The Birth of Bridger Rowan 6/25/23
Desiree and Jackson welcomed their baby boy after epic induction. I remember when I first met Desiree and how much she wanted options and preferred not to be induced. She and Jackson attended my 7-week childbirth class to learn all they could about the process and their options so they would have tools to help navigate labor in the hospital setting. In the final weeks before her due date she began to feel some pressure about induction for various reasons. Her blood pressure began to creep up, and while she advocated for more time, by the following appointment, the decision was made to move forward with an induction.
With two weeks before her actual estimated due date, Desiree’s cervix would need some coaxing before any labor. Desiree went to the hospital on a Thursday evening, and they began ripening her cervix with cervadil overnight. She felt mild and inconsistent contractions and was able to have some breakfast before the next steps.
Just past noon they inserted a foley balloon and Desiree ate some lunch. She was having irregular contractions that required some focus, but she was able to breathe calmly through them. The balloon can be quite uncomfortable, and it was a good opportunity for Desiree to stay focused on her breath through the discomfort.
Since Desiree had done her homework, she requested an enema in the hopes it might stir up some labor. She was not eager to have her water broken especially since she tested positive for GBS and was leery of any potential timeline. The balloon remained in her cervix and produced consistent contractions every 2 ½ minutes that lasted 30 seconds. She stood and sat upon the toilet to find the most comfort, but she was starting to feel fatigue set in and she was not yet in active labor. Finally, by 4:00 pm the balloon came out and that alone helped a bit with the pain.
Desiree asked to use a breast pump to stir up contractions and hopefully some labor. But between the pump and the enema she felt contractions for a limited time that eventually dissipated. It was around 1:00 am on Saturday by this time and Desiree had already been at the hospital well over 24 hours. The road for her labor was looming large and long and it hadn’t even begun yet. Thankfully, she was able to advocate for a night of rest, or as much rest as possible before trying to start things up in the morning.
Desiree got some sleep and a full plate of breakfast. Pitocin was next. They started at the lowest dose and raised it incrementally over the course of the day. Desiree wasn’t sure whether to rest or move around. It was wise to rest until her body required more of her but that’s easier said than done when you’ve been staring at the same four walls for over two days!
Just prior to 3:00 pm an exam confirmed that Desiree’s cervix had still not changed much from when the balloon came out. She was feeling regular contractions every 2.5-3 minutes that lasted 60 seconds, but she could still talk and breathe calmly through them. After some discussion, Desiree and Jackson agreed that the most reasonable next step was to break her water and hope labor ensued. They did the AROM (artificial rupture of membranes) just before 5:30 pm on Saturday and Desiree was dilated 4 cm, 60% effaced, and her baby was at -3 station. And breaking the water was a game changer! Desiree’s contractions intensified almost immediately.
This was around when I got to the hospital in the hopes, we could keep that momentum going. Desiree was vocalizing with her contractions and according to her nurse she was sounding more laborish. Jackson’s mantra to Desiree was, “You’re going to get huge!” (Look up Ina May Gaskin.) And Desiree’s nurse started to get goose bumps to see Desiree’s body respond. The contractions had jumped to 2-2.5 minutes apart and required all of Desiree’s focus.
Jackson wiped her face with a wet cloth and placed a heating pad on her lower abdomen. We put Desiree in the flying cowgirl position using the peanut ball in the hopes her baby would descend even further. This is not an easy position to maintain but Desiree was such a trooper.
After about 30 minutes it was time for the shower. Yes, Desiree was getting pitocin, but remember the pitocin pump was on the iv pole that has wheels. The wireless monitor gave Desiree the freedom of the shower, not to mention some distance from the monitor and bed. Desiree labored under the water flow with Jackson right there telling her she was strong and how much he loved her. “You’re a freaking badass,” also came out. Some citrus essential oil on a washcloth in the shower helped to give Desiree the feeling of more energy and clarity.
