My (Unexpected) Birth Story.
A Note: I wrote much of this blog post in my first few (hazy) days postpartum. I’ve been wanting to share my birth story for some time, but needed to spend much of this year processing it all before I felt comfy enough doing so. This blog post is real and raw and certainly isn’t perfect (just how we like it around here!). A friendly reminder to please be kind to yourself and remember that everyone’s birth experience, decisions, and situation is unique. No matter how you bring your baby into the world, you deserve to honor and embrace your story. I encourage you to read with care and love - thank you.
I had a beautiful birth plan.
It included soft lighting. Flameless candles. An inspiring playlist. A birthing tub. Hypnobirthing techniques. The ability to walk around and change positions as needed (aka not stuck laboring in a hospital bed). Zero unnecessary medical interventions. And absolutely NO drugs or medication. I wanted to do this naturally. Not because my ego wanted to be able to say “Oh me? I push through pain! I don’t need an epidural!” but because I wanted to be in COMPLETE CONTROL of my body.
I was approaching labor like I was approaching a marathon. It was sacred to me — requiring significant mental and physical training. I wanted to understand how my body needed to push and move and work through the labor and delivery process. I wanted to be present and aware of what was happening and how I felt with every contraction. After all, my body was MADE for this.
Now – let me be very clear that I have absolutely nothing against medicated births or those who actively PLAN to have them (every woman should feel empowered to do what is best for her body). For me however, I just knew that I wanted to be able to FEEL the pain in order to “know” if something didn’t seem right or if something felt off/wrong. The idea of not being able to feel something or be in control made me INCREDIBLY anxious.I know epidurals are incredibly safe but as someone who doesn’t even like to take Advil it felt very misaligned for me. Unfortunately (I learned) when it comes to birth and babies, no matter how perfect the plan ALL CONTROL goes out the window. So when I hit 29 weeks and the conversation shifted towards early induction, I was understandably upset and VERY stressed. This was when Lilliana was diagnosed with FGR — fetal growth restriction.
I went in for what I anticipated to be an uneventful post-COVID ultrasound (something they automatically do if you contract COVID during pregnancy), only to end up in a tiny exam room while a doctor explained the risks and realities of FGR. Babies with FGR are at greater than normal risk for a variety of health problems before, during, and after birth. These problems include potential complications with overall size of the baby and the growth of organs, tissues, and cells as well as low oxygen levels/heart rate while in the womb, a high level of distress during labor and delivery, and an increased risk of infectious disease and complications after birth (jaundice, trouble breathing, feeding, gaining weight, maintaining blood sugar, maintaining body temperature etc…). If not closely monitored, severe FGR can put you at risk for stillbirth. FGR is often caused by an issue with the placenta that makes it function abnormally/inefficiently. The cause of FGR can also be due to things like advanced maternal age, fetal genetic issues, or infection during pregnancy.
They discovered this was going on when our scan showed Lilliana was measuring tiny — too tiny (<5th percentile tiny) and while the doctors can’t pinpoint exactly why this may have happened after being perfectly on track all pregnancy long, they strongly believed it to be a placenta driven issue as a result of my COVID infection during my second trimester. Unfortunately (and understandably) there isn’t a ton of official COVID related pregnancy data out there just yet, but there IS enough of a noticeable trend to indicate a measurable link between FGR and diminished placenta function post infection. The hardest part? I was also told there was nothing I could personally do to “fix” this issue. It was not something that could be solved with bed rest, vitamins, or a special diet (you’d be surprised by the number of people - not doctors - who thought it was ok to tell me I just needed to “relax,” eat more of xyz, or stop teaching/working to better support my pregnancy. Pretty bold and inappropriate if you ask me). My doctor told me to keep doing what I was already (safely) doing and let the doctors do the monitoring. (Easier said than done for this anxious Mama – I questioned EVERYTHING I was doing and was petrified that somehow I did something wrong to cause this).
So why is FGR a big deal? Well, the placenta is the life support machine for the baby. If it is not providing adequate support or working properly the fetus can fail to thrive, develop, and grow. In some cases the placenta can abruptly stop functioning altogether — which is a life threatening emergency for the baby. This was my medical team’s fear and this was exactly what we needed to avoid. As a result, baby and I were closely monitored each week to ensure little girl was still safe inside my body vs. safer on the outside.
