At the beginning of the birthing class Hideaki and I took a few months ago, the instructor asked us to say the first word that came into our minds when she said the word "labour". Predictably almost everyone said "pain" or a similarly negative word, and only three people thought of a positive word. That word was "baby", and I was one of the ones who said it, which shows how optimistic I was about the upcoming birth. I was nervous about childbirth, of course, but mostly really looking forward to meeting my baby. My positive attitude was partly pragmatic- giving birth was going to be difficult no matter what, after all, so worrying about it wasn't going to make it any better. But looking back now I realize I had also idealized the birth and was perhaps a bit naive. I was imagining labour to be a peaceful, joyful event in which I sat in the birthing tub serenely pushing out a beautiful, perfect baby. But as any parent will tell you, childbirth seldom goes exactly according to plan, and if my birthing class instructor were to ask me again what word I associate with labour, a whole bunch would probably pop into my head at once, none of them positive. Words like "exhaustion", "trauma", and, just like everyone else, "pain". And maybe "disappointment", as there were a number of things that left me feeling let down, not least of which was my own weakness. I may be exaggerating a wee bit, and really the birth wasn't that bad as far as births go. But it was just so much more worse than I'd imagined that I can't help but be a bit overly dramatic.
Things started out fairly well. I'd had a very easy pregnancy, managing to escape any major complications and even enjoying the minor ones (or at least finding them more fascinating than annoying). I hardly even had morning sickness, and what I did have was more like a gentle queasiness than full-on nausea. I learned to control it by eating frequently to keep my belly halfway full, but even when that didn't work and my stomach ended up too empty or too full, I'd just have to lie down for a little while to feel better. I actually loved being pregnant and once I was in my second trimester found I had lots of energy and was always really happy. And then getting closer to my due date, my body had been showing signs of preparing for the birth: a softening and slightly dilating cervix, loose stools (and if that's too much information for you, you'd better stop reading right now), increasing Braxton Hicks contractions, and a strange restless feeling that made me completely unable to concentrate on anything. That last one really pleased my midwives and they advised me to go with it and stop trying to use my head for anything: no reading, writing, watching TV or movies, or deep thinking. What was I supposed to do to pass the time? Listen to music, talk to the baby, and walk (my midwives were big on walking and I was supposed to be doing it for at least two hours a day). I would have preferred to have been hit with the nesting instinct, which would have at least allowed my to fill up my freezer with muffins and other goodies, but it wasn't to be. And although the happy feelings and boundless energy I'd been experiencing were gone, but at least I knew my body was getting ready.
Despite all those good signs, Ku-chan (that was the baby's nickname when he was inside me) never dropped. He'd been in the head-down position for months, but he rode high and refused to lower himself into position. His due date passed, and the next day (the day before I went into labour) I didn't even bother keeping track of my contractions, although they were pretty frequent and even occasionally painful. I just assumed that until the baby dropped I wasn't going into labour.
That night, Sunday September 19th, both Hideaki and I slept fitfully. Hide had been having trouble sleeping for a few days and had come down with a really bad cold, so knowing he needed some rest before starting his work week he decided to take a sleeping pill. Not a decision taken lightly- those pills work so well they make it next to impossible to wake him up. We joked that I better not go into labour that night, or I'd be going it alone. Haha. Of course that night I went into labour.
Amazingly Hide's sleeping pill didn't work and neither of us slept well, as if somehow we both knew what was about to happen. Around 3:00am I was awoken from my half-sleep by my waters breaking. I'd been worried that I wouldn't know when my labour had actually started, since so many signs of labour are similar to things women already experience in late pregnancy, but there was no way to mistake this- it was like nothing I'd felt before and I immediately knew what it was. Within a split second of waking I was up and running to the bathroom, feeling like a dam had broken inside me. Often when a woman's water breaks before labour (and only about 13% of women experience rupture of membranes before labour, despite what you see in the movies) very little fluid actually comes out because the baby's head seals off the cervix, but as Ku-chan hadn't dropped yet there was nothing to hold the water back and man, did it gush. When I finally got off the toilet there was a river of amniotic fluid marking the path I'd taken from my bed. I noted with interest that the river started off clear and gradually turned pink.
