Birth Story - Hugo James Cartwright

MAY 21st

Wow it’s been a minute since I wrote a blog entry. It feels like a full year has passed between my last one (37 weeks pregnant) and this one (2.5 month old Hugo is napping next to me in the co-sleeper) and words are hard to get from my head onto paper.

Before I forget the feeling of the experience I wanted to get Hugo’s birth story down in writing. I was so lucky to have an incredible experience transitioning him from inside my body to outside my body, and as time goes on I’m just more and more grateful I put so much time and energy into finding a team and setup I felt so safe with. 

Hugo’s birth story sort of starts with my previous pregnancy because it was only upon the recommendation of an emergency room nurse in Sedro-Woolley that I made the appointment with a new OB/GYN in Island Hospital. Apparently, quite a few nurses liked the care there, and the birth center setup, so I followed suit not knowing that the pregnancy I was carrying was unviable and would later require extensive treatment to recover from.

FEB 17th

Fast forward (or rewind? time means nothing to me right now) to the end of my second pregnancy, my doc and I had bonded over my successful treatment and recovery, and I’d learned a LOT about how I might react postpartum and was up to my eyeballs in preparation for it. The birth was something I hoped the team I was birthing with would take care of - my “birth plan” was a loose collection of “less medication or invasive procedures the better but I’m not a doctor so please tell me what needs doing” phrases. The day after my 37 week checkup (where I was informed that I was now one centimeter dilated and sitting VERY low) I wake up in the night with a back cramp on my left side that kept coming and going for an hour. Eventually I fell asleep, then realized the next morning that I could very well have been experiencing early signs of labor - from what I had understood, braxton hicks contractions involved the front of the belly at least somewhat and my cramps were only in my back, and only on the left side.

FEB 19th

I got a certain suspicion that I would deliver before my due date rather than after, and called my mom to ask if she could come stay with me during Jess’s work days in case I went into labor and had to go to the hospital FAST. Since she and I both work remotely, we wound up thoroughly enjoying being eachother’s coworkers for the next couple of weeks (I’m not even being sarcastic! The cats were also thrilled). I also facebook messaged a friend who had managed to capture my “good side” on the fly in a few theater productions we had been in together, and she graciously volunteered to take my maternity pictures on her phone within 24 hours. Seriously guys. She was a godsend.

FEB 20th

My mom and her #AuntieSquad threw THE MOST AMAZING virtual baby shower for me. Since vaccinations weren’t on the scene yet, it was still peak quarantine season for myself and my parents, and even the thought of coordinating a safe outdoor shower was at least overwhelming, at worst impractical and illegal. Mom offered to coordinate something and asked me to provide her a list of all my friends (I gave her all five names hahaha) and then on Saturday the 20th a packed screen full of friends and family got to try out all the wives tales with me while I ate nonstop snacks. And then I didn’t have to clean anything up, instead I wandered around the misty spring afternoon with Jess and my amazing impromptu photographer Emily. It was a perfect day beginning to end, with so much genuine heartfelt celebration and defiance of any and all obstacles that it makes me feel fuzzy head to toe remembering back on it. Everyone needs a couple perfect days every now and then, this was definitely one of mine.

FEB 22nd

I came down with a really annoying head-cold, and got a bit excited because old wives tales suggested this may be a sign of impending labor within a week or two. At my 38 week appointment I still measured a centimeter dilated and baby’s head was still very very low. So low, in fact, that she couldn’t get an accurate ultrasound measurement of baby’s size and had me sneak into the quarantined birthing center attached to the hospital to get an ultrasound without having to venture through the main part of the hospital proper. The goal was to make sure baby was continuing to grow normally, to avoid a situation where my placenta finished up before my body was ready for labor, which would have starved the baby very suddenly and with possibly lethal consequences if undetected. Due to a mixup they didn’t realize I was chillin there in one of the birth rooms, and I had a 3 hour rest on the bed in there while the machines monitored my vitals - and it's a good thing they did because we learned that I was definitely in strong, steady labor, just couldn’t feel it at all. I had no idea that was even possible, but hey I’m not gonna look a gift horse in the mouth.

