Three days ago, May 27th, Ash had a regularly scheduled ob checkup. She’d been having contractions for weeks, but as moms everywhere are aware, these are the usual Braxton-hicks (fake) contractions that help prepare the uterus for the real thing. Ash awoke that morning complaining of some new mild back pain, but no big deal. At her appt with our favorite Dr Jenkins, she was 3.5cm and 70% effaced, progressed from 1cm/30% that was documented the week prior.
Ash: when I heard those numbers, I finally felt the mythical “nesting” urge, wherein very pregnant women suddenly feel the overwhelming need to clean their houses, cars, paint the walls, and build things. This urge subsided within 3 minutes or so (honestly, when will I ever clean anything), but fortunately David continued to feel nesty and spent several hours that evening making our apartment totally spotless.
David: Ash was six days post-term by the hospital’s count, although her carefully charted temperature/viscosity measurements throughout her peri-ovulatory period (which we never revealed to the authorities here out of fear that they’d think we were those types of people, however we were keeping this information in our back pocket in case the induction of labor became a serious consideration) suggested to us that the due date was actually much closer to june 1st. Regardless, Dr Jenkins scheduled a non-stress test for later that day to make sure the bean was doing well. She passed with flying colors.
I had an unexpected afternoon off, which we decided to celebrate with a walk on one of the most beautiful Chicago afternoons we’ve had since moving here. Little did we know that active labor would start before we got home. A short jaunt to appreciate the warm sunlight turned in to an hours-long course through some familiar spots as well as some beautiful avenues very close to our home that we’d yet to have discovered, hidden from sight within our local Grant and Millenium Parks. The long walk seemed to help Ash’s contractions strengthen-- we were quite confident that our little girl would show her face at some point over the next several days.
bean, mom and dad enjoying chicago, 39.5 weeks, t-hours to delivery
bean at millenium park
One of Ashley's earliest fo’ real contractions at Buckingham Fountain:
We got home, made some dinner, and watched Ashley’s contractions initially subside in frequency but then come back with a bit of a vengeance. She was now unable to comfortably sit or lie when they came, and were presenting every 7-10 minutes. Each one seemed a bit stronger than the last. She found it impossible to sit as they waxed and waned but managed beautifully to put herself into a bit of a trance during each contraction: hands on hips, eyes closed, deep breathing, moaning quietly with each exhale, and dancing rhythmically around our living room. Cool as a cucumber throughout; I fell even more deeply in love with her as I watched. Bob Marley and Dave Matthews Band really stepped in huge during these couple of hours. I was so impressed, and so proud of how she was handling these episodes that many others would likely have dubbed incredibly uncomfortable. It seemed far more likely that our little bean would come out for air sooner rather than later.
Because of the perceived imminent delivery, Ash lay down for as much of nap as she could between the contractions at around 11pm or so in order to rest up for what was looking to be a very long next day. At 11:45p she rushed out of the bedroom, stating that the bed was pretty soaked. Game changer. Her water breaking indicated definitively that regardless of anything else, we’d come face to face with a daughter the next morning. Fortunately the fluid showed no evidence of meconium… however, we’d been told that when her water broke we’d need to be at the hospital no later than six hours afterwards because of the increased risk of infection, since our little bean’s house was now, in theory, exposed to open air.
Ash: I was anxious when my water broke because it seemed to happen so early in labor. While water breaking tends to speed labor, I knew this also meant the contractions would become more intense and that we had a time limit before we absolutely had to go to the hospital, which was not ideal.
mom is obsessed with her.
David: Ashley stepped into a running bathtub (her truly happy place), alternating with shower, where her contractions continued to intensify consistently. We wanted to arrive at the hospital as late as possible to maximize the chances of having as drug-and operation-free a birthing experience as possible, and now knew that the clock was ticking; we could stay at home no later than about 5:30a yesterday, May 28th.
I tried to catch a few winks while Ash continued to take her contractions like an absolute champion, but concluded about 45 seconds after crawling into bed that snoozing when your wife’s water has broken is damn near impossible.
By 3a, her contractions were 2-3 mins apart and were becoming significantly more difficult to relax through. At that point the best way for her to manage was to stand in front of me, drape her arms around my shoulders and bend over. She agreed that it was time to go; after two attempts to leave were interrupted by some particularly powerful episodes, we left for the hospital.
