Our birth story


This is the story of the birth of our daughter, Stephanie.  We would like to share this story not only with family and friends, but with anyone planning a birth who may be interested in our choices or our experiences.  As a result of being written for these different audiences, it's got more detail than some people might need; we apologize in advance for its length.

The pictures are links into our photo gallery, which you can visit directly at graystuff.com/gallery.

The Plan

positive pregnancy test! Some plans work out, and some don't.  We actually planned our child's due date - April 2002 - way back on the night that Jamie proposed to Nicole, in October 1999.  We knew we wanted to have children, after spending some time together as a married couple; an April 2002 baby would help us take maximum advantage of the sabbatical that Nicole expected to be eligible for in the fall of 2002, which was 3 years away at the time.  Due to careful ovulation tracking, we actually managed to get pregnant with a due date of April 24, 2002; we're still amazed at our luck!  

it's a girl! Nicole's pregnancy was fairly normal.  We had an ultrasound at 16 weeks that indicated we were having a girl; a later ultrasound confirmed it.  We started building up a list of names, but figured we wouldn't finalize a choice until she was born.  We dubbed her "Thumper" early on, and she definitely earned the nickname as the pregnancy progressed.  "Morning Sickness" plagued Nicole at all times of the day for the first 18 weeks.  Braxton-Hicks contractions started in January, and were sometimes as frequent as five in an hour while Nicole was at work.  These made the late second and the third trimesters stressful.  While Nicole did become quite "great with child", she remained pretty calm about things, and fairly comfortable, except for sleeping.  Our OB told us that we were "The calmest first-time parents he'd ever encountered".Nicole and Jamie, 39 weeks

Nicole was pretty sure that she wanted to have a "natural" childbirth - that is, without drugs for pain control or other medical interventions.  Our birthing class, taught by Jeanne Batacan under the auspices of Mission College, reinforced this; we learned a lot of things about modern medical practices for childbirth that we found shocking.  Also, pain medications often don't work very well for Nicole, so we figured that it would be best to plan for a birth without drugs.  As suggested in class, we wrote up a detailed birth plan with our preferences on a variety of topics, and brought a number of copies to the birth.

While this may come as a surprise to some of our relatives, we don't think of ourselves as touchy-feely, all-natural California granola types; we eat meat, drink alcohol, and drive an SUV, and nobody would accuse us of being health nuts.  Nevertheless, we found ourselves outside the norm when we formulated the plan for our birth.  Epidurals have become the norm, and procedures like epistiotomies, breaking the bag of waters, and the use of pitocin are commonplace.  We learned of some downsides to these, and sought to avoid them.  We frequently were given the idea that we were doing something unorthodox, if not freaky.

Nicole has medical coverage through Kaiser Permanente, a non-profit HMO.  Thus, we planned to give birth at their hospital in Santa Clara, about 20 minutes away.  Her regular OB/GYN is in the closer Mountain View office, but  they can't do deliveries there.  With Kaiser, your regular doctor doesn't come in to deliver your baby - this is instead done by whoever is on duty at the time.  This does not mean you'll get bad care - Kaiser has a very good reputation.

The Team

Some friends of ours had used the services of a Doula - that is, a professional labor support person - to help them through their labor.  We learned more about what a doula does in our birthing class, and because we planned a natural childbirth, it seemed like an especially good idea.  A doula is trained in, among other things, a variety of ways of managing the discomfort of contractions. They also have experience at dealing with medical staff, and can help remind us of questions to ask about medical procedures.  Given how Kaiser works, it seemed especially useful to have one trained person constantly with us, as doctors and nurses come on and off duty. 

Jeanne supplied a list of local doulas; after talking to a number of them, we interviewed Rosanna Davis, a doula with many years of experience. She's also a massage therapist and Yoga instructor, and has some midwifery training. She had a great skill set, and her personality seemed a good match for ours, so we chose her to join us for our birth.

Nicole's good friend and colleague Rachel Lester also volunteered to help us through labor and birth.

First False Alarm

Our due date, April 24th, came and went without much fanfare.  After the first week passed, we began to get anxious.  The policy at Kaiser, and elsewhere, is to induce labor once the baby is 2 weeks overdue, as risks for mother and baby start to increase at that point.  Labor is usually induced with pitocin, an intervention which can lead to excessively strong and painful contractions -- often leading to a greater need for pain medication such as an epidural, and leading toward a variety of potential interventions and side-effects we didn't want.