Once the tech finally found me scurried away in one of the several birth suites the center had, the measurement was taken very quickly and easily. The better ultrasound machine that she’d wheeled in with her measured baby at the 11th size percentile though - a concerning drop from the 75th percentile size measurement baby had registered on scans up until this point. The tech conferred with my doc and the consensus was:

If we wait too long, the happy squirming baby might be at the mercy of a possibly expiring placenta and we could have a situation where baby needs to be gotten out of mama FAST. Like, emergency c-section fast. Or, I could follow one of the alarming Covid Era patterns that was emerging of sudden onset eclampsia, since women she had seen exhibit it over the last year showed no symptoms except having an unusually small baby. However, since there's not really a way to predict when a placenta will crap out, and since my blood pressure was within normal ranges, the healthy blood flow measured with ultrasound equipment could be indicating everything is in fact just fine and baby is just going to be slightly under average size when born. 

The only red flag that suggested either issue might be on the horizon was the fact that within one month, baby’s size percentile had dropped from consistently measuring in the 70’s down to just 11. 

My doc suggested I wait a week and count kicks religiously, and if I hadn’t gone into labor by 39 weeks, schedule an induction. In other words - waiting long enough that an induction might be pushing our (so far good) luck, but also not jumping the gun and inducing labor right there that night to give my body a chance to handle the birthing process completely on its own. Since I was starting to dilate and was showing strong and steady (and invisible) contractions, we might not have long to wait. 

Jess and I both agreed with her risk assessment, and packed me and our bags (that Jess had JUST arrived to the hospital with as Murphy’s Law dictates) back into the *Mom Rocket and headed home.

*The Mom Rocket is our beloved 2005 Toyota Sienna Mini-van, which I have fallen head over heels in love with.

FEB 23

To try and get labor going me and Mom took a long ass walk on the trail next to my house, and unfortunately, got caught in a hail/wind/rain storm. We decided birth could wait and went home to warm up. Jess caught a vibe in the air and began FEROCIOUSLY nesting.

FEB 24

We opened all our baby shower gifts via zoom with Jess’s parents, who delighted and oggled over every item. It was absolutely gratuitous and lovely, and a very good idea because I don’t think I would have even opened up the boxes had Jess not gotten a wild hair and arranged the zoom unboxing himself.

FEB 25 

Returned to the birth center for a non-stress test (not sure why it’s called that since all the tests thus far had not purposefully induced stress?) to measure baby and mom’s vitals. Everything was great, and I was still showing steady and strong contractions, to the point where my nurse was asking me if I wanted anything for the pain and asked if I knew I was laboring. I asked her how was I supposed to know if I was laboring isn’t that something you tell me, and she seemed less than amused. At this point I realized I might not know if I go into labor and started proverbially sweating bullets.

FEB 26th

Had slightly painful belly cramps on and off for about an hour, then diddly squat.

FEB 27th 

Got cabin fever and got my birthing nerves out by planting in the garden - 150 red onion sets, and plugs of mustard greens, dino kale, spinach, brussel sprouts, artichoke, and leeks.

FEB 28th 

Woke up tired and grumpy as HELL. I went for a walk on the same trail by our house, this time with Jess and with much better weather, and I was waddling and struggling the entire time (up until this point I hadn’t felt tired or waddly). When we got home Jess grounded me to the couch because I was too grumpy to hang out with while I was standing up.

MAR 1st

On the eve of my 39 week mark, my doctor called me to check in and told me to come in that night.

And go straight to the birth center.

With our bags.

I was THRILLED. 

I don’t do well in uncertainty, so the idea of induction was something concrete I could cling to far better than “let's wait and see what happens”. I had no idea what was even supposed to happen, and everything that had been happening (contractions, dilation) had been happening completely without my knowledge. What if I gave birth in my sleep or didn’t realize I was in labor until baby was shooting out of me like a loose cannon?!