The ride was less eventful than we’d thought; Ash did a wonderful job of staying as focused as possible on relaxing as best she could. We pulled up after the 15 min drive to where valet was supposed to be; I dunno maybe the dude was off to lunch. I dropped her off and left to park the car. She was easy to find on my walk back; I just followed the labor screams.
most beautiful baby.
Not sure if it was leaving the friendly confines of our own home environment, or that the contractions changed qualitatively, but when we got to the hospital they really took on a life of their own… Ashley dropped to her hands and knees immediately upon entering the labor and delivery (L&D) department. Even one of the resident docs asked if she was okay…”she’s in labor” was the only thing that managed to come out of my mouth.
We were underwhelmed, to say the least, with how things managed to go for us early on in L&D. My assumption is that they’re not used to having people arrive so late in labor, and that by the time people are this far along they’ve long since gotten their epidural and are sitting quietly, contracting without noticing. The nurses and residents seemed irritated that Ash couldn’t stay seated upright while contracting, and that the monitor they’d placed around her belly would stop capturing the bean’s heartbeat during that time, which is a critical time to be able to monitor the goings on since cord compression can lead to decreased heart rate and some unfortunate outcomes. Ash was now 5cm/100%. Progress from the prior afternoon, but I think Ash and I both hoped that she’d be far closer to fully dilated at this point because we did not want an extended pre-delivery stay. They immediately suggested a fairly invasive fetal monitor involving attaching an electrode directly to the bean’s scalp. They agreed to give the current external monitor a chance to work before trying anything more significant., and then took us from triage to her private room. Along the 30 second trip, the nurse who was wheeling Ashley got into an argument with another nurse about when it was appropriate to take a lunch. Not optimal.
All Ashley wanted to do was walk around during her contractions and take a bath, which is truly where she could find comfort at home when they started getting more pronounced. Without any external pain administration, this was how she was going to be able to cope with the contractions that by now were causing her face to grimace in ways I never hope to see again. The medical powers that be immediately placed an IV in her hand, which prevented her from bending at the wrist and therefore leaning over the bed during contractions, which seemed to be the only way to make things as tolerable for her as possible under the circumstances. Nurses and residents alike just seemed more irritated. We were underimpressed at the time, and even more so now after a cooling off period, with their bedside manner. In retrospect they were correct in pushing for more invasive monitoring since that was going to be the only way to get a reliable tracing, and which ultimately may have saved us from a less-than-happy outcome (see below); however, their approach to everything left much to be desired.
Ash: In my experiences on L&D wards, I have seen firsthand the disdain with which undrugged women are treated by medical staff, so I wasn’t surprised, and actually was on such a different planet I didn’t even care. I felt terrible for David, because I knew he was very conscious that essentially all we hoped to avoid was coming true, and he knew how important it had been to me leading up to labor to hope we would be able to make the experience at the hospital as positive and aligned with our beliefs as possible. Unfortunately, we were unable to do so—fortunately, again, I was so totally on another plane of existence I didn’t care.
And to be fair, the coping mechanisms women must use to deal with the discomfort of unmedicated labor do make it difficult to start IVs (I have two blown veins and many nice welts and bruises as evidence), gather background information (honestly, why did four different people ask me the same 15 questions within one minute of each other?), and monitor fetal heart rates, which can only really be done successfully if a women lies totally still on her back. Not only is that the physiologically worst position for labor in terms of moving the baby down, but I’m also now personally convinced it’s impossible unless you have been drugged in some way because of how unbearable it is. Humorously enough, I thought I’d have to explain a million times I didn’t want any pain meds, but I actually only rejected the epidural once and it was never offered again—I’m relatively certain this is because I was so disliked as a patient they had no interest in relieving my pain, which I think is kind of funny, and also reflective of the general attitude we got on the floor.
David: Finally, after two hours or so without any good tracings during contractions, and some suggestion that the bean’s heart rate may be decelerating at critical times, we all agreed that the scalp monitor was necessary. They checked her cervix at the time they implanted the device: 6cm. Ash was incredibly uncomfortable with these contractions that were occurring quite forcefully every 90-120 seconds or so.
