Executive Summary: It all turned out fine! I got a healthy baby out of it, and for the most part recovered entirely within a few weeks after birth.
What I Learned the Hard Way:
- Take a LOT OF NAPS if you’re more than a week overdue — you never know when you’re going to go into labor, and you need your energy.
- Talk to your doctor about what to expect during labor and delivery, but also during the postpartum experience at the hospital — and what to expect during “off” hours like the middle of the night or a weekend. (I had assumed, perhaps foolishly, that hey, it was a hospital–there were no off hours!) If you might be giving birth during a holiday weekend, or another big vacation weekend, talk with your doctor about how that might be different too. (Jack was not born during a holiday weekend, but I wonder if it was a big vacation weekend, perhaps because of grade school start dates.)
- Talk to your husband or significant other about being your advocate (and your child’s advocate). You WILL NOT BE YOURSELF during your labor. Even if you’re conscious and listening, you need to trust that he will take the action, ask the question, make the call — even if you don’t.
- Know your options. I’m the one who asked for a vacuum, which helped me avoid having a C-section. I wish I’d known more about fetal monitors, and when I HAD to consent to sitting on one, and what a reasonable time frame was if I had to use a fetal monitor. (Looking back, sitting on one for 2-3 hours upon arrival at the hospital was a bad start.)
- Don’t expect to rely on anyone but yourself for taking care of your newborn. I expected the hospital to do a lot more — make sure that my son was getting enough to eat, make sure that I knew what to do to take care of him, make sure that nursing was going well and I had what I needed (a pump, a different hold, whatever). We received none of that. Looking back, I wish I’d known a lot more about how the first 24-48 hours of nursing are supposed to go.
- Have a plan, but keep an open mind (particularly about epidurals and formula). This is my own $.02: the two things I’d read a LOT about avoiding during this experience were epidurals (they slow down birth and make a C-section more likely! it drugs the baby as well as the mama!) and formula if you want to nurse (nipple confusion! the baby will reject the breast!). I succumbed to both in the end, and frankly wish I’d succumbed a lot sooner to both. Talk with your doctor about what to expect re: epidurals — and if you can, find a lactation consultant ahead of time to talk about formula. (In the week or two following Jack’s birth, when we were actively supplementing, we gave him the formula in a cup or dropper rather than a bottle; there are other methods and devices your lactation consultant might recommend.)
- Pick your child’s pediatrician, and make sure that you know what level of care (if any) you can expect BEFORE the first visit. In our situation, Jack was born Friday morning, and we took him home Saturday night. The pediatrician’s office was closed over the weekend, but as we found out later, they would have taken our emergency questions. Unfortunately, the answering service incorrectly told us they couldn’t take questions if we weren’t yet patients, and I didn’t know enough to push the issue.
- On nursing: get a lactation consultant recommendation BEFORE you give birth — and if you’re giving birth during a vacation season like summer, know who is still in town. I’d also suggest buying The Nursing Mother’s Companion before you give birth, as well as a breast pump.
Every birth story is different, but they are also all the same, at least the ones I’ve read: nothing goes as planned, everyone hates multiple parts of the experience, but (fortunately) most people come out of it ok. Here is the story of my first son’s birth. I should stress at the outset that mine was, objectively I think, a “bad” experience, and not a normal one — but it still may be beneficial for you to read and at least talk about with your doctor.
Jack was due on August 12, 2011, or maybe August 10 — I don’t remember the exact date. I had heard that the full moon always brings the babies, so I assumed he would actually be born on August 13. He wasn’t. So we waited … and waited, and waited. Over the next few days I tried every trick in the book to get the kiddo to come out (eggplants! acupuncture! sex!) — but he wasn’t budging. My doctor scheduled an induction for August 22, which freaked me out, but is apparently standard procedure.
I woke up the morning of Wednesday, August 17 and started having slow contractions, about 25 minutes apart. They continued all day, eventually getting closer together, and I thought it was finally happening – my son was about to be born. At one point, mid-afternoon, my husband and I made the 45-minute trek from Brooklyn to the hospital (St. Luke’s Roosevelt, on the Upper West Side of Manhattan) to get looked at by my doctor.
