Luka's Birth Story

"The temptation to quite will be greatest just before you are about to succeed."

If there ever was a quote to sum up our birth story that would be it.  

Some of you have followed along my pregnancy from the beginning, so you know that I did not find out the gender of our sweet babe until the delivery.  Luka Hot Halverson entered this world on Monday, May 18th 2020 at 4:07 PM weighing 8 lb 3.4 oz and measuring 20.5 inches.  Our world has forever changed for the better and despite such a small package, my heart and Andy's is overflowing with love.  I believe every birth story is beautiful and unique and I wanted to share my experience with the ULA community.

At 39 weeks (of 40 weeks gestation), I went in to see my OB/GYN and was surprised when she did my first cervical exam and told me I was dilated to 4 cm and 70% effaced.  For those of you that aren't familiar with pregnancy, you need to be 10 cm dilated and 100% effaced to deliver.  My OB/GYN told me that she would be shocked to see me at my  40 week appointment and that my body "was ready" for this baby.  Needless to say, I started anticipating and waiting for beba's (Bosnian for baby) arrival.  Fast forward to 40 weeks and 4 days, no baby and same dilation.  I had researched the ACOG Guidelines and a few different trials and knew that ideally births happen between 39 and 41 weeks gestation.  After 41 weeks, you can have a medical induction and prior to 41 weeks it is elective.  In addition, at 42 weeks they medically induce you because the chances of c-section and complications increase further given baby is growing and there is only so much room in utero.  Although I really wanted a natural birth, I ultimately wanted a healthy baby and preferably a vaginal delivery.  I scheduled an "elective" induction for Sunday, May 17h a 8 PM when I was 40 weeks and 6 days pregnant.  Again, elective until 41 weeks and the plan was call the hospital 2 hours ahead of 8 PM and see if they have availability.  When I anticipated a natural birth, my plan was forego an epidural as long as possible and try a drug-free birth.  Being a pharmacist, my explanation to my husband was I wouldn't just take ibuprofen preemptively for my first ever headache because someone told me to.  I would wait to experience the headache and determine if I needed the ibuprofen.

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That Sunday was an emotional day.  We woke up and thought it was our last morning as just the two of us + Teek.  We had a lazy morning in bed and took Teek, our Weimaraner, for a long walk by Lake Washington.  While we were on that walk, we missed a call from Andy's dad.  We learned Andy's grandmother passed away that morning from COVID-19 complications.  Andy saw symbolism in one strong soul passing and a new one entering this world and hoped that our baby would have some of the admirable traits of his grandmother.  She was small in stature, but fierce and independent.  She was the matriarch of her family.  She did everything from playing bells in her church group to building the family log cabin in Wisconsin.  Among her many joys, was gardening so we decided to make a detour on our walk and buy a plant for our yard to commemorate his grandmother.  That evening we got everything ready for our potential induction and made one last yummy meal together.  As we were sitting in our backyard, enjoying each other's company, I called Swedish Ballard and was informed that they were too busy at the moment and would call us back at 7:30 PM.  In my mind I knew our induction would likely be pushed back.  At 7:30 PM, this was confirmed and the charge nurse asked us to call back Monday at 6 AM.  

Andy asked if I was sad and honestly I was not.  I knew we were close to meeting our baby and strongly believe everything happens as it should.  So we went to bed that evening and I hoped in the morning we would be en route to meet this stranger.  At 6 AM on the dot I dialed Swedish Ballard a second time and heard the best words, "we can get you in at 8 AM."  Andy and I got up, made our bed, sipped our coffee, and walked Teek.  We dressed for the hospital and picked up bagels for the nurses en route.  We updated our family, a few friends, and our doula.  It felt so surreal.  It was a planned induction, but there were still so many unknowns.  Like are we having a boy or girl?  Will it have hair?  How long will this labor be?  How much will it hurt?  

It is the time of COVID-19, so we wheeled our overnight bag into the hospital wearing face masks and were screened before getting to the L&D unit.  We got settled in our room and met our nurse and the on call OB/GYN before change of shift.  I already knew I wanted to be induced with pitocin.  I was too far dilated for a balloon catheter and didn't want misoprostol.   I did ask about them breaking my water to see if I would naturally go into contractions, but was informed that for first time pregnancies they prefer to start pitocin first and ensure contractions progress to minimize chances of infection due to potential delays that can occur.  If you don't know much about pitocin, the gist is that it replicates naturally occurring oxytocin and induces contractions that are much more intense (read painful) than naturally occurring ones.  After the OB/GYN repeated a cervical exam and noted I was now 5 cm dilated and 80% effaced, the nurse started pitocin at 9:45 AM with a plan to increase the dose every 30 minutes until I developed consistent contractions.  We updated our doula and her plan was to arrive in about an hour to allow time for the pitocin to start working.