We started out with twice weekly appointments – one weekly ultrasound appointment and one weekly fetal non stress tests. Every few visits doctors would do another measurement scan to ensure Lilliana was stable or growing (just not falling further behind). At the first growth scan, she hadn’t really progressed but she hadn’t fallen behind drastically either. She was stable so we continued with the twice weekly appointments. By our next measurement scan at almost 33 weeks she was measuring even smaller. Down to the first percentile. This time the stakes changed. That scan was concerning enough that I was immediately given steroid injections to help speed up the development of her lungs and better prepare her for early delivery. It was a tough pill to swallow — already my perfect plan of an unmedicated pregnancy and birth was “ruined” (or at least it felt that way at the time) and I wasn’t even in labor yet! My doctor told us to pack our hospital bags and keep them in the car so we could be ready for anything at any time in case of early delivery - just to be safe. (Woah).
From there we started having three to four appointments each week. Two ultrasounds and one to two fetal non stress tests. The goal of these appointments was to ensure Lilliana wasn’t suddenly showing signs of struggle. They monitored her heart rate, oxygen, fetal movement, intrauterine fluid levels, and the umbilical cord blood flow. They also monitored me to see if I was having contractions. I was told to monitor her fetal movements more closely — less movement could mean she was in danger. Over the next couple of weeks we ended up in the emergency room twice when I stopped feeling movements completely (I can still remember the panic I felt as I drove myself from the Cape to Newton Wellesley at midnight one particular Friday because the doctors were afraid they would have to deliver her that evening and they wanted me off Cape to do it). Due to my anterior placenta (which means my placenta was attached to the front of my uterus acting like a pillow) it was already hard enough to feel Lilliana moving throughout my whole pregnancy - so you can imagine how anxiety-inducing this all was! Both times we went to the ER she was ok (thank goodness) — just very very sleepy.
By the time we had one more measurement scan at just over 35 weeks my medical team made the call to induce early by 37 weeks at latest. Baby girl was hovering around 4lbs (still too small) and 37 weeks was now considered my “full term.” The main goal was to get her there (as 37 weeks offered a better health outcome for baby, particularly regarding lung development) with a very high probability of inducing sooner than that. The doctors scheduled my induction and prepared us for the possibility that she likely would need to be admitted to special care/NICU after delivery. I pushed and pushed my team to let her keep growing inside beyond 37 weeks but the risk was far too high they said. She wasn’t growing anymore and needed to come out SOON.
I quickly wrapped up working and teaching, got myself organized (the best I could), and started to wrap my head around what induction would mean. I had heard a lot of horror stories about induction often being more painful than traditional labor due to the unnatural/forced/drawn out nature of it all, and I was hopeful mine could still be a beautiful birth experience albeit different from what I had hoped. A part of me had to grieve the lack of “surprise” that would come along with going into labor naturally. For me there would be no water breaking in the kitchen while making dinner or laboring at home then rushing to the hospital once contractions were just a few minutes apart. Instead I would show up, check in, and a medical team would artificially provoke my body into having this baby before my body and baby were truly ready. OOF.
Don’t ask me why but, every time I thought about induction all I could envision was an unripe banana or avocado (lol - but really.) I mean, you can’t FORCE an unripe banana to be ripe enough for banana bread! Or an unripe avocado to become guacamole! It just won’t work the same! My lady parts were basically unripe produce for God’s sake. I laugh about it now, but it’s also quite a comparable analogy, no?! I really HATED the idea of it all. I HATED how against nature this all felt. And I HATED that the magic of a natural birth experience felt like it was being “taken” from me. Nonetheless - whether I liked the plan or not this WAS happening. I allowed myself to cry and be upset for a short while and then told myself I had to relinquish control and forget about how I wished things could be in order to ensure my little girl could enter this world as safely as possible. After all - that’s all that really mattered at the end of the day, and I would ultimately do ANYTHING necessary to make that happen.
Fast forward to Thursday, Sept. 8th 2022. My husband and I ran some last minute errands and tried our best to relax before heading to the hospital at 8:30pm for induction (PS - it’s an incredibly weird feeling and quite hard to relax when you know you’re heading to the hospital in a few hours for an appointment to birth an actual baby!). When we finally got to the antenatal room (the first of three stops during labor and delivery) the doctor came in to explain the first step of the induction process — cervical ripening (SEE! My produce reference wasn’t so far off after all!). (P.S. – Here’s where the medical talk picks up, so read at your own risk!)
