My Labor Story :: Pain Med-Free Induction at 37 Weeks with Pitocin (Intrahepatic Cholestasis of Pregnancy)

I did it. I’m still in shock. Wow!

Leading Up to the Induction

Thursday, March 30th was originally the day of our induction, but it had put me at 36 weeks and 6 days pregnant, so one of the nurses on the unit called and had the date changed to the 31st. Having been diagnosed with intrahepatic cholestasis of pregnancy, I had spent the past two months worrying myself sick about the baby, knowing that the risk of stillbirth increases as the weeks go on, risk of respiratory issues at birth can become an issue, risk of meconium aspiration increased, and so forth. I was so mad. So mad! I’m not usually one to be irate with people, but I was just beside myself from the hormones, the worrying, and the disappointment of the last-minute change. I had spent so long preparing myself mentally for that date that I had only just begun to feel at ease with the idea of an induction.

Our kids were with their respective other parents and we settled in for our last night together on Thursday. The weather was warm and the sun was shining brightly without a cloud in the sky… A sight we hadn’t seen in a while as our valley had been sunk with snow for weeks, followed by dreary rainy weather. An external testament to our internal stress levels. The subsequent sunshine breaking the wave of stress just enough for an eerie silence to take over our home as we prepared for the unknown that was to come the next day. It was no surprise that the weather had returned to overcast by morning.

We went to bed early that night after a large dinner of butter chicken, naan bread, raita, and rice from our favourite Indian restaurant. Despite my fear of what was coming for us the next day, I slept the best I had slept in quite some time. Unfortunately, this did not make waking up early any easier.

Waking Up Pregnant for the Last Time

My partner woke earlier than me and prepared coffee. His careful and subtle morning movements startled me awake around 6:15 a.m.. I gathered my stress-filled thoughts and called the hospital to confirm coming in for a scheduled induction, secretly hoping that perhaps they would not be able to accommodate an induction. They told me they were all set and ready for us and I drew in a gentle sob as I let that sink in for a moment before thanking the woman on the other end of the phone and hanging up.

Shifting heavily under the weight of my belly, I maneuvered through the house, almost pacing. Drinking my coffee. Nausea waving over me from my continued morning sickness and made worse from the fear of the upcoming pain and worry for the health of our team green baby. The induction instructions say to eat a good breakfast before coming in, but I could not stomach the idea of food just yet. I imagined the induction method that we would decide on this morning would allow me to eat. Vivid and wild imagination I have.

I packed up the last-minute essentials into my hospital bag and my partner packed his. The silence of our home this morning was palpable, broken only for necessary interactions, “ready to go? Five more minutes?” By 7:15 we were en route to the hospital…no turning back now.

Starting the Induction

I was quite fortunate to have an amazing maternity nurse who stayed with me throughout the induction, with the exception of breaks which were relieved by other nurses. She helped me into the bed of the delivery room. I took a moment to silence my internal dialogue after every emotion in the world hit me at once; this is the same room my daughter was born in almost 11 years ago.

Strapped into the external fetal monitoring machine, we waited for the doctor or midwife to come in to assess my cervix and see what method of induction we were going to try. I had two main fears going into this induction: first, being induced with pitocin and second, having my waters artificially ruptured. The high risk doctor comes in around 9:00 a.m.. He has been working with my midwives due to the diagnosis of intrahepatic cholestasis of pregnancy, making the pregnancy high risk. I am forever grateful that I was able to keep my midwife team in spite of my diagnosis.

The doctor checks my cervix and to everyone’s surprise, at 37 weeks pregnant, my cervix is soft and already dilated to 3 cm. Baby is high and not engaged, however. He recommends a pitocin induction as we cannot break waters with a baby sitting so high and we cannot use cervical ripening agents on a cervix whose job of softening is already done. I ask for a lesser dose range and these wonderful medical professionals nod in agreement, allowing my wish to start slow to be granted. Rather than the usual 4 milliunits, they would start me at 2 and increase by 2 unless it is obvious that it isn’t enough.