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My doula arrived after they had increased the pitocin from 4 to 6.  If you don't know what a doula is, it's okay, I didn't either until I moved to Seattle.  The PNW is the doula capital of the US.  A doula is a trained professional that helps provide informational, emotional, and physical support for the mother before, during, and shortly after birth.  Our doula was critical in coaching Andy and I through various scenarios that may arise during the delivery and was a huge support in the birthing suite.  She suggested I start walking, squatting, or using the exercise ball to help the baby drop and accelerate the progression of labor.  During all this, I felt the contractions build as a pressure at the top of my uterus that would slowly progress down to my pelvic floor.  However, I did not experience true pain.  I was able to converse and laugh.  By 11:45 AM, I was dialed up to 10 of pitocin and the plan was to hang out there for at least an hour.  Right around the hour mark, the nurses stated the on call physician offered we break my water given my contractions were so close together and consistent.  They shared that this would likely intensify contractions and labor.  I jumped at this offer since the pitocin had done it's job in terms of creating contractions and I didn't want to hang out waiting for hours for labor to intensify.  From my research, I also knew that manual rupture of the membrane (water) is often necessary too --don't believe everything you see in the movies.  The physician came up before 2 PM and repeated a cervical exam prior to breaking my water.  My dilation and effacement had not changed, despite the pitocin.  About 10-15 minutes after breaking my water, the pain of the contractions changed significantly.   The best way I can describe labor contractions is like ocean waves or earthquake ripples.  You feel them building before they peak and they take over your body from the core outward.  It is more painful than anything I have experienced before, yet I had no desire to cry.

I started off by laboring leaning against Andy with feet wide and shifting my bodyweight on him.  Then I progressed to the exercise ball.  The position that ended up being preferred for me was laboring, leaning over the hospital bed with 2 pillows propped under my chest.  My doula gave me a fine-toothed comb and I would squeeze the teeth into my palm as a way to transfer or distract the pain.  I held Andy's hand with my free, left one.  He was rubbing my back and helping me stay with my meditative breathing.  My mantra was "inhale confidence, exhale fear and the bullsh*t."  Our doula was also helping alleviate pressure on my hips by squeezing in and up on either side with the contractions.  After about an hour I asked the nurses what we were looking for.  HELLO new to this and unsure what the goal was, but I was in a lot of pain.  They asked for pain on a pain scale and my slightly, sassy response was well this is the most pain I have felt, but I am unsure if it can get worse so really not sure how to answer that.  They asked if I was feeling pelvic pressure persistently or with each contraction.  Now, I will say that my contractions were probably only 30 seconds apart at times and would last up to a minute. There was significant pressure building.  However, at that moment the pressure was not consistent, but still slightly intermittent.   Around 3 PM, my doula suggested laboring in the jacuzzi to provide relief and the nurses said it would take about 20 minutes to get it ready.  At 3:07 PM, I remember the time because it was on my infusion pump, I told Andy and the doula that I needed an epidural.  I didn't think I would have the energy to push if I was expected to keep persevering through these contractions for hours.  I was unclear on how long I would be in this transition phase and wanted to conserve energy.  

I was informed by the nurses that the room next to us requested anesthesia 5 min before me.  I would have to wait 15-20 minutes while they finished placing that epidural and then they would come to our room and it would take about 15 minutes after the epidural was placed to feel relief.  I wrapped my mind around that timeline and said okay.  For some reason, it's always been easier for me to cope when I know what to anticipate (Type A planner mentality).  Twenty minutes passed without an anesthesiologist and my laboring had become animalistic.  I asked for any update.  There were complications next door and it would be another 15-20 minutes.  THAT SUCKED TO HEAR.  I asked them to turn down my pitocin to 8 because it felt unbearable and I started praying for an epidural. My husband kept coaching me on how tough I was.  At some point, either I said I needed to pee or the nurses suggested it.  My doula was in agreement that a lot of mothers find laboring on the toilet to be more comfortable.  I made my way to the small en suite bathroom between 2 powerful contractions.  My legs were quivering from the contractions and the squats I had been doing with each contraction.  The last few contractions had felt like I was going to rip from the inside out with this immense pressure by my rectum as well.  As I sat down to urinate, I told the nurses that I felt like a bowel movement was coming.  I had heard this could happen during labor, so didn't think much of it.  However, they ran over and checked me.  They said that's not a bowel movement, that's a baby.  

WOW.  As a first time mom, you don't know that pressure is what you are looking for.  It means it's time to push.  Two nurses helped me to the bed.  They paged the on call physician and started coaching me on how I would push.  My husband came to the bedside on my right.  I will be honest, these 15 minutes were a blur and part of me still feels every detail, while another part of me has blacked it out.  I recall the nurses and charge nurse hustling around the room.  Andy told me later that he could sense, they did not think the doctor would make it on time and they would be delivering the baby.  I pushed for 13 minutes.  It was either 4 or 5 rounds of contractions and I pushed about 3 times with each contraction.  I felt when my tear happened, I felt when my baby's head surfaced.  The doctor told me it would take just one more push and II used every ounce of strength I had and heard our baby cry.  Andy announced we had a baby boy and within moments he was on my chest.  

That moment is one I will cherish forever.  They say you don't know love, until you experience the overwhelming love that comes from holding your child for the first time.  That is such an accurate statement.  I have never been more proud or felt more courageous.  I was a mama and he was worth every moment of discomfort.