My cervix was completely closed and there were two options to help open it - I could take a medication by mouth or I could have a medication inserted into my cervix and released over 12 hours. The difference with the second option is that the device delivering the medication could be removed if the baby began to show signs of distress (aka if the contractions were too much for her - which was my team’s fear due to her small size). With the pill, nothing coud be done to stop the medication so if the baby was struggling the chance of needing an emergency c-section increased. We chose to have the medication inserted. I had already had all the other parts of my birth plan thrown out the window so I wanted to do everything possible (in my power at least) to avoid a major abdominal surgery.
That night was long. The contractions were consistent. And a few times an hour nurses kept coming into my room to change my position when baby girl’s heart rate dropped during contractions. That was really scary to see and hear on the monitors - but maneuvering me around worked each time. I thought I’d maybe be able to sleep (LOL) but that was not happening. Once it was time for the medication to be removed 12 hours later, a cervix check confirmed I had only dilated 1.5cm. UGH. (For reference - fully dilated is 10cm. and induction with Pitocin can usually begin around 2-3cm. dilated )
By the time the doctor came to see me later that morning, they were ready to move me to labor and delivery to get things moving and were already talking about inserting a foley balloon to manually open my cervix. This procedure involves inserting a catheter into your cervix and filling it with saline. The saline solution causes the catheter to inflate like a balloon, putting pressure on the cervix to help it dilate. The “real deal” labor typically begins shortly after. This sounded pretty awful so I asked if there was ANYTHING else we could do first to allow my body to jumpstart the labor process less invasively. They agreed to start a low dose of Pitocin to stimulate contractions and see if my body could kick into gear on its own/if the baby could handle stronger contractions. A few hours, many stronger contractions, and another cervix check later — there wasn’t much of a change. By Friday evening it was time for the foley balloon to be inserted. Thankfully (a blessing!) my regular OBGYN was on duty and she’d be the one to do this yucky little procedure. I trusted her implicitly and she had been a huge part of our whole journey ever since our first pregnancy ended in loss. I was really hoping she would be able to deliver our little girl. Talk about full circle.
Now. I knew this was going to be an unpleasant experience when I asked her and the nurse how uncomfortable the balloon insertion would be and they didn’t try to sugar coat it AT ALL. Instead they took a breath, apologized, and said they would try to be as quick as possible and asked my husband to hold my hand and help distract me. I mean, how comfortable could it be to have someone reach their arm up wayyyy up you know where while digging around in your cervix for an extended period of time without being on any pain medication? It took multiple attempts to get this device to stay inserted. I don’t think I actually have words to explain the discomfort and pain this involved, but I DO know that the entire time it was happening I tried to mentally transport myself to another dimension and separate myself from my physical body. My fellow Mamas who have had to have this done — I am so sorry. We survived, but it TRULY SUCKED huh?
Once the balloon was inserted that’s when the real labor pain began. The contractions came on fast, strong, and HARD and the doctor began to increase my dose of Pitocin. The pain was intense and I was prepared to put my mind to work as I breathed through each one with laser focus. They rolled in like waves — increasing, intensifying, breaking, (breathe), ready to begin again. I remember the pain going from intense to severe not long after all this began. After that “switch” happened, honestly things get a little blurry for me. At some point the pain became severe enough that I couldn’t stop vomiting and full body shaking with every contraction. My blood pressure and heart rate dropped very low and so did the baby’s. Once again the nurse quickly maneuvered my body into a variety of positions and pulled the Pitocin back until we were both doing ok. After a while another doctor came in to check on my vitals and progress and gently increased the Pitocin again.
This pattern continued to happen over and over and over for the next few hours. A contraction would hit. My heart rate would drop. Her heart rate would drop. Switch positions. Pull back. Throw up. Repeat. I wanted to be out of bed but I felt extremely faint every time I tried to lift my head or sit up. My teeth were chattering but I was sweating profusely. I couldn’t think or speak. I was totally out of it and at one point I felt like I was losing consciousness. At this point my husband started to get REALLY freaked out.. He began begging me to consider an epidural but I was adamant that I didn’t want one. Finally, early Saturday morning he called in my doctor and they had a “come to Jesus'' moment. Their advice? My stress was stressing out the baby. I hadn’t slept or eaten in almost 48 hours. The quick induction process was heightening my labor pain and none of these factors were helping me or the baby tolerate labor. It was safer and more responsible for everyone if I was more comfortable — especially with the balloon still in there. Plus there was still a very high risk that I’d need a C-Section if things continued as they were. They weren't going to take on any additional risk with the baby’s well being from here on out. This was kind of a last ditch effort for a vaginal delivery.