Ten days after our due date, just after midnight on May 5th, Nicole had some bleeding that we thought might be excessive.  We called Rosanna, who said it sounded normal - but that we could call the hospital if we were anxious.  We should have just listened to Rosanna and gone back to bed, but instead we drove in to Labor & Delivery.  They did an exam (Nicole was at 1cm), and hooked her up to  the fetal monitors.  Everything seemed to be fine.  Still, the doctor wanted to induce labor then & there, as we were a week and a half overdue.  When we declined, she did want to keep us for observation for a while.  We didn't leave the hospital until after 6am, more than 4 hours after we got there in the first place.  We got no sleep that night at all.

Labor Begins

Almost as soon as we got home and had a little breakfast, Nicole finally started having some "real" contractions.  Unlike the Braxton-Hicks contractions that had been going on occasionally for months, these really brought along some discomfort - at 8:30am on Sunday May 5th, 11 days after our due date, labor had begun.

We called Rosanna and Rachel, and got down to the business of labor.  For Jamie, Rosanna, and Rachel, this meant doing our best to help Nicole stay comfortable during, and in between, her contractions.  Among the measures we used:
back pressure The support people also did their best to keep Nicole hydrated and fed - water and a juice-based sports drink called "Recharge" (she probably drank a case of this), and simple foods like canned peaches, plain noodles, and crackers.  

We timed the contractions, often using a Palm Pilot application written for just this purpose (we're such geeks!).  We had some good runs of 5-minute-apart contractions, sometimes for an hour or so, but then they would spread out again.  

Second False Alarm

By about 9pm Sunday night, contractions seemed to be getting pretty strong and close together (3-5 minutes apart), and we'd been laboring a good 13 hours.  It seemed to us like it might be time to head in to the hospital, so we headed in.  Rachel drove the Trooper while Jamie helped Nicole in the back seat; Rosanna followed in her own car.

The staff at Kaiser on this night did not put us at ease.  The nurse seemed threatened by our party of four and our apparently unconventional expectations.  We described some of our preferences from our birth plan, including the fact that we didn't want to be offered any pain medication; she replied that  there was a new policy in all hospitals in the area, that the staff must offer pain medication at certain points, and mark the fact in the chart, no matter what our wishes (whether there really is such a policy or not, our wishes were respected by the staff on the night we actually delivered our baby).  While the doctor was measuring the fluid around the baby with an ultrasound, Nicole said she was starting a contraction and said she wanted to pull her legs up; the doctor actually asked her to wait, while she finished the measurements.  We were all shocked; Nicole, after contorting with pain for a few moments, simply pulled up her legs anyway.

After the ultrasound confirmed that there was still good fluid around the baby (we had thought Nicole's water had broken), the doctor did a pelvic exam.  Nicole was only at 1.5cm!  We were very disappointed; we had thought that after all that work, we would be farther along.  That wasn't enough dilation to justify staying there, so we went home to continue laboring. They did give Nicole some pain killers (Percoset) to help her get some sleep Sunday night; as often happens for Nicole, the painkillers had little effect.  Rosanna and Rachel went home to get some sleep in their own beds.  


In Labor Land

Nicole managed to sleep for about an hour and a half, with some help from Jamie, who read a Patricia Cornwall novel to her aloud until she fell asleep.  The pain of the contractions became too strong for sleep, though, in the middle of the night.  She labored alone until about 6:30am, when she just couldn't do it alone anymore and woke up Jamie.  The contractions had slowed down overnight, to about 10 minutes apart.  Rachel and Rosanna arrived about 1pm Monday, and we tried to speed things up with walking, etc.

Nicole eats noodles on the deck Monday was Nicole's 31st birthday, and she spent the entire day in labor.  Getting a little bit of food had a marked positive effect on Nicole's lucidity and energy level.  Some plain spaghetti noodles on Monday afternoon got Nicole feeling much better, and gave her better strength for handling the contractions.  We watched the movie "A.I." to provide some distraction; with the frequent pauses for contractions, it took about five hours to watch.

Monday dragged into Monday night, which dragged into Tuesday morning, which dragged into Tuesday afternoon.  This was when having a support team of 3 people really paid off - we could provide each other with enough relief that we could get a little sleep and some breaks to eat, while still making sure Nicole got constant support.  Rachel went home late Monday night, and actually took an exam Tuesday morning; Rosanna and Jamie took turns snatching a couple hours of sleep Monday night.

For much of Tuesday, Nicole was in the altered state of consciousness known as "Labor Land".  She was focused completely on the current moment.  She would direct those around her on how to help her with simple gestures and non-verbal cues.  Those around her quickly learned to identify which gesture meant to bring a straw of water to her mouth, and which meant to apply counter-pressure to the small of her back.  And of course, we all learned to track the onset and departure of contractions.

