Labor and Delivery

My wife jokes that we've now experienced the labor-and-delivery trifecta: One C-section (unplanned), one vaginal delivery with epidural (a planned VBAC, which I almost missed), and one unmedicated birth (very much unplanned). This is the story of that last experience and what it says about our medical system when it comes to hospitals and labor.

Stephanie's contractions began in the middle of the night on Nov. 5 and were still far apart—about 10 minutes—when we called the doctor. She suggested we come to her office first thing in the morning, rather than heading straight to the hospital. Hours later, the contractions had not increased in intensity or frequency, and so we went to the doctor's office. Her doc confirmed that everything seemed fine and healthy and said she'd normally suggest we return home. But we live about a 45-minute drive from the hospital, and she said, with a third baby like ours, things can change very quickly from slow to fast. Oh, how right she was.

The doctor suggested we stay close by--her office is just blocks from the hospital--and so we spent the morning having a lovely time on Manhattan's Upper East Side, just Stephanie, me, and our doula. We went out for a luxurious brunch and took a walk. I was the one who was most agitated, feeling like we should be settled in the hospital, but contractions remained eight to 10 minutes apart and Stephanie was feeling OK. She, her doctor, and our doula all agreed that we had plenty of time.

We eventually made our way back to the doctor's office, where she put Stephanie on a fetal monitor and we continued waiting, a surreal day getting stranger.

At one point, we went out for another walk, but things were clearly starting to progress. Still, nothing seemed imminent. The doctor said she'd do a quick exam, and then we'd head to the hospital. Stephanie, however, said it was time to go—NOW.

Then her water broke.

The baby was coming. Fast.

Our doula ran out to hail a taxi. (She later told us she put all our bags in the trunk before telling the driver that a woman in active labor was coming. Smart woman.) The doc and I escorted Stephanie, slowly and carefully, to the waiting car. I later found out that the OB had grabbed gloves and an emergency receiving blanket. You know, just in case of a street-side NYC taxicab delivery.

We were off, eager to go the very few blocks between the office and the hospital. However, this being New York, nothing is quick, and the streets were clogged with bumper-to-bumper traffic the entire way. Our driver did his best to weave and dodge, but with nowhere to go, we inched along as the doc called ahead to let the hospital know to be prepared. I started to feel weak and nauseous and just kept thinking: All that planning, and we're going to have this baby in a cab. I didn't sign up for this.

Finally, we turned the corner to the final block of our trip, and traffic remained at a stand-still. The OB got out to literally negotiate with the cars in front of us to move over just a few inches so we could get by, but then I noticed a school bus half a block ahead—and suddenly, its red lights turned on. No one was passing until those lights went off. It felt like a ridiculous movie, where the director piles on a hopelessly implausible set of challenges and obstacles.

Our doctor called ahead once again, and suddenly our taxi was swarming with nurses. They helped Stephanie into a wheelchair, and we ran full force the half block to the hospital. The doctor and I ran just ahead, gesticulating for people to move and screaming like maniacs, "Out of the way! Out of the way!"

We finally made it inside. The nurses shooed everyone away from the elevators and used their powers to summon an emergency elevator. Once in a delivery room, they got a gown on Stephanie, and told her to start pushing. She asked, repeatedly, for the anesthesiologist, for her epidural, but there was no time. Just a few pushes, and I saw the head; in about 10 minutes, our baby was born. Little Sophia made quite the entrance. It was 3:11 p.m.; I'd made a phone call to my parents at about 2:20 telling them that Stephanie's labor was just starting to speed up and that we'd be going to the hospital soon. That's how fast this happened.

It was not the birth we planned for, for sure. But there were benefits, besides a great story. No need for an IV, for one thing: Immediately after Sophia came out, the nurses were about to put in an IV port—because that's what they do for all women in labor—but our doctor stopped them. What purpose would it serve, now that the delivery was over? And despite the pain, Stephanie said she had fewer lingering side effects after, and the baby seemed more alert at birth.

It can often seem like labor is a battle. You go in with a plan and a set of expectations (hopes, really) and try to stick to it, even as circumstances dictate otherwise. We were prepared to navigate the rules of the hospital--issues such as whether the fetal monitor is worn constantly or intermittently and how long someone can labor before a C-section is warranted--and, of course, to follow the advice of Stephanie's doctors.

But we also knew from experience that these rules are sometimes constraining. For instance, a fetal monitor can inhibit the someone from laboring in certain positions, which in turn can make labor longer and more painful, which in turn can lead to additional, potentially avoidable interventions, including a possible C-section.

So we decided to stay away from the hospital as long as we felt we could. In the end, the extraordinary speed with which Stephanie's labor turned from slow to baby-coming-now, not to mention the challenges of New York traffic, conspired to make this birth dramatic. Perhaps that could have been avoided if we felt like the hospital experience would be more collaborative and supportive, in which case we may have gone in earlier. Instead, however unintentionally, we were able to experience a completely unconstrained labor--Stephanie was able to walk, eat, and drink, whatever was most comfortable for her--which resulted in a successful vaginal delivery with no complications. But obviously, we'd rather not have had the last-minute scare. If only we could have the benefits of an unconstrained labor and the support for the laboring mother's needs and choices in the safety and comfort of the hospital.

After it was over, we asked the nurses how often this sort of thing happens. They told us that a baby was born in an ambulance on the way just that morning. I'm grateful that Sophia made her debut in the hospital, and of course, that everyone is safe and healthy. Our doctor gave me the blanket she'd taken along in the taxi as a memento. Happily, it's still wrapped in its packaging.

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