She sent us home. The contractions stopped entirely at 6 PM. I was bummed, but figured this was par for the course for a new mama.
What I Should have Done: Take a nap.
What I did: Had dinner with my husband. It was 6 PM at this point — dinner time — and I just wanted to bond over our near-birth experience.
Real Contractions & White Collar
At 9 PM that same day, contractions started up again, and they were about 10 minutes apart by 2 AM. I sent my husband to bed, figuring at least one of us should get some sleep. I continued to labor through the night — bouncing on my birthing ball, doing bellydance moves, and, for some reason, watching a million or so episodes of White Collar. We had been told by the doctor not to call the hospital until contractions were at 3-1-1 (three minutes apart, lasting one minute at least, for one hour); by 6 AM the contractions were close to that and it was hard for me to time by myself, so I woke my husband up and we called my doctor. She cheerfully told me to head to the hospital. “Maybe eat some breakfast first,” she said. (Which surprised me considering that I’d heard fairly graphic stories of friends projectile vomiting if they ate during labor, but maybe she knew we had a long road ahead of us.)
That was the last time I’d talk to, or hear from, my doctor – or anyone from her office – for the entire three days we ended up being in the hospital. We left a message with her service the morning after my son’s birth when we called to complain that we were falling through the cracks, and I CC:ed her on a letter I wrote to the hospital about my experience months later, but looking back, that call marked the end of our relationship.
What I should have done: I honestly don’t know what I could have done differently, but maybe to manage my expectations better — my doctor and I had talked about what the labor would be like, but I had very little idea what to expect in terms of postpartum care while at the hospital. I expected her to check on me at least once before I was discharged and otherwise be around to make suggestions or referrals if things were going poorly, I suppose.
The other thing I would have done was have a big discussion with my husband about what I was expecting. This is a very, very tricky rite of passage for relationships — if you are normally the more strident, vocal one in your relationship, your husband may not realize that you NEED him to speak for you. You just have no idea how exhausted, in pain, and bewildered you’re going to be — you may be sitting right there talking to the doctor, nodding your head, but not actually be processing much beyond the headlines of what you’re being told. Your husband is likely going to be exhausted as well — but unless he’s also been in labor and awake for many hours, he’s going to be the better one to make decisions and do the critical thinking. One of my friends specifically hired a doula for her second birth because she wanted a better advocate than her husband; another friend eventually got divorced, with the husband’s (perceived or real) failures during the birth experience looming large in both of their minds (along with other issues, of course). In our situation, I don’t blame my husband for anything that happened or how it happened, but part of me wonders if our roles were reversed, if I would have done the same things he did. (As they say, though: hindsight is 20/20.) What I will say is this: if you’re the kind of person whose husband is only half-confident ordering dinner for you at a restaurant because you like things a certain way, you’re going to have a helluva ride ahead of you.
What I did: Write a four-page letter a few months later to the Dean of Obstetrics to complain about my birth experience and CC:ing my doctor. Before my labor, I LOVED MY DOCTOR. I had always felt like we were in very good hands, and was confident that the “vibe” of my labor & delivery would be in line with the plan we had discussed; and I had heard wonderful things about St. Luke/Roosevelt as one of the best hospitals to have a baby in NYC. So much for carefully choosing an OB/GYN!
Arriving (and Waiting) at the Hospital
We arrived at the hospital maybe around 10 AM on August 18 — about a week after my actual due date, and four days before my scheduled induction — and went to the Triage Unit on the L&D floor. Between the cab ride, waiting in the triage waiting room, and then being made to sit on a fetal monitor (for about 2-3 hours, which felt like forever and during which I couldn’t move), my contractions slowed down considerably. I was bummed they slowed down, but I was so exhausted at that point that I was happy for the reprieve; hospital staff did not seem alarmed. Nurses at the triage unit had offered me an epidural as soon as I arrived, but I had refused, hoping to have a natural birth. We were finally admitted to a labor room in the early afternoon; I was barely dilated at all. My parents arrived around this point, having driven 7.5 hours from Cleveland, and my dad took up his post in the hospital lobby while my mother joined my husband and me in the labor room.