So it was a big mess but I had little time to worry about clean up, as almost as soon as I woke up my contractions started. Not the wimpy Braxton Hicks contractions I'd been having for the past month, but real ones- again, there was no mistaking them. We tried to time them, but soon I had another thing to worry about- the water in the toilet was brown. I knew that was a potential indicator of meconium (baby poop, which isn't supposed to come out until after birth) in the amniotic fluid so we got on the phone to Mejiro Birth House, our midwifery clinic. We had some trouble describing exactly what shade of brown we were seeing- the classic sign of meconium is a dark green or black colour, and apparently if it was a light beigy brown it might not be a problem. What really got me worried was when my midwife asked how much the baby was moving- in all the excitement I'd forgotten about the actual baby, and now that I thought about it I hadn't felt it move since the evening before. How could I not notice something like that? I felt horrible, and terribly worried for Ku-chan. To be on the safe side we were told to come in straight away, so we finished up our packing and called a taxi.
It was a disappointment to have to go right to the clinic, as I'd hoped to spend as much of my early labour as possible at home. But in the taxi my pain increased and I found myself glad we were going early, as the ride was uncomfortable enough as it was- I couldn't imagine doing it once the real pain had begun. At the clinic we were greeted with another disappointment- the midwife had already been on the phone with the doctor (the clinic has no doctor of its own but works closely with a few), who advised against a water birth as he considered it risky when the waters have already broken (something that nobody had mentioned to me before). One of the main reasons I'd chosen this clinic was their water birth option, and suddenly it was denied me. I tried not to think about it too much, but was starting to dread having a natural birth outside of the tub.
After getting settled in I was checked out and with great relief we heard the baby's heartbeat- it was fast and strong and showed no distress at all. I was only 3cm dilated, and the baby still hadn't dropped, so we were encouraged to go out for a walk to help speed things along (and to get some snacks, since we hadn't eaten since the previous night's early dinner). It was nice to get out at first, but soon the pain became impossible to bear standing up (like most of Tokyo the neighborhood had no benches or anywhere to sit) and we turned around and headed back before reaching the local convenience store. Once back at the clinic my contractions really started to hurt, and although I'm not totally clear on when each stage of labour ended and the next one began, I think this was when active labour started.
Around this time I experienced a major disillusionment: it turns out that having a baby is very undignified. I don't mean that I had thought labour would be free of yuck and gore, but I didn't expect all the burping. Or the throwing up. But here I was, hit with a sudden wave of nausea, like all the morning sickness I'd never experienced during pregnancy had been saved up somewhere and suddenly unleashed. First I threw up a few times, making my empty stomach even emptier. Then smells started to overwhelm me- the smell of soap, the fumes from a passing car, and various other unidentified but thoroughly vile scents. Then the burping started. I stopped being embarrassed by about the 50th burp, but until then it was pretty mortifying.
And then there was the more expected part of labour- the pain. I thought I'd been handling it well up until that point, but I soon realized that was only because it hadn't been very painful yet. I tried a few different positions to see which one was the least painful, including one suggested by the midwife- me sitting on the birthing chair (an awful low stool with no arm or back support, topped with what appeared to be a toilet seat), leaning back into Hide who was sitting in a higher chair behind me. His chair was a cheap, wobbly folding chair with flimsy back support, and with the crappy chair, his cold, the heat (did I mention we were in the last heat wave of the year and the tiny room was kept un-air conditioned?) and all my weight on him, he wasn't doing well. He actually had to leave the room a few times to avoid passing out, poor guy.
I didn't find it much more comfortable than Hideaki did and the other positions I tried were worse, so I requested that the midwife unfold the cot and let me lie down, which she did rather reluctantly. I lay on my side, facing the wall, and this was the nicest position of all, so I stayed there for as long as I could (I think a few hours). Between contractions it was very restful, and during contractions I could get through the pain by using my arms to brace myself against the wall while Hide pushed into my lower back (he tried the balls of his hands, a tennis ball, and a plastic drink bottle, and the latter worked best). The midwife also tried rubbing my back which made it hurt even more, but for some reason I was too nice to say anything directly so just kept asking Hide to do it. That shows that the pain wasn't really that bad yet, because by the end of the birth I had no trouble letting it be known when I didn't like something.
