I’d had a couple of friends that had children, but none that I intimately discussed prenatal, or labor and delivery care with. I started doing my research and realized that I wanted a doula present for my birth. I was worried about the so-called cascade of interventions that often happens with hospital births. I was more afraid of the possible effects of an intervention than of the pain of labor. My husband and I attended a doula meet and greet and after a conversation with one I’d scoped out online, we booked her. 

After a relatively uncomplicated pregnancy, I went into labor at 40w3d early on a Monday morning. I let my doula know that my contractions had started but were very tolerable and were still erratic. I labored at home all day Monday, eating when I felt hungry, walking to help bring labor on more, and talking with family. Not knowing how long labor would actually last, I asked for my doula to arrive Monday evening. There were several stronger bouts of labor that night and early the next morning. I was advised to rest. I remember sleeping for maybe a couple of hours, but when I woke, labor was more intense. Contractions grew stronger throughout the day Tuesday, however were still slightly erratic in timing. One reason I strongly wanted a doula was because I wanted to labor at home as long as possible. I did not want the hospital setting to interfere with the mojo of the physiologic birth that I had envisioned. So far, so good. I had a conversation with my doula about when to head to the hospital. She felt I could stay at home longer if I wanted, however, I’d just vomited and was feeling a much stronger intensity in my labor and chose to go. 

When I arrived at the hospital, I’d already been in labor for 36 hours. Upon arrival, the resident that performed a cervical check said that I was at 7cm! I was ecstatic. I had done most of my laboring in the comfort of my own home. Baby was in a posterior (sunny side up) position. My doctor arrived and said that when I was feeling the urge to push, to call her back in. I had envisioned moving around much more in labor than I did. My husband was the one that sat and bounced on the birth ball while I rocked in the hospital rocking chair, as that was all that was comfortable to me at the time. Any counter pressure on me was more painful. I was also incredibly hot and they continued to place a washcloth with ice water on my forehead to help cool me. I remember feeling like it was time so we called the doctor in and she agreed based on her exam. Because I’d been in labor so long and I’d been deep breathing my way through, it took a few contractions to get the pushing technique right. My water finally broke after my first proper push. My doctor did ask before I started pushing if I wanted her to break my water. I said no. After a few pushes in, she wanted to check on position of the baby. I’d been seeing my doctor for nearly a decade, and had come to love her calm and attentive demeanor. At this point, I could see a panic come over her. She told me that typically she should be feeling baby’s round head at this point, but she was not sure what she was feeling. We had a bedside sonogram completed to rule out a breech or other malposition. Sono said all was fine. She called the on-call hospital OB to help her determine what was happening, all the while, I was told NOT to push. I had never met this doctor before, but he politely introduced himself, told me he was going to examine me, and we’d discuss the situation and figure out a course of action. After his exam, he explained that our baby, instead of coming out top of the head first, was actually positioned to come out face first so that the length of baby’s face (forehead to chin) would need to pass through my pelvis and the birth canal. He explained that while a vaginal birth wasn’t off the table, he could not guarantee what type of trauma the baby could endure during a vaginal birth. While I do not recall having a conversation about the risks of a cesarean, he ultimately left the choice to us. Baby was not in distress and was otherwise doing well. Looking back now, I wish we would have discussed what our options were in terms of trying to maneuver baby without pushing. Though I don’t have regrets on the decision we made to have a cesarean.

After the conversation with the hospital OB, the female medical student that was with him, walked up to me and did her own forceful internal exam. I did not know who she was, why she had done that and why on earth she was so rough. I do not remember what words came out of my mouth, but I do remember my own doctor saying that the student needed to get out. Thankfully, I did not see her again during my stay in the hospital. 

The hardest part during this ordeal was to sign paperwork, sit still for a spinal during contractions where I normally would have been pushing, and feeling like our fate was now completely in the hands of the doctors. When I arrived in the OR, the staff were astounded at how mobile I was. I’d not had an epidural or any type of pain relief. Besides shaking what felt like uncontrollably, and a growing pain in my left shoulder, my cesarean was typical. Cord was cut right away, baby was taken away to be cleaned up and weighed, and there was no lowering of or having a clear drape. My friend that had shared her birth story with me just 6 months before did suggest to have a cesarean plan in place. I thought in my head that I wasn’t going to need one, so I didn’t need a plan. In hindsight, this would have been a helpful backup plan to have had. Overall, because I felt that I had informed consent along the way, and had a doula to otherwise help me achieve my birthing goals, I don’t look back on my cesarean birth with negativity. It had still been the empowered and informed labor and birth I’d planned.