Ash: I tried very hard not to be discouraged about cervical dilation because it can be very unpredictable and does not necessarily follow a pattern, but I have to admit, hearing 6 cm after those two hours put legitimate doubt and fear into my heart. Just as they placed the scalp electrode, I had two back to back contractions that felt unnatural and wrong, and expelled an abnormal amount of amniotic fluid, which the bean needed to maintain oxygenation. I knew at this point something really was not right.
Eli's first car ride...may she always rest so comfortably.
David: Immediately, everyone in the room got a little quiet when we found that our poor little bean’s heart rate was dipping down to the 80s during these contractions (below 110 and people start to get nervous). Too low. Ash was placed on high-flow oxygen and the room soon filled with other nurses, residents, an attending physician, and a transport team ready to take Ashley to the operating room for a c-section because the risk to the bean was pretty high at this point. Ashley, of course, wanted only what’s best for the little girl and signed the consent form. We were ready to go.
Ash: When envisioning our birth experience, ending up with an emergency c-section was so worst case scenario, I didn’t even seriously consider it would happen. However, for as wonderful as the first several hours of labor were, the portion at the hospital was truly challenging. I liken the experience to that of King Kong getting captured. I felt like a wild primate trying to do my animal thing with all these humans chaining me down, restraining me, speaking to me disrespectfully, telling me what to do, how to feel, how hard I was making their jobs, and how much danger my baby was in. I went from feeling very uncomfortable but totally in control in the peaceful atmosphere of my home to being in a foreign, hostile environment where the very few measures I could take to maintain that paramount control were stripped from me. It was sort of terrifying, because I could feel my body getting ahead of me and I could no longer manage it, critical to successfully laboring without drugs. The beautiful, peaceful labor I truly felt capable of this was not—I was screaming, thrashing, crying, and even biting (sorry, David), but I did somehow refrain from using any profanity so I would not hurt the bean’s virgin ears. When they presented the option of c-section and made it sound so dire, and knowing that my body too was very near its limit, I quickly ran through what that might mean—major abdominal surgery, a painful recovery, likely more c-sections for future children, many many potential risks, but I was still happy to consent if it meant keeping the bean safe and preventing my body from actually exploding.
David: At the last minute, the attending present gave one attempt to stave this off by suggesting that if we decrease the force and frequency of the contractions somewhat, we might be able to avoid compressing the cord as much, allow the bean to recover, and avoid the operation. Maybe he said this because it was now 6:15am (only 45 minutes before the end of his shift) and he wanted to exhaust all options before scrubbing for a procedure that would keep him here late, or maybe he said it because he really just wanted to avoid the operation if at all possible. Doesn’t matter, it worked. Terbutaline, a drug to ease uterine contractions, and some fluid through her IV allowed Ash to rest for a few minutes, regain some strength and composure, and precluded her subsequent contractions from being so severe as to cut the blood flow to our little girl. That intervention was the best thing that could’ve happened.
Ash: This scene was sort of the climax—there were ten people at least in that room trying to figure out what to do with me, and I had very little ability to stay abreast of what was going on. Totally naked on all fours (I think the staff also really liked my insistence of remaining in my birthday suit despite several attempts to robe me), I had people pulling on one arm to attempt my third IV, people on the other side injecting the terbutaline, somebody explaining the risks of c-section and blood transfusion and holding up papers for me to sign, and everyone else putting in their two cents. And then, suddenly, everything got quiet, the room emptied, and I realized I was laying still on my side. Remarkable. I lay there and rested for what felt like an hour (apparently was actually 5-10 minutes). When the contractions started to gain intensity again, I noticed a new level of fear—now that I’d had time to recover somewhat, I was unsure I could withstand what I had just gone through again. I just did not think my body or mind could handle it, and it gave me anxiety every time a contraction started. It seemed my loss of control might get the better of me.
eli and her dad show off the moro reflex
David: Slowly, her contractions started up again, less dramatically at first. Then, suddenly, holy sh*t. She had a contraction that was body shakingly different than any of her previous. She stopped breathing throughout the entire episode, her face turned beet red, she couldn’t tolerate the oxygen mask, her hips flexed, and her legs stiffened. Of course, my role throughout the entire night was to try my best to keep her as relaxed as possible during the contractions, which is most easily achieved by helping her to focus on her slow, deep breathing. This monster, however, grabbed her by the soul and there was nothing I could do or say to prevent it. Several more of these over the next 10 minutes and Ash was suddenly talking about how she was pushing without meaning to, that the bean was far lower than she had been just a few minutes prior, and to go tell the doc that she felt like she was pretty damn close. (Looking back on these specific contractions, Ash says that they didn’t hurt as much as the earlier ones, but that the whole body involvement and pushing was something that was totally involuntary.)