I continued trying to labor naturally, but I wasn’t dilating at all, which is how it goes for a lot of women. By now exhaustion was starting to set in — I’d been up for about 30 hours. I had researched various labor positions and knew about using bellydance moves to hasten the process, but had forgotten about the now-obvious fact that the more you move, the more pain you’re in — it makes the birth go much faster, obviously, but it also makes it much more painful. At some point I consented to having my water broken. They may also have given me a topical thing to try to help me dilate, but maybe not – my memory on this is clouded by exhaustion and pain.
Epidural and Pitocin
By 11 PM, I had been in labor for about 26 hours and awake for 40. The nurse who was attending me started asking about Pitocin and an epidural, but I had seen The Business of Being Born and taken Lamaze classes, and I really wanted to labor on my own. My pain hadn’t even reached the point of no return. Fine, the nurse told me, but if you change your mind and want an epidural in the overnight/early-morning hours, you could be waiting for hours because there are less staffers on hand. At the same time, I was texting with an old friend who had just had her second child and is a neonatal pharmacist at a Cleveland hospital. She was shocked they’d let me labor for 26 hours by myself at that point, told me to take the epidural, noting that everyone does. I asked if I could labor on Pitocin without an epidural and was unequivocally shot down. So between the looming threat of “no one will be around to help you” from the nurse and my friend’s encouragement, I was convinced to take the epidural at that point. I insisted on having the attending anesthesiologist give me the epidural, as another new-mom friend had recently told me her story about a resident screwing up her epidural, resulting in several weeks of severe headaches after giving birth – and finally drifted off into a few hours of blissful sleep. My parents headed to a hotel 15 minutes away.
Time to Push — and Wait
At 3:30 AM on August 19, a doctor I didn’t recognize woke me up and told me it was time to push. I begged the doctor to wait 15 minutes for my mother to return, and she left without saying when she would be back. My mother returned 15-20 minutes later.
Here’s where things get really hazy: We couldn’t get a doctor to stay in the room, and I don’t remember exactly why. The doctor who had woken me up returned at one point – maybe around 4:30 AM? – but promptly got a call on her cell phone, and turned around and left without talking to me at all. We assumed she’d be back momentarily; she wasn’t.
What I should have done: I was so exhausted, and kind of desperate to push — I maybe should have sent my husband or mother out of the room to go physically ask someone else for help.
What I did: We all just waited.
Yet another doctor came into the room and started trying to get me to push, but another mother in L&D – or maybe her baby – was in distress, so the doctor had to leave again. At one point, I remember asking the nurse — who had stayed with us for hours — “Are we waiting for me? Or the doctor?” She, like me, was also clearly frustrated with the situation, and said something to the effect that she didn’t understand why we couldn’t get a doctor to come back to the room. Compounding my physical pain, exhaustion, and considerable discomfort at this time was the fact that I had a horrible, horrible stitch in my side this entire time, and the only way it felt better was by pushing – but everyone was telling me not to push until the doctor came back into the room. My catheter may have still been in for part of this time.
“Push Where You Go Ca-Ca”
Finally, maybe around 5:45 am, the doctor who left to help the mom in distress came back, and I pushed for what felt like about 10-15 minutes, the whole time with the doctor screaming, PUSH WHERE YOU GO CA-CA! (Totally not the vibe I expected, but I didn’t even care about it by that point.) Outside, dawn was breaking. I’d had so little sleep, and was so exhausted, that I asked the doctor, “At what point are we going to talk vacuum?” The doctor agreed, and left the room for what felt like an eternity, but what was probably only 20 minutes, to hunt for the vacuum.
My MAIN goal going in to the birth had been to avoid a C-section. My mother had had me by C-section under horrible circumstances, and while we both survived, recovery was much rougher for both of us than it should have been. I had not wanted to use the vacuum – during Lamaze class, forceps had always sounded like the better option, even though I knew the vacuum was more modern. The vacuum was actually my second-biggest fear, so when the vacuum started to sound like a great idea, I knew things were bad.