The doctor leaves the room and I try to keep my stoic face on, but I fail miserably. Tears drop from my eyes with no control while I sob, “I really didn’t want pitocin.” The nurse asks why and I go on to share the story of my mother’s own induction that I beared witness to almost 15 years ago. How I had never seen my mom in pain until that day. How she had three natural deliveries without pain medication and her pitocin-induced labor was the first one that had her asking for an epidural. How my fear of an epidural was so great that I’d want to be put out in the event of a cesarean because I am so afraid of not feeling my own body. How my fear extended to pain medications making me too high to be able to bond with my baby after they are born.

Fear… fear… fear…

My nurse listened well and worked with me to calm my nerves. I had a bond to her that made me feel like her break-relief nurses were imposters and I panicked a little everytime she left the room, but I didn’t say anything.

Pitocin Drip

At 9:15 am, an IV was inserted into my left arm and blood samples were taken from my right inner elbow. Pitocin was started at 2 milliunits per hour, then increased by 2 until we were at 6 and it was evident that no progress was being made, so up by 4 until 14, then 16, 18… 22. Monitors still in place on my belly, I sat on a birthing ball, leaning as forward as I could to encourage the baby to descend. The contractions were barely noticeable and had no rhythm; labor was still a distant thought that had yet to come to fruition.

My mom came in sometime after 1:00 pm, a welcome sight as my partner was needing a break from the hospital room and I welcomed the opportunity for him to care for himself… I would surely need his strength later.

My midwife came in sometime around 2:30 pm to check any progress, but we were already pretty certain that none had been made yet. I was still 3 cm, but baby had at least come down enough to make breaking the waters safe. I let out a whimper or two as breaking the waters was another fear of mine; what if there was meconium in the water? What if I was placed on an invisible timer that meant baby had to get cut out of me after x-hours of laboring? What if an infection set in? What if this caused intense contractions that I couldn’t handle? Or contractions so strong that baby couldn’t handle them?

Labor Truly Begins

My midwife broke my waters around 2:45 pm and I immediately asked if they were clear. Indeed the water was clear and I cried once more in relief. No meconium. Baby isn’t in distress. On the midwife’s suggestion, I went to the toilet and sat through a few contractions to allow the remaining waters to trickle out.

I put on my dress to cover my stomach so we could walk the halls a little bit. Nothing fancy, just a dress I had packed to make it a little less hospital-like and little more comfortable. My partner and I walked down the hall to the water machine to fill up my water bottle. We landed ourselves there just in time for me to throw myself over the counter and allow one of the first painful contractions to take over.

I filled up my water bottle, turned around and spotted my favourite nursing instructor… I called out her name but thankfully she didn’t hear me because within moments I was into the next contraction. We carried on in our journey down the hallway where another contraction hit me, so I found myself bent at the waist, pressing into the footboard of a bed that was parked in the hallway, trying to not be in the way of the housekeeper whose shoes I witnessed walk past, following their cleaning cart as my eyes were focused purely on the ground beneath me.

After returning to the labor room, I sat on the bed and the four of us conversed: The nurse, my partner, my mom, and myself. It wasn’t long before I was removing myself from the conversations silently, leaning forward at the edge of the bed and letting the contractions take over, breathing, then returning to where we had left off. My nurse had her hand on my belly, noting that my uterus wasn’t relaxing fully between the contractions. Even though the waves of pain had a beginning, a middle, and an end, the contractions themselves were not ever fully going away, so my pitocin drip was lowered to 18.

It didn’t take long before I could no longer sit and insisted on standing up, leaning over the bed for a few contractions, but bending at my waist was causing more pain. I had asked for a popsicle sometime around this point in time, figuring I’d be laboring for a while and since I hadn’t eaten much, I needed something for energy. I focused on eating the popsicle in between contractions. The contractions became stronger and I found myself with my arms wrapped around my partner, borrowing his strength and relaxing my lower body as I hung from his shoulders. Words of encouragement from everyone in the room played a pivotal role in my staying focused and relaxed.