Around this time my sister-in-law Atsuko and her daughter Marya came to visit. It was nice to have a distraction, and Marya got to see that childbirth wasn't that scary (thank god she didn't come a few hours later), which is important as her mom is pregnant and due in December. Meanwhile Hideaki had gone out to get some snacks and drinks, and the midwives (there were now three) were encouraging me to eat to get my strength back. I still hadn't eaten since the night before, and I'd thrown up again, and they were getting worried that I wouldn't have enough energy to get me through the birth. Unfortunately my nausea made all the food we had seem disgusting, and I couldn't keep down a bite of anything until someone suggesting Hide go out and get some jelly drinks (I have no idea what these are called in English, but they're little pouches filled with jelly that you suck out of a screw cap). I'd never this stuff before and the sports drink type he bought tasted vile, but at least I didn't have to smell it so was able to keep it down.
The jelly did seem to give me a bit of energy, which I really needed as I was exhausted. I hadn't started pushing yet so I wasn't really physically exhausted, but the pain was really tiring. I was rather proud of myself that I was able to bear it, and bear it quietly- the breathing exercises I'd been taught were working and there was none of the screaming and groaning I thought there'd be. I only panicked once in this stage and was soon encouraged to breathe properly, which calmed me down. Of course if I'd been able to actually speak articulately I would have demanded to be taken to a real hospital and given drugs, but I kept quiet about that.
I was still urged to eat real food and also to walk around but neither were possible, and as my labour wasn't really progressing I had to get off the cot and back into the dreaded birth chair to make use of gravity. I think this was also the time they strapped the monitor belts around my tummy (they'd only been doing occasional monitoring up till then), which I hated and kept asking to have taken off, which of course they couldn't and I'm now glad for it, since the meconium and my apparently slow progression made constant monitoring necessary. My contractions were getting more intense and I think I was almost fully dilated- I'd stopped paying much attention to anything by this point- and I'm pretty sure this was the transition phase (the stage of labour that comes before the actual delivery) but Ku-chan still hadn't dropped, so one of the midwives decided to reach in and grab him. This felt exactly as pleasant as you imagine, and I don't know if this is widely practiced in Japan or if it's just something done by my crazy midwives. This didn't seem to help things but still those hands stayed in there for pretty much the rest of the birth.
I was now in the second stage of labour and feeling the urge to push. From the very beginning of the birth I had kept being surprised by the escalation of pain, feeling at each stage that it couldn't possibly get any worse but then quickly learning that indeed it could. But pushing brought a whole new different kind of pain, and it wasn't a quiet kind of pain. I don't know how to describe the sounds I made while bearing down, but imagine screeching and grunting and shouting and moaning all at once and you'd probably be close. Just like the burping, it was undignified and for some reason I found it really embarrassing at first. Soon, thankfully, I wasn't even aware of my sounds, and was barely aware of anything except for the pain. Even when the midwives said the head was visible, I didn't even think to ask for a mirror to see it, and my only real interaction with anyone was accepting or rebuffing offers of drinks.
I vaguely recall hearing hearing that my contractions were too weak and I needed to push harder, but I was pushing as hard as I could. I also heard the head midwife on the phone a few times, telling the doctor that my labour wasn't progressing. The head kept appearing with each push and then disappearing again, which is expected but it seemed like it was going on for too long. Hearing the midwife talk to the doctor about it made me start to panic again, and I decided that I had to get that baby out. I used all my strength for each push, and still the baby's head would retreat as soon as I stopped. I don't know how long this went on but it seemed like forever, and I could feel myself getting weaker and weaker with each contraction. This made me even more panicked and I started to doubt that I could make it through. The monitors around my belly became unbearable and I kept trying to tear them off, and I was trying to demand the midwife get her hands out of me. I think all that came out was "NO NO NO NO!", which not surprisingly they failed to understand. In fact they made it worse, and if having the baby's head pulled out of my uterus by hand was uncomfortable, having another midwife push down on my belly was ten times worse. The nonono's continued and I was ready to ask to lie back down and take a break, but another phone call to the doctor brought me back. I finally consented to eat a bite of a Snickers bar, which at the time seemed like the most disgusting thing I'd ever had, especially as it was half melted in the thirty-plus degree room temperature.