Finally, they came back with the vacuum, and after just a little pushing – literally, it was only maybe five minutes – my son was born, crying, at 7:20 AM. I had read a lot about bonding immediately after birth with your baby, and had imagined him being brought over to be laid on my chest, maybe to nurse – but none of that was happening. Jack was put on a warming tray while a nurse attended to him, which I thought just routine maintenance. The doctor who delivered us stayed intent on me. I’m still really hazy about all of this, but my understanding is that I had second-degree tears and had lost a lot of blood; she was stitching me up and monitoring me. I remember attempting to order my husband to take his shirt off on and pick our son up so he’d have skin to skin contact, but I don’t think that happened. They finally handed Jack to me at 7:50. The nurse’s shift had ended, and a new one came on — as she handed Jack to me she pulled my gown down and roughly tweaked my nipple (which sounds stranger now than it seemed at the time). What I presume was colostrum started coming out, and Jack started to nurse.
Postpartum, Part 1 — “No, We Don’t Need Social Services, Thanks”
Following all of this, the doctor – in a move that surprised no one – left the room, followed quickly by the nurse, my mother (who left to go debrief my father and brother, who had both been waiting in the lobby since 3:30 that morning), and my husband (who left to pick up a quick fast food breakfast). I was left with the baby on my chest, which sounds fine until you remember that I’d been up for almost 48 hours straight, and had just gone through a 34-hour labor — my head was fuzzy, and I was suddenly holding a squirming baby who, I was a bit alarmed, might fall off me. (I may also have had a blood pressure thing on my arm that was inflating and deflating, which I felt was affecting my grip on my son — who was, incidentally, the first newborn I’d held for more than a minute.) I pressed the buzzer for the nurses’ station.
No one came.
My cell phone was on the bedside table, out of reach with my son in my arms, and I remember looking longingly at it, psychically broadcasting to my husband, GET BACK HERE. I pushed the buzzer for the nurses’ station again.
Again, no one came.
After the entire experience at the hospital thus far — waiting in triage, waiting for an epidural, waiting for a vacuum, waiting for a doctor — I tried to get more aggressive, and pushed the button a few more times.
A nurse showed up (the same one who had “helped” me nurse Jack), clearly annoyed. “I need you to take the baby,” I said, and her eyes got large, then narrowed — I forget her exact words, but whatever she said next made clear that she had understood my plea not as “this kid is going to fall off me when I pass out any second now” and instead thought I was saying, “I need Social Services to come and take my baby before I harm him.” I quickly cleared all of that up, and tried to apologize if I’d been overly aggressive with the buzzer, explaining the experience that had already happened (particularly the waiting FOUR HOURS for someone to come and catch the baby). She seemed to understand and put Jack down in his little warming table. My husband came back, alarmed to find that I was alarmed. My father and brother came up to say hi. They continued to give me Pitocin (I think) to help my uterus decrease. I mostly passed out, and around 11 AM they moved us to a new room in the recovery wing.
Postpartum, Part 2 – Sleepin’ The Day Away
Now: If you know anything about nursing, and babies, and births, you may know that you’re supposed to nurse a newborn every 90-120 minutes to get the milk started. I did not know that. In fact, no one mentioned that to me until around 11 PM. (This is particularly annoying, looking back, because I had read SO MUCH about everything, and talked about so many things with friends who were having kids around my due date — the fact that this ONE simple but all important detail escaped me haunts me.) As someone who’s always been larger-of-breast, I hadn’t been expecting any problems with nursing or supply. I figured my milk would “come in” naturally after birth, and I’d be full and uncomfortable — I had gone so far as to ONLY pack a nursing tank top because someone had suggested a nursing bra would be too constricting in the early days. As it turned out, my milk took days to come in — again, something I know now is not that unusual for new moms.)
This lack of a schedule was even more problematic because the first room they moved us to — after delivery — was an “isolation room,” not because either Jack or I needed it, but because they didn’t have any other rooms that were available. All we could see were the pros at the time — we had a big room to ourselves, and the normal limit on visitors (no more than 2 at a time) was ignored. At one point all four grandparents, my husband, me, and our son were in the room. I mostly slept. I remember feeding (or trying to feed Jack) a few times in this time period (before they moved me yet again), but there was certainly no schedule that any of us were aware of.