Ash: I think I only had two strong contractions without the urge to push before I transcended to a new place where my body totally took over, and thank God. Now, instead of having no way to cope with the fear and sensation, my body made great use of the contractions without me having to try and remain calm or in control. I had been dilating so slowly I was worried I might be pushing against a partially closed cervix, so I told David with urgency that I couldn’t stop pushing and somebody needed to come and make sure that was okay. Now that we had avoided c-section and my body seemed to certain of what it was doing, I was re-committed to a vaginal birth.
the bean meets her grandparents
David: Dr Boots, the oncoming dayshift resident, was awesome and in control at 7:30a. (Importantly and luckily, the new team of residents, attendings and nurses that came on at 7a was truly outstanding and really made the end of the marathon a beautiful thing rather than an ordeal we just wanted to get over with.) She came in, took a very quick peek at the goings on and called for the team to assist with the pushing because the bean’s little head was knockin on the world’s door. (19 hours to get from 3.5 to 6cm, then 90 minutes to delivery. Such is labor.) Right as Ash made her first conscious push, our very own attending Dr Jenkins strolled in and took the reigns. This was not expected and a very comforting sight because we have complete faith in her as a person and physician. (We later found out that she’d told the L&D staff that if Ashley Higgs was about to deliver, to please page her immediately because she wanted to lead the way. I love that chick.)
Ash pushed as if it were her meaning in life for all of 10 minutes. In the meantime, our little bean did everything she was supposed to: presented face down, turned her head when she needed to turn, stopped when she needed to stop, delivered one shoulder at a time in a very graceful manner, and slithered out right into Dr Jenkins’s arms, happily completing the 9-month adventure and beginning her long next chapter of extra-uterine life.
left to right: my apparently 9-foot-long arm, my baby, my little girl, me.
first kiss
first kiss
Ash: Looking back, it’s very easy for me to understand why women elect to medically manage pain during labor. As we were told in our birthing class, labor is the hardest work you will ever do. And there were times where I certainly would have loved to be more comfortable than I was. However, I would not go back and opt for the pain meds at the expense of respecting the ancient wisdom of my body. A midwife in Mexico summarized it well in saying, the body that made this baby knows how to get this baby out, if you just give the woman space. I cannot imagine a labor wherein I might impede my body’s ability to do exactly what it needed to do to birth our daughter without harm to either of us, not to mention how quickly we both recovered from the experience (seconds, literally). Nobody has to say a word about how I should push, when, or where, and I had no conscious involvement either. My body just did the job, and perfectly.
More than anything, I am so grateful to have had an astoundingly supportive and brave advocate/partner, without whom I am certain none of this amazing and defining experience would have been possible. In many ways, his job was far more difficult than mine—I can’t imagine how upsetting and scary it must be to watch the person you love go through so many intense emotions, always wondering if you’re helping enough and in the best ways. He was truly, truly incredible. I love my husband. He is my hero. Also, the bean is freakin awesome.
David: Eliana Isabel Higgs (‘Eliana’ is a name Ash has loved for years, and I loved it from the moment she mentioned it; ‘Isabel’ is a name shared by my aunt who until now was the last female born into the Higgs family, 77 years ago) showed herself to the world for the first time, pink as can be with a beautiful cry and more hair than her daddy, at 7:48a on may 28th, 2010. 6.4oz (‘that’s all?’ says ash after the little girl passed through her vagina) and 19.5 inches in length. Officially, she is 25% Lebanese, 12.5% Indian, 12.5% Welsh, and 50% other Western European. She was placed immediately on mom’s chest and looked entirely at home with her beautiful dark hair and dark eyes. She was taken away briefly for an assessment and returned to Ash, where she made a beeline for the nipple with a picture perfect latch on her 1st effort. Her instincts definitely seem to have everything under control from a feeding standpoint. Strong work.
