Waylon's Birth - Slow Start Induction with a Fast Finish

As told by both Sarah Beth and her doula, Bianca Wooden IBCLC
(Bianca’s comments in parenthesis)

(When Sarah Beth reached out to me, I wasn’t really sure if I was taking any doula clients. But, a former client had recommended me to her, so I  went ahead with an interview.  I was in love immediately.  Sarah Beth is funny and has some serious sass.  I knew I wanted to be a part of her labor and birth.  Her and John attended my childbirth class and we met a couple of times to prepare for labor.  Sarah Beth was determined.  She did not want to be induced, wanted her body to labor naturally and be free of medications and any other interventions. She also knew that often, labor and birth throw us curveballs.  No matter how much you are aware intellectually of the unpredictability of birth, it still catches you off guard)

At 37 weeks, I started developing gestational hypertension. Week 39 Dr. Moore said we had to discuss induction. Of course, this was the last thing I wanted to hear. I spoke with my wonderful doula, Bianca 🤩🥳, who said she would dig up some information about hypertension vs. preeclampsia and at what point is induction necessary. She gave me tips to lower bp, including increased protein intake and Epsom salt baths, which the last week I did every day. At this time, I also started looking up good ole wives tales of how to naturally induce labor.  I read about Evening Primrose oil, which I started taking 1 pill every night, and I would rub 1 pill into my perineum. This supposedly made you efface. 

Sunday, I asked my boss man to let me leave work early. And thank God, I did.  Looking back, I was doing that last minute preparation. I went to the store and got snacks, pads, witch hazel. All the things. 

(Sarah Beth was coming to terms with the reality that her blood pressure was high and not going to come back down.  Current ACOG Practice Bulletin (number 202, 7/23/2019) guidelines recommend induction when a diagnosis of gestational hypertension (BP of 140/90 or more on two occasions at least 4 hours apart that developed after 20 weeks gestation) has been made and the person has reached 37 0/7 gestation.  If you find yourself with gestational hypertension please discuss the latest evidence and guidelines with your provider.  Ask to see a copy of the latest ACOG Practice Bulletin (it is not available to the public online).)

Monday morning Bianca came over an hour before my 39w6d check in at Dr. Moore’s. She gave me information about induction, and then and there, it dawned on me I would have to be induced!!!! I didn’t want to risk my baby’s life or my own. (My grandmother almost died giving birth to her third child with Toxemia (which I believe is what old people called preeclampsia back in the day??) and my biological father died in his 50’s of stroke and aneurysm) So induction was happening!!!!!😟☹️ 

Bianca, John, and myself came up with a plan to firstly let the doctor check my cervix and see  if any effacement and dilation had happened. I think he said I was 80% effaced (which I contributed to the Evening Primrose oil (whether it worked...who knows) and 2 cm dilated. 

Then I allowed him to do a membrane sweep. Fun stuff. Honestly, as a woman, it was pleasant to feel a small dose of discomfort and see BLOOD. That’s what we’re accustomed to every month! I was hopeful that was just the push my body needed to jumpstart this process and go naturally. 

The next step Bianca, John, and I discussed was foley bulb. We knew Dr. Moore practiced this procedure often, and it made sense to us. So, I consented to do a foley bulb that Monday evening, 23rd of December. John and I headed to the Ocean Springs Hospital.  A nurse asked me some questions, then I requested John to come back in the room, then the doc showed up. They laid me back on the table and put me into...almost an inversion. The nurse applied pressure on my fundus and doctor Moore pushed and pulled and yanked and snagged at my cervix. Lord have mercy!!! His whole arm was shaking as he tried to grab my cervix with his fingers. Finally, he did. Sheeeeeesh. He said “Well, she’s tough. I give her that.” They put the bulb in, filled it up with 60 cc of saline....then the part no one discussed with John and I.....from the bulb is a few hard plastic, stretchy, I don’t even know...but they attached it to your freakin’ knee. This is supposed to create tension and apply pressure to cervix to dilate. Ok. I tried sitting up, and as I went to move my leg, I could feel this thing tugging in my vagina. It was raking across my labia too. More fun stuff. I told Doc “Hey man, this thing is about to pop out!” And he said “then it will have done its job.”  

