbirth would affect my sciatic nerve. I knew that during labor, there would be a lot of moving parts in my abdomen. I didn’t know what exactly this would do to my nerve, but I suspected it would be bad.
My own actions during labor defied all prescriptions of good spine hygiene. All that squatting, and kneeling, and straining could not have been salutary.
Yet, I was pleasantly surprised. Considering the strain childbirth placed on the rest of my body, my sciatic nerve got off relatively easy. True, I had some twitches and small cramps while I was squatting besides the bed. But I can recall several airplane rides that wrought more havoc. I’ve had worse cramps on a standard Tuesday.
Why was labor so unexpectedly gentle on my nerve? I don’t know for sure, but I suspect the saline drip had something to do with it. Although I was sweating like a freshly poured iced tea in Florida, I never felt the familiar rush of nerve pain I associate with breaking into a sweat.
After labor, I was so swollen, I resembled a Macy’s Thanksgiving Day Parade balloon version of myself. That this swelling was so noticeable is itself notable, since I’d had a respectable case of edema since mid-pregnancy. I was thankful for this extra padding, since I’ve noticed that retaining fluid seems to dampen the nerve pain.
What an Unmedicated Labor Feels Like
When I was still pregnant and looking for suitable alternatives to an epidural, I tried to figure out what kind of painful childbirth would be. Was childbirth painful like sciatica was painful? Like a stubbed toe was painful? Like a chemical burn was painful? Pain encompasses a vast array of sensations, and I wasn’t sure what which kind to prepare for.
After labor, I tried to analyze and catalog my own body’s sensory memories. The best analogy I can come up with is this: Labor feels as if your body just up and decided to run a marathon one day without any training.
It’s painful, yes, but painful in the way that comes from intense physical exertion. During labor, I was thankfully for every squat, every pull-up, and every overhead press I did while pregnant. Afterward, I resolved that if I ever got pregnant again, I’d embark on an even more intense fitness regime.
But if I was unprepared for labor pains, I was wildly unprepared for the third stage of labor and the few hours immediately postpartum. Although the pains of this period were different, and never rose to the same intensity as active labor, they were perhaps more emotionally charged.
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