My partner left for a quick break and I fell to the ground for one last solo contraction, leaching onto him as soon as he returned. At this point, I had fully entered the zone where my primal self took over. My voice now a faint sound that my partner had to interpret for the others in the room–and boy did he do a great job of that. The midwife had entered and asked me where I wanted to deliver the baby. I was slightly off-put, wondering why they were asking me this now. Labor had just started and I had only just now had a few contractions painful enough for me to let out moans. Why the rush? I finally just told them the bed and they contently set it up for a delivery. I clung mercilessly to my partner, drawing on his strength once more as my lower body relaxed, I could feel the pressure build as baby descended. I could feel my nurse tug down my bottoms in preparation of baby coming. I was so in the zone that I did not care about being suddenly exposed or the fact that my shorts and underwear were now missing in action.

I felt an intense urge to pee, so I excused myself to the bathroom solo, IV pole in attendance. This was a mistake. As soon as I sat down and relaxed, a contraction hit and no doubt about it, baby descended even more and I let out a holler despite my mind telling myself to be quiet so as to not scare the birth team. It took seconds before my nurse and midwife came rushing in exclaiming not to have the baby in the bathroom. “I don’t want to!” I agreed while preparing myself to dash to the hospital bed as soon as the contraction was over, anchoring my feet for take-off.

Rushing towards the bed, my partner asked if he should hop onto the bed and I said yes before he could finish his sentence. I’ve never seen him so graceful as he lept onto the bed, ready to receive me as I relaxed onto his lap and into his arms. Silence had fallen over me once more, not wanting to speak. A few mashes of the bed controls were attempted as we tried to get into the best pushing position. I never intended to push on my back, but this is how my body chose to land. Head raised slightly, bottom of the bed dropped ever-so-slightly to allow my legs down rather than in the traditional open-legged position.

Another contraction hit and I could not help myself from pushing. My body pushed and the pain was too intense not to push along with it, yet the pain was too intense to continue pushing, but I did anyway. As soon as the contraction was over, I returned to a silent, overly relaxed, zen state, flopping down as though my batteries had died and my robot self had shut down. This carried on for two contractions before baby was crowning. I instinctively placed my hand on baby’s head, and felt my body as foreign, feeling its edges. This is where my timeline gets a little messy. I don’t remember when the spinning happened; before the head was out or after.

Another contraction and baby’s head was brought halfway out, getting half their head and face squeezed enough to cause bruising across their face for the first day or two of life, complete with eyes swollen shut. I remember someone, I think it was my mom, exclaiming “The head is out!” And the nurse or midwife who were perched at my feet said ‘Yes! Well, sort of. It’s half out.”  Something I had never experienced before. Usually, the head comes out in one full contraction. I digress, my hand found its way to the head again and I heard the midwife say “They’re just moving” reassuring me that the feeling of baby’s head rotating against my hand was normal. I felt baby move inside of me as they turned into a better position; something I hadn’t experienced or something I had forgotten from my previous births.

I prepared mentally for more contractions and more pushes, but my body did its own thing and baby was born one or two contractions later, rather unexpectedly. No one was quite ready to catch baby just yet and so my poor little one was born onto the bed. It took me a moment before I realized that they were now entirely earthside and needed to be picked up. I pulled them up onto my chest. I think either the nurse or midwife helped with this, but I don’t fully remember. One very thick umbilical cord stood in the way of revealing the gender of our new baby. I lifted baby from my chest and saw nothing but that umbilical cord. I moved it out of the way and it was revealed that this little cupcake–this being that had me worried for months, sick for even more months–this precious little being was a girl. Little Elora was born at 5:16 pm after 2 and a half hours of labor.


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