Oky doky. I slowly lowered down into a squat, and it didn’t come out so I thought, “huh....?!” ((I told john to imagine having a nipple clamp attached to his nipple that attached to a piercing in the penis (forgot the name for those) but imagine it is pulled so tight you didn’t want to stand erect.)) 
I immediately felt like I had to take a bowel movement. So I went to the restroom. I sat there. I had bowel movement and then pressure pressure pressure POW 💥 goes the foley bulb and all the bloody show I had looked so forward to seeing one day!!!! Great! 

We loaded up. 
We went home. 
We packed our bags. 
We got in bed.

I tossed and turned all night long. I kept going back and forth in my mind.....
“Doc is going on vacation day after Christmas. He just wants to induce to get me out of his hair. My blood pressure isn’t even THAT high. I’m not going in tomorrow. I’m going to stay home and take some castor oil and go into labor naturally.”

Aaaaaand.....

“Okay. I’m doing this for the health of my baby. For my health. I do not want to endanger us. This is the best option. I still don’t have to get epidural. I won’t be tied down. I can still do this.” 


Next morning, December 24th, John and I arrived at the ER again. When we walked up a lady said, “Awe, you’re like the 4th pregnant lady in a row we’ve checked in this morning.” 😡😩 Induction. It made me so mad. Just lining us up like cattle. 

We got to the third floor. I told them my name. They buzzed us back, and we got a room on the old side of the floor (with The fancy commode and hot tub) because I actually called the night before and reserved it. 🤣🤣🤣🤣 The nurses were awesome to me!!! I want it known. The staff was A1!!!! 

Alright. So basically they start me on 2 of “Pit” as my nurse, Yolanda, said. Low and slow....go up 2 every 15-30 minutes or so. 

(At 9:20a, Sarah Beth was checked and found to be 5cm dilated and 80% effaced.
At 11a, Saraha Beth was checked and found to be 6cm, 80% effaced and -2 station.
1:30p, Sarah Beth was checked and found to be 6cm, 80% effaced and -2 station.
By 1:30, Pitocin was up to 16, but she was not feeling any contractions, was not in any discomfort and was not having any cervical change.  By now, we are all realizing that this Pitocin is not doing what needs to be done. We had done all the things both Sarah Beth and I could think of. )

...........fast forward to 5p, Pitocin on 30, and still no pain. It was scary! The nurse kept mentioning breaking my water, which I was sooooo opposed to, because as y’all know once the bag has burst, you are really on the clock!!! Finally the doc came in to discuss our next step. 

(According to the package insert that accompanies Pitocin, dosage is .5-1mU/min to start and increase 1-2mU/min every 30-60 minutes until the desired contraction pattern is reached.  It goes on to say that “infusion rates up to 6mU/min give the same oxytocin level found in spontaneous labor.  At term, higher rates should be given with great care, and rates exceeding 9-10mU/min are rarely required.”  Starting at 2 and going up by 2 every 15-30 minutes is typically what I have observed as a doula. In my experience the rates often go to 16, 20 or 24 with an induction.  However, that is not the dosage recommended by the manufacturer.  The rate of increase that Sarah Beth received was not particularly slower than is typical with an induction.  But it did go higher than I have ever seen. I genuinely surprised that it was not causing painful contractions. As a doula and childbirth educator, I had never heard of someone receiving pitocin at such a high rate of infusion and not feeling contractions. Contractions caused by Pitocin are known for being more difficult to cope with than natural labor. ) 

I love my doctor! I do. But (now mind you he had 8 inductions Christmas Eve! EIGHT!!!!!! 8!!! Freaking 8!!!! The entire L&D floor was packed. There were 11 mothers giving birth total. 🤬Anyways...) he got short with me. He said, “We need to break your water and we need to break your water now, basically.” 
And my baby, John, went head to head with him....
John questioned him, “If we don’t want to have water broke, what is our next step? Can we turn off Pitocin, cut it in half and restart it. What are our other options???” 
I was total deer in headlights. I cried.
John was my hero, my champion, my biggest advocate. 🤪🤩😍 it was really freakin sweet. 
So, Bianca spoke up and said let us have a few moments to discuss. Doc and nurse left the room. I cried. They nurtured me. We realized the moment we got to the hospital we were “on the clock”   Sooooo, this was our best option. This was happening. My water was about to get burst. And Lord please let him come down my birth canal. Please!!!! 

