Updated: Jun 14, 2021
Trigger Warning: This blog post contains photos from the birth that some may find graphic.
At 41 weeks and 1 day, Logan decided to make his grand entrance into the world! Over the course of 12 hours of challenging labor, I was able to bring Logan earth-side at 4:35pm on May 1st, 2021. He weighed 8 lb. 6.5 oz, 21 inches long, with a 15 in. head circumference.
Let me preface this birth story with a back story of what lead up to the birth. Most of my pregnancy, Logan was positioned OP (occiput posterior). When most people think of proper baby positioning, they mostly think about breech presentation vs head down. While this form of baby positioning is SUPER important, another factor to positioning is where the baby's spine is and how their head is entering the birth canal. The most ideal position for a baby to be in for birth is OA (occiput anterior) which means that their head is down in the birth canal facing in the direction of either the birthing individuals' left or right thigh, with their belly facing the spinal cord of the birther. OP is where the belly of the baby is facing the belly of the birthing individual, making it more challenging to let the baby depend into the birth canal.
When babies are in a posterior position leading up to and during labor, this can increase likelihood of:
back labor (more pain in the back than in the abdomen)
prolonged labor and delivery
severe perineal tearing
increased risk for assisted vaginal delivery (forceps or vacuum)
increased need for a cesarean delivery
start and stop labor pattern
less engagement from baby during pushing stage
longer neonatal stay (admission to NICU) in the hospital
I have been 'fortunate' enough to experience OP positioning with both of my babies! I was not educated on baby positioning with my first, so I did not realize that this is what was happening and while it did make my first labor a bit more uncomfortable than if he was presenting OA, I was still able to progress in a timely fashion and delivery him without a struggle. With this delivery, something just felt off. It felt off prior to labor beginning and I just couldn't put my finger on why. I wasn't as confident as I was going into labor with my first and I strongly feel that this contributed to labor being so much harder this time around.
At about 39 weeks pregnant I began having labor pains, but they weren't 'sticking around'. I would have one strong contraction and then nothing. At first it was exciting but as I watched my 40th week of pregnancy fly by, it became discouraging. I had a midwife appointment at 40 weeks and 6 days and had her do a vaginal check where she informed me that I was about 50% effaced with very minimal dilation. While this is completely normal and doesn't mean a whole lot as far as how soon the baby can arrive, I found this to be very discouraging for how hard I had been working over the last few weeks with trying to get this baby to rotate and drop down into the birth canal. With all of my efforts in place, he still wouldn't budge.
On Saturday morning, I awoke to a strong contraction. I got up and went to the bathroom to see if they would continue to progress. I was attempting to time them but they were not very rhythmic. Sometimes they were 4 minutes apart, sometimes much longer and they were varying in severity. Within an hour, they were still inconsistent in length but they weren't stopping and discomfort was beginning to set in. Contractions were uncomfortable and I was not in the right headspace and just couldn't manage to get there. We decided to have a home birth and I believe that the fear of the unknown was causing me to be tense. I had no idea where the best place in the house was to labor, and I was having a challenging time imagining what the birth and my birth team would look like in my house.
At 6:30am or so, I had my husband take our older son and drive him a few minutes up the road to his grandparents house because I felt that things were picking up and I was feeling a bit uneasy about how the rest of this delivery would go.
At 7:20am the midwife's arrived at our house, and with my permission placed an IV in my left arm and gave me some fluids to help me hydrate. I was very grateful for this because it is hard to want to eat and drink when things become intense during labor. At this point, I was laboring in the kneeling position with my upper body draped over a birth ball.
At about 8am I began to walk around in hopes of encouraging baby to rotate. This was making contractions more intense but it didn't seem to be doing much as far as turning the baby. My midwife encouraged me to try getting on the bed and side lying with my legs wrapped around a peanut ball. Once my legs were around the ball, she had me arch my back and pull my legs back as far as I could. This position helps open up the pelvis and allows baby some more room to rotate into a better position. At this point I was 4 hours in, was uncomfortable, and was only 3.5 cm dilated. The most uncomfortable part at this point was the intensity of contraction and the way they were causing discomfort in my lower back. Contractions were still spaced out pretty far but when I did have one, it was intense. My body was working hard to turn this baby.
After about 30 minutes of this, I got back up and started walking around the house again. After an hour or so of this, I went and laid back down with the peanut ball on the bed and resumed the side lying position I was in previously. Because I was still in the beginning stage of labor, the midwives departed for awhile to let me have some quiet time alone. At this point, I went and took a bath to try and relax. After awhile, I got out of the bath and went back to the bedroom where I tried laboring on the birth ball. When I did this, I felt as though I had to push. I told Jacob to call the midwives and let them know that things felt as though they were progressing. I got on the bed, just incase this baby was going to come flying out (if only I knew I still had 4 and a half hours to go!).