I remember trying to go to the bathroom for the first time — by then I was off all of the IVs from the Pitocin and the catheter had been removed — but I wasn’t expecting my legs to feel like jelly. My mother helped me to the bathroom, giving me her cane (she uses one more and more to walk because of arthritis). I was proud of myself for getting onto and off the toilet myself. I was headed back to my bed when a nurse came in and freaked out — why are you going to the bathroom BY YOURSELF? she asked. (Um, because no one had told me not to?) The day continued; Jack and I slept through most of it.
Around 10 PM — close to when visiting hours were ending — we were told we were being moved to another room, this one shared. A private room in a Manhattan hospital can go for up to $800 a night, so I had been half expecting this.
Postpartum, Part 3: Meet Patient Zero (Also: More Fun With Nursing)
What I hadn’t been expecting was my new roommate, who had a hacking, wrenching cough. Another new mother herself, I heard her say that she was sending her baby to the nursery for the night and decided to do the same. (When the nurse presented the option to me, she noted also, “this way someone can wake you up every three hours to nurse.” That was the first time I’d heard anyone at the hospital mention a schedule to me.) I passed out shortly thereafter.
Breastfeeding throughout the night did not go well. I’m sure it hadn’t gone well in the first recovery room, either, but during the night was the first time I remember being really aware of how little I knew and how little the baby knew about nursing. I’ve heard this from a LOT of my friends, also — we’ve had breasts for our entire lives and now they’re supposed to magically do a new trick? Nurses tried to help, but for the most part nothing helped us to nurse better.
What I did: Try to struggle through, assuming the doctors and nurses would be watching out for my son.
What I should have done: Called a lactation consultant, read The Nursing Mother’s Companion before getting to the hospital (or at the very least, bought the book on my Kindle at the hospital and read it there).
Day 3 at St. Luke’s – Trying to Get Some Modicum of “Care”
I woke up in the morning feeling more like my old self. My roommate was still coughing up a storm, and her doctor was examining her. I assumed someone would come to examine me as well, but no one came. (Shock!)
By this point, I was pretty alarmed that they’d basically just left me and Jack to our own devices for the entirety of Day 2, and I started to blame the fact that, you know, my OB/GYN HAD BEEN MIA FOR THE ENTIRE PROCESS. I had never expected to be delivered by my doctor, but I figured that she or one of the three doctors in her practice would eventually check in to make sure that everything was fine. I had been told when I arrived at Triage that one of the doctors in the practice was on call, but by the time my water was being broken someone also mentioned that that doctor had to go home. I called the office and left a message with the answering service, saying that I felt like we were slipping through the cracks because we didn’t “belong” to a doctor at the hospital, that my son and I had no idea how to nurse, and that no one had even shown up to do a postpartum exam on me or my stitches.
I never heard from my doctor (or anyone from her practice — particularly disappointing considering their offices were literally across the street from the hospital). Instead, Dr. Ca-Ca showed up. She stood at the base of my bed, and listened while I — admittedly half-hysterical — explained again that I felt like we were falling through the cracks and not getting any “care” at the hospital, and no one had even examined me or my stitches. On this last point, she laughed (literally: she laughed), and told me I was fine. No one had circumcised Jack at this point, and when I mentioned this to her she said she would do it. (Our local pediatrician later said “well, I’ve seen better, but I’ve seen worse too.” Yeouch.)
My husband had arrived back at the hospital by now, and had discreetly taken one of the nurses outside to express concern about Patient Zero, as we had started to call my roommate. Wasn’t her cough of concern to the newborn? The nurse told him that “she just had a C-section; sometimes you cough,” and brushed it off. (My roommate’s husband (I presume) showed up later at the hospital — he had the exact same cough. Funny.)
By this point, I decided I wanted out of the hospital. Dr. Ca-Ca had already cleared me; we just needed to wait for someone to clear Jack for departure. After his circumcision he was almost totally non-responsive — I demanded to know what he’d been given for the circumcision, but told he hadn’t been given anything. I was truly alarmed at this point, but the nurses assured me that it’s just how some babies react to being circumcised.