Rosanna massages Nicole's back By Tuesday afternoon, Nicole's back was starting to hurt severely, even between contractions.  We called the Kaiser advice nurse to see if there was anything they could suggest for pain.  They suggested tylenol, and warm compresses.  Nicole took the tylenol, and we added a bit of wine.

Throughout the labor, Rosanna had been using her portable doppler stethescope to listen to the baby's heart rate.  In general, it had been bumping along at a healthy 120-140 beats per minute, which is in the normal range.  Around 6pm, she took another measurement - and the rate was so low she didn't even want to count it, more in the range of 60 beats per minute.  She called us together and said we had to make a decision: whether to call 911 and ask for an ambulance,  or drive Nicole to Labor & Delivery ourselves.  Rosanna had Nicole change position, and headed out to her car to get her oxygen tank and mask; Jamie got on the phone with Kaiser to ask for a recommendation.  As Jamie was attempting to describe the situation to the advice nurse, Rosanna took another measurement, and the heart rate was back into the normal range.  Whew!  This was a relief, but the brief panic scared Nicole completely out of "Labor Land".

The advice nurse told us that occasional drops in heart rate are normal, but the scariness of the experience was enough to make us want to head in to the hospital.  We packed up our stuff yet again, and headed for Kaiser Santa Clara.

This Time For Real

We checked in around 7:30pm Tuesday.  We went through the by-now normal routine, of putting on a gown, having basic vitals checked, and being hooked up to the fetal monitor.  After the last experience, we weren't expecting much to have changed, despite the fact that almost 2 days had gone by.  Then, a cervical check: Nicole was at 7 centimeters!  We're here to stay, and we're gonna have a baby!  

We were excited and relieved.  Contributing to our sense of optimism was working with the first of a great set of nurses and doctors.  They were very friendly and caring, and supportive of our desires for our birth.  We showed our birth plan to our nurse, Daphney - she was very receptive, and told us she would put a copy in our chart.  Other staffers who came through seemed to be familiar with, and respectful of, our plan.

Setting up the labor room We settled into our labor & delivery room.  We dimmed the lights, and set up a portable CD player and speakers playing familiar "comfort music" for Nicole.  The music was chosen mainly for familiarity to Nicole; we listened to one Indigo Girls album heavily, but also some Crash Test Dummies, They Might Be Giants, Sheryl Crow, The Eagles, Billy Joel...Alanis Morissette's "Jagged Little Pill" raised some eyebrows as an unusual choice for labor room music.  A nifty glowing thing called a " Zzzz Light " was a  useful focal point at times (the staff liked it, too - one of the doctors wrote down the URL on the bottom).  We used some aromatherapy oils to mask the hospital smells -- everyone who came in said, "Hey, it smells great in here!".  We pulled a couple of trash cans into the middle of the room for Nicole to walk around, as sort of a labor "obstacle course".  In the meantime, the nurses had set up all the medical instruments that would be needed for the birth, and covered them with sheets; they were wonderfully tolerant of everything else we did to the room, including covering the clock with a towel so Nicole wouldn't be focused on the time.

After several hours of walking around, there had still been no progress.  The doctor suggested breaking the bag of waters (the amniotic sac around the baby) to help speed up the labor, and after discussion, we agreed; this was done at 11:24pm.  (This was probably the first item from our birth plan that we chose to abandon based on circumstance.  There are downsides to using this to induce labor in the first place, but it ended up seeming like the right decision based on where we were in our labor; we were already pretty far along).  Actually, it didn't seem to end up helping; progress was not significantly effected.  One of the other reasons for doing it was to provide early detection of meconium (fecal matter (okay, baby poop)) in the amniotic fluid, which is more likely for such a past-term baby.  If detected sooner in labor, it can be irrigated out with water.  The fluid was clear initially.  Meconium did appear later, though - and for some reason, this irrigation was never done; maybe it was too late by the time the meconium showed up.

Nicole handles a contraction We kept on laboring through the night.  These were hard contractions, but Nicole was handling them fine.  What was getting to be a real problem was Nicole's back.  The strain of nearly 3 days of labor, with all the stooping and bending involved as she moved through contractions, took its toll on the muscles in her lower back, and they were locked up tight, and in terrible pain that didn't end with contractions, but went on continuously.  She could find no comfortable positions, and none of our measures brought relief.  This wasn't "back labor" brought on by wrong positioning of the baby, just simple muscular pain.  Sometime after 5am, we brought in the doctors to talk about pain medication.  It felt like a defeat, but Nicole just couldn't go on; we at least needed to help her get a little rest.  Before discussing drugs, another exam was done - we were still at 7cm, having made virtually no progress.  This was further discouragement.