(Every birthing person has their own priorities and values.  For Sarah Beth, not having her water broken artificially was a big priority to her.  Just as she struggled with the decision to go in for the Pitocin, she had to face the decision of having her water broken (AROM).) 

Doc came in. I told him not to nick my babies sweet head!!!! Water burst. And I sat up in bed with the bottom half lowered all the way down. Was told to stay that way for 15 minutes or so because we didn’t want a prolapsed cord. 

That happened at 4:52. By 5:30 the fun began!!!! And I mean boy, was it fun!!!! Full on contractions. We moving and jiving. Mind you, I’m still plugged up to the Pit. So every new position required Bianca and jOhn to reposition my IV. Also, because of the high bp every 15 minutes I had to be plugged up to check that also. But....we made it work. Me, in my raggedy gown working through each one. They really got intense. I went to the restroom. Bianca told me to try and relax on the commode (I miss that warm seated commode.) That helped. Then all of a sudden, I needed to brush my teeth. Did that. Then I threw up! Nurse was concerned I was going to push little Waylon out on the bathroom floor. Ha! Transition was bloody awful. There was no comfortable position. I think I was mostly on all fours with my face buried into a blanky we brought from home. 
The two of them created counterpressure which was wonderful. I didn’t get much rest inbetween to the next hard contraction. ​

(A nurse checked and said that there was just a small bit of cervix not yet dilated on one side. Sarah Beth was laboring beautifully.  She was moving with her body.  We provided counterpressure, massage, heating pad, wet cloths, fanning, aromatherapy and lots of love and support)

Then all of sudden....nothing. I got scared. Dear Lord, please don’t tell me labor is stalling. No, no, no. I even remember asking Bianca, “Where did they go?” 
Then BAM 💥 it was pushing stage. Just a little grunt here and there. Things were really getting FUN now!!! The more I pushed, the more I felt like my clit was about to bust wide open. Also, it felt like my b hole, rectum, large and small intestines were going to just fall right out of me, to be frank. So, I asked John to apply pressure to my anus. And he did!!! Bianca was applying warm compresses to my perinium. So every contraction there they were. The freakin  💫 DREAM TEAM ⭐️ where were the nurses, you ask... they were in the back row, just watching. At one point I asked one nurse to please spray Eucalyptus in the air. Because every time I pushed, a little feces would come out. Oh, fun!!!! And John would clean me up. 

(At 8:15p, with just John and I in the room, I started to notice just a little pause at the peak of the contractions and with each contraction it turned into a stronger grunt and push.  No one told her it was time to push or when or how to push, Sarah Beth just trusted her body.  Around 9p, I started to see just a bit of the baby’s head at the peak of each contraction.  I stepped away to the nurses station to give them an update.  Dr. Moore and some nurses were in surgery, so the nurse manager and a nursery nurse came in to the room.  The nurse manager very calmly told Sarah Beth that Dr. Moore was in surgery but to keep doing what she was doing, they were able to catch the baby if he did not arrive.  No one told her to stop pushing or hold it.  This is a wonderful thing and I wish every mother had this experience.)

Anywho, that pushing stage really
Sucked. It sucked. The doctor ffffffiiiiinally decided to make his way into the room. He was doing a C-section just prior. I was his last patient of the day. Hahaaaaa! (John said he could give us the 2019 Biggest Pain In My Ass Award 🥇) anyways, Bianca said The doctor is here if you were holding back before. 
​
(Sarah Beth pushed squatting, and laying on her side.  Then suddenly, she readjusted herself and got situated with one foot up on the squat bar and that was what she needed - Waylon was born just moments after the re-position.)