I felt out of options and I was too tired to think. So I said yes.
The anesthesiologist came in quickly, explained the procedure and possible risks, and had me sign off that I understood. I explained that my biggest concern over an epidural was feeling totally paralyzed - particularly in my legs. I wanted to be able to feel some pain and move my legs. She explained that the medication affects everyone’s body slightly differently and she couldn’t promise how much feeling I would or wouldn’t have. We moved forward.
The epidural began working quickly (honestly like magic) — it took the edge off of my contraction pain, but I could still feel small windows of discomfort and even though the doctor offered to adjust and insert more medication to fix this, I actually preferred it. I could feel my body moving through the contractions - it just wasn’t vomiting level pain anymore. I felt myself coming back to earth - I could think again. I could not, however, feel my legs AT ALL. I’m talking “can’t wiggle a single toe or even feel someone touching my legs” level numb and this threw me into a PANIC (as I knew it would - hence why I didn’t want one in the first place!). I immediately wanted the epidural reversed. This is exactly what I feared would happen and I felt INCREDIBLY anxious. Cue the racing irrational thoughts that something went wrong and I would never regain feeling again. Thankfully my wonderful nurse calmed me down and suggested I try to at least sleep and get some rest before making any decisions. Labor was picking up and I needed my strength for the grand finale. One great thing about the epidural? I WAS able to get some much needed rest. BLESS.
The next time a doctor came into the room it was time to remove the Foley balloon (thank God!). She did another cervical exam and said my water still hadn’t broken (usually the balloon takes care of moving this along). The doctor decided we needed to break my water manually to keep things progressing. UGH. This was yet again something I REALLY didn’t want. At this point I was feeling pretty defeated and feeling so sad for my body and baby. Clearly neither of us were ready and as a result none of this was going to happen on its own. Every part of my plan was out the window and I could tell I didn’t have many more choices. I needed to relinquish control and trust the experts.
Once the doctor broke my water she said things would start moving fast. I immediately began feeling intense pressure. I was told this was normal and we could expect a baby in my arms within the next few hours. I couldn’t believe it! Even though this didn’t go the way I expected, I knew all of this would be worth it the moment I saw her little face. I sent my husband to go get himself lunch so he could finally have a bite to eat and take a break before I needed him the most (aka be fueled up for the main event!).
Knowing that we had a general timeline, everyone left to do what they needed to do until then and I was finally alone in my hospital room for the first time. I embraced the silence and imagined holding my daughter for the first time. After a few minutes someone poked their head in the doorway. It was the midwife I’d been seeing at my doctor's office between my normal doctor visits. She happened to be working that day and came in to say “hello” and asked if she could do a quick cervical exam. I figured SURE what’s one more poke and prod at this point (HA). She began the exam and quickly stopped. “Ok Ashley, so, the baby’s head is RIGHT HERE. It’s time to push!” It was 1pm.
I couldn’t believe it. I blurted out “WHAT?! Wait. Really? OMG I’m not ready! Am I ready?!”
Things started moving REALLY fast after that. The midwife ran into the hallway and called for support. I could hear parts of an exchange between her and my nurse but couldn’t make out the words. She came back in and shared that the doctor was in an emergency C-Section, and asked for permission to deliver the baby. Due to Lilliana having FGR the plan was to have a doctor and not a midwife deliver just in case emergency intervention needed to take place immediately. I didn’t really think I had much of a choice at this point so OF COURSE I said yes! I quickly called my husband (who as you can recall I had just sent to lunch!) and told him GET BACK HERE it was time to push!
As soon as my husband came in the room the midwife put him right to work! There was no time to lose. My nurse held my right leg, Robbie held my left. The midwife set herself up at the bottom of the bed and directed me to push. I brought a framed photo of my Mom and I to the hospital and kept it on my bedside table so she could be “with me” during the birth of my baby – her first granddaughter. I remember looking over at it thinking “Ok Mom - it’s go time. Thank you for watching over us and keeping us both safe. I love you.” (P.S. – I will be sharing about grief/being a Motherless Mother in a future blog post).