Amazingly, that one awful bite gave me the strength I needed and with the next contraction I gave a few final, mighty pushes. And at 5:05pm, September 20th, my baby was born. Just like that. One minute the baby went from barely crowning, and the next minute it was ripping though the birth canal and landing in the arms of the midwives. I do mean ripping, by the way. One of the big reasons I had wanted to deliver with midwives and not a doctor is that midwives can't perform episiotomies, which are still routine in many hospital births here. So I guess a perennial tear was my punishment for not wanting to be sliced up.
I keep saying that each stage brought a new level of pain, so I'm sorry for sounding like a broken record but it's true. Despite the tear, I'm glad the baby went through my vagina so quickly, because that was a whole different kind of pain and, understandably, I was getting rather tired of hurting. "Ring of fire" is a really apt name for the baby's journey through the birth canal. But finally I was feeling more than just pain, and there was also a very odd sensation- I could actually feel the baby slipping out. I mean, when the baby was crowning I couldn't really feel it and wouldn't have known it unless I was told, but nobody had to tell me now that there was a baby coming out of me. I could feel the head, the shoulders, the butt, the feet, the umbilical cord, everything. It was a strange, slippery, rubbery feeling that I'll never forget and that made me feel instantly better. I was too tired to even look, but knowing the baby was out brought an amazing sense of happiness and relief.
I was helped to lie down on the floor and right away I hiked my skirt and top up to my neck and waited for that slippery brand-new baby to be placed on my chest. And waited. And waited some more. I'd been told that babies usually don't cry loudly after birth like they do in the movies- they are often quiet or will wail a little. But the baby seemed too quiet, and they seemed to be taking too long cleaning it up. I willed myself the strength to lift up my head and look around, and saw that they were suctioning something out of the baby's mouth and nose. I got up a bit more and looked at the sheets between my legs, and they were stained not just with blood but with a huge amount of mucky dark brown liquid- my amniotic fluid was indeed filled with meconium. It was explained to me that the baby had drunk and inhaled the meconium, but I didn't need to be told. Nobody seemed terribly concerned, and the baby was breathing, but the fact that the baby was not in my arms was starting to worry me.
I was still in labour and still attached to the baby by the umbilical cord. When the cord stopped pulsing (this is what I'm told, I never even looked at it) Hideaki was asked to cut it, something that he had thought he wouldn't be able to do. But he did it, which I'm really proud of him for, and he later reported that it was kind of cool and not gross at all. I was too tired to pay much attention. It took forever to pass the placenta. It didn't seem fair that I still had to work to push it out and that I was still in pain, but all of the distractions made it easier than delivering the baby had been. The pain didn't end when the placenta was out, though- one of the midwives put her hand back inside me and started mucking around in my womb. She said she was removing all the blood, something I've never heard of, and it was pure torture.
Meanwhile the midwife was on the phone again, and it wasn't to the doctor. She was calling her back-up hospital, and then she was calling the ambulance. Apparently the baby was still having trouble breathing and there was too much meconium for them to suction out with their equipment. And now I really was worried. I started imagining this was the last I'd see of the baby so I asked to hold it. The baby was placed on my chest, and much to my disappointment it didn't find my nipple and start to suckle- the time for that had passed apparently, but at least it was breathing and at least I could hold it. I could barely lift my head so didn't really get a good look, but I just enjoyed feeling it there and wished it could stay there and that we could be left alone together. I was scared but at the same time I was so happy to be holding my baby and so overwhelmingly tired that I chose to believe everyone when they said the baby was only being taken to the hospital as a precaution and that everything was going to be all right. And it was a choice- I made a conscious decision not to worry, being aware that giving in to my fear would make me lose it and I knew I just didn't have the energy to console myself.
The midwives continued to work on me and to occasionally suction the baby's nose and mouth but it stayed in my arms and just before the paramedics arrived I thought to ask about the gender. They held up the baby for me and I saw it was a boy. A boy! Shuma! I asked for a picture, still half worried that it might be our last chance. I look exactly how I felt: exhausted, out of it, and happy. He looks pretty tired too.
And then we heard the siren, and the paramedics were there, and Shuma, Hideaki and the head midwife left for the hospital. I was still keeping my worries and fears at bay, but I had no defence against the emptiness I felt. As the remaining midwives busied themselves cleaning up I allowed myself some tears, then resolved to stay awake until I'd heard some news.
To be continued.
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