9:29 here comes Waylon. Slippery little .... they put him on my chest. John was laugh/crying. And I was like “whaaaaattttt theeeee fffffuuuuucccckkkkk was that?!!!!!’n” excuse my language but seriously. PTSD. I had it for a while after. I mean I really did. The pain was so real. So terrifying. Bianca and John said that on the outside I looked so calm and peaceful, moving around and using my tools we learned. But on the inside....it was a perfect storm. I cussed, I screamed, I writhed in pain. Just using the bathroom was scary. My vagina was soooo so traumatized. 
Not to mention when they got me up to pee the first two times, I passed the hell out. Lord have mercy!!!! 
I was emotional . I kept crying. I couldn’t stand straight up. I had really wrenched my spine during the pushing!!! 

Rewind a little bit.....I tore. Hell yea, I tore. Grade 3 I believe he said. So after all the pain from pushing this little 8lb 6 ouncer out, he sticks me with numbing stuff.....which hurt. I was so tired of pain. Then he stitched me up. I swear I could feel the last couple and the tugging. Horrible. And not to mention I could see him doing it. Across the room was a colonial picture of mother and baby, and it was acting like a mirror with that bright overhead light on full blast. 
(I am pretty sure it was a minor to moderate tear.  Dr. Moore commented that it was possible to heal on it's own, but he recommended stitches to get everything lined up correctly.)

It was a bloody mess!!! John said it looked like a slasher movie 🤣 Anyways. One thing I thought was particularly horrible was after allllllll that after all that, the nurse has to rub down your uterus. Which freakin HURTS!!!!!! Still having contractions....whyyy? I know why. 😭 but geeeeeze. When would the pain be over. 

I told my sister the next day, adoption was the way to go!!!!

I love my baby boy!!! He is the best thing that ever happened to me. I could not have done it without Bianca and John!!!! Fact. Everyone needs a doula for birth. Everyone needs a partner to stand up for them!!! Advocate for yourself! Educate yourself! Be the mother who will stand up for themselves and for their child. Have a voice! Be empowered! Our birth plan “went out the window” to a certain degree, but I still got the end result....healthy baby boy, healthy mamma, with options explained and my voice heard. 


(I asked Sarah Beth what she would tell a mother who wanted to give birth without and epidural but is afraid of the pain.  Below is her response.)

Pain is temporary and with time the memories will soften. Before you are to experience the GREATEST PLEASURE of your life, it’s only right you should experience the greatest pain. Because one can not exist without the other. You have to respect one to appreciate the other. 

True active labor and pushing only lasted 4 & 1/2 hours. It was because of the intense pain I felt that allowed little Waylon to make his way down the birth canal. I was allowed to move, being without epidural. I changed positions. I rocked. I got on all fours. I sat on the commode. I walked. I laid on my side. I pushed my leg into the birth bar. All of that moving allowed shifts in my pelvis, which allowed Waylon to wiggle his way down. I honestly believe that. 
I could NOT imagine being in pain and being tied down to a bed. I can NOT imagine. 
Just because you have an epidural doesn’t mean you’re without pain. I have a friend who got an epidural and it only took to one side. Imagine that!!! 
Also, research showed epidurals can give some mothers a spinal headache. This sounds miserable to me, as I have lived with migraines my whole life. Imagine bringing new life into the world...your heart and joy...finally meeting your baby for the very first time.....and you can’t even enjoy it because you have to lay completely flat due to side effects of the drug. 
Also, research shows babies are more alert and HUNGRY, ready for the tit 🤠 when they haven’t had pain medication. This was also important to me because I wanted breastfeeding to be successful. That was just another hurdle I could avoid. Waylon was placed on my chest, both of us naked as jay birds, and he picked his little big head up and started searching for my nipple!!!! It was incredible. Just like I’d seen in all Bianca’s birth videos. He latched on, no problem. 

You’re a woman!!! Which means you’re already way stronger than you think! Don’t underestimate yourself. You were made for this. God intended for us to feel pain. One of my favorite scriptures is Psalm 139:14 
I will praise Thee; for I am fearfully and wonderfully made: marvelous are Thy works; and that my soul knoweth right well. 
Fearfully and wonderfully!!!! That sums it up right there. Trust in God! Trust in your own strength!

(Sarah Beth faced an unexpected complication and continued with confidence.  She listened to her body and looked inward for coping techniques.  It was a wonderful Christmas gift to me to be witness to the power of a baby and mother being born.)