Really, it’s hard to argue against the fact that she looks like her dad did on his birthday:
davidcito, april 9, 1975
Ashley’s pre- to post-partum transition was smoother and faster than can almost be imagined. As soon as the cord was cut, Ash was totally back to her baseline. This can certainly be attributed to a lack of any pain meds and epidurals. The nurses commented about how they’re used to having to wait for the moms to regain sensation and function of their legs--- Ashley pushed Eli out and immediately afterwards declared that she was ready to go back to class. She hopped out of bed, walked to the bathroom, and for christ’s sake told me to have a seat and relax for a few minutes. The only reason she was taken via wheelchair to our overnight room was because of hospital policy. She could easily have skipped her way over without issue. Every single person who comes into our room now comments on how impossibly impressive it is for Ash to climb on to her bed, which she elevates to 5 feet off the floor for easiest access to Eli in her bassinet that stands right next to the head of mama’s bed.
Hospital protocol also mandates a 2-day inpatient stay before they send us home. Since arriving to our overnight room, we have done nothing but enjoy our little girl. Unfortunately I caught a minor cold at some point recently and am so paranoid about transmitting it that I wear a facemask for all but a couple of photo ops and wash my hands several times per hour. I’m hoping that Ash caught the same bug years ago and is now passing the appropriate antibodies downstream. That’d be sweet. Eli better get ready for when I feel like I’m over this, cuz I’m gonna have some compensating to do. In the meantime, I’ve been doing a fair amount of swaddling and diaper changing, and appreciating how beautiful Eli really is. Yesterday I spent a fair amount of time admiring her hands and fingernails, then last night I noticed her eyelashes, then this morning it was her feet. Everything is so small and so perfect. Her first little sneeze was f-bomb priceless.
I also love that everything she sees when we walk around is a first; I therefore get to be the first person to show her an outlet, how a closet door opens, and what a sharps container looks like. Good sh*t, even though she can’t see very well, and I think her eyes were closed for the closet showing.
kangaroo care. mom is in love.
The bonding that takes place over the first 24 hours is impressive. Yesterday we loved her of course, but today, after one day together, we really missed her when she left in the morning to get bathed in the nursery. She has completely won us over, even for mask-wearing, sitting-in-the-corner me. (I have a small phobia that she’ll think that I really look like I have a f*cked up face and that she’ll freak out when I show myself close up without a mask.) Ash of course has had the opportunity to stare at her little daughter for hours during feedings, which really has taken the bonding to a new level. Along those lines, can I just say that Ash’s instincts as a mother are predictably enviable. I’m so glad she’s my baby’s mother (not to be confused with babymomma)-- the way she holds her newborn daughter and already knows how to sooth and calm her is so easy for me to watch. I love that.
Overall, the bottom line is that you can hope for whatever you want in your labor/delivery, but life will always throw a curve. While of course the primary goal is always healthy mom and healthy baby, we definitely did want as hands-off a process as possible with minimal medical intervention since we believe that this is one field of medicine where often times much is done unnecessarily and can lead to medications/procedures that can do more harm than good. Of course, we’re not crazy, and made the easy decision to have the baby in a hospital just in case precisely what happened were to happen, since quite frankly medical interventions in this field frequently also save the lives of moms and beans. The early membranes rupture changed the outlook tremendously, and we even were within literally a minute or two of getting wheeled to the OR after signing consent for a c-section. Fortunately, due to some less invasive interventions by some astute physicians, Ash was able to deliver this amazing little girl who appears to be as truly beautiful and healthy as can be. As it stands, Ash was still able to complete the entire ordeal under her own power and without the aid of any pain management, which allowed her to fully appreciate what her body was telling her throughout, told her when to push, kept the baby awake and alert starting her first second of life, and made for a dramatic recovery by mom to focus entirely on raising this child as best she can from the very impressionable beginning. I am so proud of her.
It really takes having a child to appreciate how dramatically and suddenly priorities can become rearranged. Our lives are palpably different, and we’re not even home yet. We are totally in love with this newest addition to our family.
benjy meets the bean (and gives her a kiss)
livvy meets the bean
we are so happy to finally meet her and bring her home... we could not be happier to have our little girl home with us.