The midwives arrived back at our house at around 12pm and at this point I was started to moan through contractions in order to manage the sensation. I then transferred to the floor and began leaning over the peanut ball again. I did have a bulging bag at this point but was at about 6cm dilated. I was having back labor to the point of needing counter pressure during contractions. We discussed doing water injections for pain management and I agreed to it. At this point, I needed either the baby to magically rotate and drop into the birth canal or some sort of pain relief to help take the edge off. I was becoming increasingly more aware of the fact that labor was dragging on and that I was not progressing very quickly. I happily agreed to the water injections and while they do indeed hurt quite a bit while being administered, the pain relief that I felt instantaneously brought tears of joy and relief to my eyes. This labor was pushing me into uncharted territory. My body had never been tested like this before and to feel that instant relief from the pressure that was taking place in my back was absolutely fantastic. My legs relaxed instantly and I found myself go from keeling to doing the splits because of the amount of relaxation that flooded to them.
My midwife now had me sit on a birth stool and lean back against my husband, who was behind me. This position felt good but did put a fair amount of pressure on the cervix which was causing the sensation of needing to push. Because of this, I transferred back to the bed and back to side lying. Contractions were now happening every 3 minutes and were lasting for about 60 seconds each.
At 1pm, I mentioned that I was having a strong urge to push, and so my midwife came and checked me again. I was still 6cm dilated, and my cervix was actually tightening with contractions. She did an ultrasound with her handheld machine to get an idea of where baby was, and we saw that he was still OP and had a hand up by his face (another object blocking him from rotating to OA...great). For 30 minutes, she had me get into a kneeling lunge position while leaning up against the birth ball. After a few contractions, I would rotate which leg was up in a lunge and which was kneeling on the ground.
After this set of positions, she had me try sitting backwards on the toilet. This position was absolutely a no go for me. I could not tolerate it so we then tried an inversion. She staked 3 pillows on each other and I kneeled on the pillows and had the rest of my body draped on the floor. I was able to tolerate this position for roughly 3 contractions before needing to switch it up.
At this point it was 2:30pm and I was exhausted, extremely uncomfortable, and was beginning to feel light headed because I was only able to stomach one fruit leather the entire labor thus far. The midwives felt it was appropriate to administer 500mL of Lactated Ringer's solution to help offset my lack of oral intake and at this point, I went and laid on the bed side lying with a pillow in-between my legs. This position allowed me to relax to the point where I was able to tolerate contractions without needed to moan through them. I was able to simply breath through them and actually get some rest in between.
I was done. I was 100% ready to get this baby out and get this over with. The rest was exactly what I needed to get the motivation necessary to get this baby earth-side. At this point, I was 9cm dilated and 100% effaced. I requested for my midwife to break my water if it was safe to do so and get this show on the road. After she determined that it was indeed safe for baby to have my water broken, she went ahead and did. At this point, I began to feel the urge to push (for real this time) and I eased into the process of pushing with each contraction. Little did I know that they battle was not yet won. This baby STILL did not want to drop into the birth canal but I was determined that I was going to get this baby out. There was no hesitation within me anymore, only determination. We tried a variety of different pushing positions (leaning back on a birth stool, kneeling, side lying on the bed) and I, very slowly, but surely worked this baby down and out the birth canal. After an hour of hard pushing, HE WAS OUT! When they passed him up to me and placed him on my chest, I felt a flood of relief. My beautiful baby boy was here, and I was done with labor. It felt too good to be true. The discomfort was over, my boy was healthy and in my arms...what more could a momma want?
Slowly over the course of the evening, I realized that even though this was by far the most intense experience that I have ever been through, I did it. I was able to have a home birth just like I was hoping for, my boy was here safe and sound in my arms, and due to my midwife's diligent care I had very minimal tearing and very manageable amounts of postpartum bleeding.
Two weeks later, I still look back on my birth experience with gratitude for all those who helped me get through such a challenging endeavor. I would be lying if I didn't admit that I feel mixed emotions about how it all played out. I am so incredibly happy with the outcome, but at the same time can't help but feel disappointed that I haven't experience what it is like to not have to wrestle my babies out of my body through intense active labor. I will continue to reflect on my experience and over time will come to terms with the challenges that it presented. I am so grateful for the amazing care that I had with my midwife and her team of birth workers. If it wasn't for them, I may not have been able to have the birth that I did. I might have needed to transfer to the hospital which would have lead to a totally different experience than the one that we had.
With all of that now written down, I want to say again just how grateful I am for my beautiful baby Logan. I would do it all again for him if I needed to. He is an absolute blessing and I am so happy that he is part of our family.