Just past 8:00 pm Desiree got out of the shower and draped herself over the cub birthing chair upon the bed. Jackson did double hip squeezes on her lower back and then a short while later Desiree did alternating lunges. Her hands and knees position also gave us easy access to her back, so we placed a heating pad there. Desiree’s nurse contorted herself to adjust the monitor while Desiree lunged. She was extremely supportive of facilitating Desiree’s labor process and for that we were all so appreciative.
Around 9:00 pm Desiree told us she felt constant pressure “down there.” We were hopeful for significant cervical change, but an exam had her dilated at 5 cm, 50% effaced and her baby at -2 station. It was not the big change she was hoping for. The pitocin was at 18 mu with not a lot more to go, and Desiree was wondering how much longer she could endure labor without relief. She had been at it off and on for over 48 hours.
In an effort to minimize intrusion to her process, internal monitors were proposed so Desiree could avoid so many hands on her belly to find baby and contractions. She was comfortable with that and once they were inserted, she labored on her side a bit. She was feeling very tired. She rolled to her hands and knees on the cub again, then sat upon the birth ball beside the bed and rested her head on a pillow between.
By 11:00 pm, with the pitocin at 22 mu and her contractions stronger than ever, Desiree mentioned for the first time that she needed relief. Jackson encouraged her to soldier on longer though, as she labored on, even trying Froggy Walchers to help her baby come down. This is another very uncomfortable position! She straddled the peanut ball on the bed while Jackson squeezed her hips, and even lay in the left runner’s position.
But as the clock neared 1:00 am, Desiree knew the best thing to do was rest. And the surest way for that to happen was to move forward with an epidural. Making the decision was the hardest part. But once decided it didn’t take long for it to be in place and for Desiree to have relief. It was in by 1:00 am and she was comfortable and eating jello soon after. And by 2:00 am everyone got some sleep.
But as the clock neared 1:00 am, Desiree knew the best thing to do was rest. And the surest way for that to happen was to move forward with an epidural. Making the decision was the hardest part. But once decided it didn’t take long for it to be in place and for Desiree to have relief. It was in by 1:00 am and she was comfortable and eating jello soon after. And by 2:00 am everyone got some sleep.
The sleep was interrupted by a cervical check around 2:45 am, only to reveal that Desiree’s cervix was still 5 cm. it was much thinner at 90% and her baby was at -1 station, two very important points of encouragement. Her baby’s heart rate was showing some variables, so they did an amnio-infusion to float the cord in case the decels were positional. And her baby’s heart rate stabilized over time.
Pitocin was bumped up again, this time to 28 mu. There wasn’t much more left to go! But it seemed to be the magic amount for Desiree’s uterus because at 6:54 am Desiree was fully dilated! Her baby was at 0 station, so technically a bit high, but still much lower than the days preceding. Desiree was so relieved she cried, and the rest of us might have teared up a bit too.
They decided to have Desiree give pushing a whirl. I think there was a strong suspicion she would be an excellent pusher due to her natural strength and because she could finally actually push! And that’s exactly what happened! With a mirror to watch her progress, and her original OB and nurse back on shift, Desiree gave birth to her baby at 7:22 am after less than 30 minutes of pushing!!
They did not know the gender, so Jackson made the announcement that it was a boy, Bridger Rowan. He was latched in the first hour and weighed 7 lb. 12 oz. and measured 20 in. long. He was a good size for 2 weeks early.
Desiree was dilated 5 cm for 36 hours! Remember, she was admitted on Thursday night and didn’t welcome her son until Sunday morning. While that may sound like something no one would want, it goes to show how patient her providers were and how well Desiree and Jackson advocated for their options. They were informed and prepared and knew what to ask for, thanks in part to their childbirth education and having a doula to help them navigate hospital options. But Desiree stayed positive and patient the whole way through and that at the core is what had the biggest impact on her experience. The steadfast support of Jackson was another important part of it.
I wish I could say that once Bridger was born, Desiree’s preeclampsia was cured, but I can’t. She was admitted again a few days postpartum. At the time of our postpartum visit, they were home and recovering well, fine-tuning their diapering skills and interpreting Bridger’s various cries. They are joyfully and sleepily taking it day by day and I couldn’t be prouder of them.