We checked in happy and excited at 6pm, and a little papery strip with cervadil was stuck up my hoo haa by 9:30pm. The night nurse, Brin, tucked me in and told me to ring if I needed anything. The chemical cervadil kicks your labor into gear by getting your cervix mushy, as a precursor to something more intense like pitocin that makes your contractions ramp up. 

Unexpectedly, my contractions got pretty intense and lacked any break for the subsequent 11 hours, but didn’t dilate me past 2 centimeters. Eileen, the day nurse/magical midwife started me on pitocin at 8:15am in an effort to get me to dilate, and again, unexpectedly, pitocin toned down and regulated my contractions but did not dilate me any more than I already was. Something was clearly holding up the process.

By 9:50am my doctor had arrived to assess my sitch and performed a membrane sweep, which revealed two things. 

The first was that the baby was so extraordinarily low that she could feel hair with her fingers. He was basically about to be chillin in my birth canal, perfectly positioned to shoot out of me like a bat out of hell.

The second was that there was a lot of scar tissue on my cervix (most likely from a LEEP procedure I’d gotten almost a decade earlier to remove precancerous tissue) that was so inelastic that it had formed a solid ring, keeping the rest of my very stretchy and willing cervix from opening enough to let the baby out. 

There was a third bonus discovery for just me - that breaking up cervical scar tissue manually while in labor was the most uncomfortable experience I had ever felt in my life to date. It was the feeling of intense diarrhea, but from the soul, and located in the vagina, all coated in a candy shell of intense head to toe pain.

As is very logical following this bonus discovery, the lovely anesthesiologist was brought in to consult with me on the procedure for getting an epidural. Since we had yet to try the Foley Balloon, I deferred till later to see how far I felt comfortable going without numbing the experience at all. 

After a quick lunch at 11:40am of delicious beef broth in a cup (again, not sarcastic, Island Hospital has scandalously good food). My doc came back, checked that I hadn’t continued dilating, and installed the Foley Balloon at 12:30.

It was at this point that I realized the temporary hell of a membrane sweep could extend indefinitely, sending my whole body into such pain and panic that all I could do was poop as if my life depended on it (bonus points for me, it was in the bathroom and not on any of the staff) and mutter “oh my god oh my god oh my god” while Jess found a nurse and let them know I’d absolutely love an epidural at their soonest convenience please and thank you.

The epidural was in and working by 1pm, and god bless Carisa who helped Jess hold me down on the table in a sitting position while the anesthesiologist skillfully plugged a web of fibers into my spine and down my back. The sensation of these fibers entering my body (even though I’d been thoroughly oriented with the process) and then releasing fluid into my cramping and resisting tissue freaked me all the way out and back again and then all the way back out for a second time and if Jess and Carisa hadn’t each been holding an arm and a shoulder to the table I would have crawled up the drapes and broken out the hospital window like a rabid racoon.

At 1:30pm I realized I would live and took a much needed nap after the survivors' high wore off. After we had checked in last night Jess had gotten a few hours of sleep, but the onset and lack of breaks in my contractions had kept me awake and laboring up until this point. As I drifted off, Carisa upped my pitocin intake, rolled me on my side, stuck magical pillows in between all my joints and in all my crevices, and left to let it all work its magic.

At 4:30 the doc checked me again and we all celebrated the sight of the wicked Foley Balloon, released from the grasp of my stubborn cervix at last! The way the balloon works is this - a deflated sack is shoved up inside the cervix up against the baby, and a tube inflates it in stages so that the pressure from the inside of this inflating balloon expands the cervical tissue and allows you to reach the stage of labor where you are fully dilated, and ready to help the baby out of the body via the vagina. The Foley Balloon is about 4 centimeters in diameter, which means that when it falls out, the cervix is dilated to at least 4 centimeters.

At this point, the doc goes ahead and breaks my water per our previous planning, and tries to manually break up the rest of the scar tissue parts of my cervix that still haven’t elasticized. This time I felt none of the discomfort, the epidural having numbed the skin of both my legs and the ability for me to move one of them. All in all, I felt much more than I had dared hope with none of the pain and realized that my anesthesiologist must in fact be a very powerful wizard disguised as a mere mortal. 