PUSH #1. (Breathe)
PUSH #2. (Breathe. Holy sh*t I am delivering a baby. I am having an outer body experience right now).
PUSH #3. “She has blonde hair!” The midwife exclaimed.
PUSH #4. “OMG how did that happen?!” (We all laughed).
PUSH #5. She was almost here. Just one more big push and our little girl would FINALLY be in our arms. “We DID IT body - and what a journey it’s been to get here.” I thought to myself.
My husband turned to me with a big smile on his face, squeezed my hand, and said “We know her name, right?” (We had narrowed down our list and had been going back and forth about two names for the past few weeks - but we wanted to see her first before making a final decision). “Yes” I whispered through happy tears. “We know her name.” At that moment the midwife excitedly exclaimed “Ok Ashley, this is it - BIG PUSH!”
And so I did - with ALL my strength.
PUSH #6. Silence. Then I heard her cry - what a beautiful sound. She was really HERE.
The nurse placed her tiny wrinkly body on my chest. I held her tightly as tears streamed down my face.
“Meet Lilliana Janine Basiri!” I quietly announced to our little birth team (P.S. - I’ll also be sharing a post about the significance of her name shortly). I kissed her head and stroked her cheek. Her eyes opened and looked right at mine. “Welcome to the world baby girl - Mama already loves you SO much.”
The midwife delivered my placenta and stitched me up. I had a couple minutes of bliss with the baby before the next part of our unexpected birth story began. A nurse took Lilly over to the scale for weight and vitals. After a few moments she said she was so sorry, but Lilliana had to be admitted to the special care unit upstairs. At 4lbs. 5oz she needed some extra eyes, tests, and attention just to be safe. I sent Robbie with her. I did NOT want her to be alone. He left. The nurses left. The midwife left.
Suddenly I was alone.
I was not allowed to be transported upstairs to see Lilliana until my epidural wore off and the doctors performed a few rounds of uterine massage to help contract it down and prevent postpartum hemorrhage (FYI - After the placenta detaches and is delivered, the area where it was attached to the uterine wall bleeds. The uterus also has to shrink from the size of a large watermelon down to the size of a cantaloupe and fundal massage helps this process along). My epidural didn't wear off for HOURS. I was a mess. Close to hysterical. All I wanted was to get upstairs to see my baby, hold her, bond with her, and attempt to breastfeed. Finally, later that evening, I was cleared to see her.
My husband wheeled me upstairs. It hurt my heart to see her hooked up to so many machines and I couldn't wrap my head around how they even got an IV in a vein as tiny as hers. But she was perfect. Tiny and mighty. I snuggled her and smelled her until I couldn't keep my eyes open anymore. The adrenaline from birth had worn off and I reluctantly went back to my hospital room.
I thought leaving Lilly upstairs in the Special Care Unit while I slept a whole floor down from her was bad enough, but a couple days later that feeling grew so much worse. I was well enough to be discharged, but my baby was not. She was still struggling to regulate her oxygen and blood sugar levels and was still on a feeding tube. I had to leave the hospital without my newborn baby. I was a wreck. This brought up a lot of unexpected feelings/past trauma surrounding my previous pregnancy loss. One moment I was pregnant with a baby in my belly, and the next I was in a car without a baby in my belly or my arms.
As hard as those first few days were, I knew Lilliana needed to be there. So every day we’d drive to the hospital with a breast pump and a bag full of all my “down there care” in tow (my Mamas know…there's a lot of healing and bleeding and pain going on in the days after birth!) and spent every moment from sunup to sundown with our little girl. Finally, after 10 days, we got the news we’d been waiting for. Our little girl could come home!
Lilliana still had a long way to go. We had a home nurse who visited every week for the first few months and we continue to work on her growth to this very day, but long story short, almost 11 months later she is HEALTHY and THRIVING! I think back to my pregnancy and my birth and the intense stress I felt at the time, but I’m proud of how I carried myself and handled it all – always armed with questions, always ready to advocate for myself and baby, and above all else, ALWAYS with my baby’s health at top of mind. Do I hope to have that magic birth I mentioned above at some point in my life? SURE! But at the end of the day, never forget this very important truth – however you bring your baby into the world is and always will be MORE than good enough.