The pediatrician came and cleared Jack. Around this point the hospital photographer showed up so we agreed to take some pictures (we later paid $350 for the DVD of pictures, if memory serves), and we got ready to go. I mentioned to the nurse, almost as an afterthought, that I knew Jack had pooped a bunch, but wasn’t sure he’d peed. (I don’t think I’d changed a diaper myself at that point — it had all been done on his various trips to the nursery.) She panicked and whisked the baby out of the room; my husband followed and watched as the baby was given a huge bottle of formula. (Looking back, this was probably also the reason for his non-responsiveness.) He had been born at 8 lbs 13 oz on Friday morning; when we checked out of the hospital on Saturday at 6PM he weighed 8 lbs 7 oz.
I remember walking down the long hallway to the hospital lobby, and feeling, again, like I might pass out. “I feel really woozy,” I told the nurse. “Yep,” she said, unconcerned. “Labor is a big deal.”
The sun was shining as we left, and I was never happier in my life to leave a place.
Sunday: The La La Cries
Things didn’t go that well at home either — nursing was not getting any easier, and I was staunch in my decision to not give the baby any of the gallons of formula we’d been sent home with by the hospital. Jack would make little “la-la” cries, which we thought were cute but later came to recognize as “FEED ME, WOMAN!” cries. We had a doctor’s appointment on Monday morning, and above all I did not want to return to the hospital. I just wanted to make it through to Monday morning. I hadn’t purchased a breast pump yet — having been told by friends that the baby wouldn’t take a bottle of breast milk until week four or five — and had no idea how much (or how little) my supply was there. One of the other inane facts I’d heard (I think from a friend arguing against formula) was that a newborn really only needed a very small amount of milk — a thimbleful, really! — at a time. I had no idea what letdown was supposed to feel like. And I had no idea how a newborn was supposed to be — they cried and slept, right?
Sunday night I freaked out, I forget exactly why (it was either because he was sleeping too much or crying too much, I’m sure), calling our pediatrician’s line for help. The pediatrician’s answering service answered, telling us that the doctor couldn’t help if we weren’t patients yet. (We later found out that this wasn’t the case, and they would have answered our questions.) At this point, I may have supplemented with a teeny, tiny amount of formula. We made it through the night.
By the time we got Jack to a pediatrician on Monday morning he weighed in at 7 lbs 10 oz; the doctor told us that if Jack had lost much more weight we would have been sent to the ER. He did suggest we supplement with formula, and he gave me a recommendation for a lactation consultant. I was relieved, but not in a “we just avoided near death” way, just an “Ok, Life, hit us with the next thing” way. The pediatrician left the room, and the nurse apparently did not agree — first she chastised me for not using formula. “It’s just formula!” she said. “Why wouldn’t you give your baby some?” She then turned to my son (while taking blood or doing some other nurse-y thing), cooing at Jack, “Poor baby, Mommy didn’t feed you.” My husband had to physically hold me back (shouting, he adds, “ENOUGH!”), and I’m sure I wound up shouting certain things that probably should not be shouted in a pediatrician’s office. (Having already abruptly decided I was never talking to my OB/GYN again, I didn’t want to burn another bridge, so yes, that is STILL our pediatrician.)
What I did: Freaked out when nursing went poorly. My mother had nursed two children (albeit 30+ years ago); I think I had hoped that she would be able to provide better guidance, but lactation consulting really is a special skill, and every child (and mama) is different.
What I Should Have Done: I let things get to a bad point. I wish I’d known how quickly things would go downhill with Jack’s weight; I wish I’d known I could have asked the pediatrician questions; I wish I’d had a breast pump and known about the concept of “building a supply,” I wish I’d had a lactation consultant to call with questions; I wish I’d just sucked it up and supplemented with formula. (We later did supplement with formula for about 2-3 weeks after Jack was born, primarily using either a cup or a dropper — messy, but I was confident there would be no nipple confusion.)
Final Thoughts: It Could Have Been Worse
If you’ve made it this far — congratulations! I’m going to stop whining now. Obviously, this wasn’t a great experience for me or my family — as I write this it’s 2.5 years later and I still feel betrayed by my OB/GYN, and I am still haunted by decisions I made (or didn’t make) in those few days. Having said all that, though, it could have been a lot worse. Surgery! Infection! Blood clot or other crazy medical emergency! We had a rough few days but both Jack and I survived the ordeal, and he’s a thriving, happy, very energetic toddler now.