At 5:30pm Carisa comes back and rearranges the magic pillows, and places a giant peanut-shaped inflated rubber thing (creatively named a Peanut Ball) between my knees to try and bring baby back down into the birth canal. The nasty stupid Foley Balloon had pushed baby back into a higher position in my body, so the goal was to get him back to the super low position he had been in for likely weeks. The side supported position was so comfortable that I promptly fell back asleep until 6pm. What a slacker, I know.

At 6:30pm I suddenly became overtaken with the idea of pushing a baby out of my vagina. I know, it sounds incredibly weird, but just the concept of it was suddenly all consuming. I wondered out loud to Jess when I was “supposed to be pushing”, and I could tell by the look on his face that biology was now in full control of the situation. He very astutely told me “please don’t even think about pushing” and very quickly let the nurse know I was “wondering when I should be pushing”. I noticed that my legs were shaky every few minutes, which I assumed coincided with contractions (thank you epidural wizard).

By now Brin was back and hung out with me while Carisa, having checked me and stated calmly “oh I can’t seem to find your cervix at all, let me just go get the doctor” damn near ran out of my room and down the hall. Within minutes my whole team, Jess, my doctor, and nurses Brin and Carisa were gathered around me at each corner of my body, ready to coordinate delivery. Upon arrival, the doc had confirmed that baby was at a +3 position, meaning head inside the birth canal and on the move. I have no idea how my body could tell this was happening, since sensation-wise nothing had changed for me. Clearly my mind was tuned in to the process though because it had registered my stubborn cervix was finally out of the way and the rest of me (which had been primed for days by now) took over. 

Humble brag - my doctor said that I was an absolute champion pusher. I started “pushing” at 7pm, coached and counted through each contraction by the nurses and by Jess respectively, and at 7:30 I could reach down and touch my baby’s head. Yes my brain exploded that this felt biologically normal. And then it exploded a second time because I could feel hair too! It felt like I was giving birth to a squishy foam ball with fur, and somehow that was normal for the moment.

At 7:38 my doctor helped pull out my baby, and I heard Jess announce that he was a boy. His first cries were almost musical, and didn’t really sound like crying to my ears, just the perfect soundtrack. He was passed up to me and I felt myself take him and lay him on my chest as he cried his first cries, and I couldn’t believe he had just entered the world. I cried a lot, and didn’t stop. 

We all waited for my placenta to come out on its own, but after half an hour, my doc had to go spelunking in after it. We think my molar pregnancy had possibly created a sticky tissue patch on the inside of my uterus that clung on to my placenta, since the tissue inside my uterus had to be scraped down twice over to extract the molar tissue that was growing inside of it. Fortunately, my doc is amazing and got everything out and I didn’t hemorrhage at all, just took an antibiotic via my IV as a precaution against any infections that could have tried sneaking in. 

I cried and oggled at the creature I’d just somehow shoved out of me for about ten minutes, then caved and took another nap till 10pm. I woke up to Jess cradling our little baby Hugo on his bare chest in the big armchair next to the bed, and was beyond amazed all over again. At that point the magical epidural was magically reversed (witchcraft of the highest order) and I got up, used the bathroom, and then was wheeled over to the recovery room with Jess and baby in tow.

That night and all the next day I learned what waking up every two hours to hand squeeze colostrum out of my boobs felt like, and just stared every moment I was awake at the little face that was peeking back at us from the bassinet. He had been born with no complications, no swallowed meconium, and all his exams showed a perfect bill of health. I couldn’t believe how lucky we were. That afternoon, we got to take him home where he met two of his four adoring grandparents, and where Jess and I spent every second for the next 24 hours falling in love with him over and over and over again. Continuously, because I don’t think we slept. But we had our little baby boy and it all felt magical and fuzzy and rose colored, and we soaked it all in.