Our two main options were an IV narcotic, and an epidural.  The epidural seemed like it would be best for the baby, and stood the better chance of being effective.  It would mean Nicole wouldn't be able to walk around anymore, but that clearly wasn't helping labor along anyway.  We decided on an epidural, crossing out another line from our birth plan.  At about 6am, Nicole's epidural was administered: Jamie held Nicole while she sat upright on the bed, and a doctor worked on her back, inserting a needle into the sheath around her spinal column to administer the anaesthetic. Jamie did his best to keep telling her encouraging words as she went through this; sensing what she must be going through, he almost broke down himself.  In one of those strange serindipities, Sheryl Crow's "Are you strong enough to be my man" came up on the CD player, and challenged him to get it together and keep on encouraging Nicole.

As Nicole lay in the bed connected to a fetal monitor, a contraction monitor, an IV, an epidural tube, a blood pressure cuff, a catheter and an oxygen mask, she thought to herself, "This is exactly what I didn't want - I can't even roll over by myself." However, the thought was more comforting than distressing, because it reassured her that the decision to try natural childbirth was the correct one.  On the other hand, it was the first time for hours that Nicole had been remotely comfortable; Nicole realized that she really had needed the epidural.

While the epidural did bring rapid relief from the pain, it didn't mean we were back to making progress.  The doctor talked to us about how very little progress had been made in the 10+ hours we'd been laboring at the hospital.  It was time to consider Pitocin.  Well, we had wanted to avoid using Pitocin to induce labor in the first place, and one of our original concerns with it was that it could lead to an epidural and the resulting loss of freedom of movement.  Well, Nicole already had an epidural, and the resulting maze of tubes and hoses running around and into her body.  Again, our particular situation led us to drop another line from our birth plan, and the pitocin went in around 7am.  They would start it at the lowest dose, and ratchet it up every half hour if needed.

Almost immediately, Nicole's next contractions led to to wonder, "What happened to my epidural?"  They were stronger and more frequent.  They seemed to lead to real progress, as well.  Two hours later, Nicole was feeling the urge to have a bowel movement, and requested a bedpan.  The nurses asked her to hold off until a doctor could do a pelvic exam, as this urge could easily be the "urge to push" signaling that things were getting close.  Indeed, a pelvic exam revealed that Nicole was almost fully dilated - there was only a thim rim of cervix around the baby's head.  To prevent tearing of the cervix, Nicole would have to fight the urge to push that was beginning to come with her contractions.  This urge was overwhelming, and Nicole wasn't sure she was managing to not push, but Rosanna, the rest of Nicole's team, and the hospital staff reassured her that she was not pushing as long as her chin was up and she was breathing.

Half an hour later, a nurse checked Nicole's cervix, and she was fully dilated.  Oh my gosh, we're going to have a baby!  The nurse quickly gave Nicole instructions on how to push, got her into the stirrups, called for the doctor, and began setting up the room around her.  This nurse, Joyce, was amazing - she managed to be a calming, caring, encouraging presence, while simultaneously being a whirlwind of activity, efficiently turning our soothing labor room into a bustling delivery room.  Suddenly, there were more people in the room - a pediatric specialist was setting up her station to receive and treat the baby, and more nurses were setting things up.  Nicole began actively pushing at 9:15am.

Things Get Exciting

Things get a little interesting here.  The Labor & Delivery ward at Kaiser generally has two doctors on duty at any given time.  At this point, one was involved in a C-section, and the other had just been called into another delivery.  Nicole was in the active pushing phase, and making rapid progess.  Joyce said the on-call doctor had been called, but was clearly prepared to deliver the baby herself if necessary.  The baby's head was already beginning to visibly appear during Nicole's pushes when the doctor finally arrived.  Fortunately, it was one of the doctors from the previous shift, Dr. Huggins.  

When the baby's head is starting to appear is not the ideal time to be discussing one's particular birth preferences with a doctor who's just managing to put on a mask and gloves, but this is the situation that Jamie found himself awkwardly facing.  Rosanna had the presence of mind to point out that Nicole wanted to avoid an episiotomy - Dr. Huggins resolutely replied, "So do I", which brought Nicole great relief.  Jamie explained how we had wanted to delay clamping of the cord, and put the baby on Nicole's chest after she comes out, and that he would like to cut the cord.  Dr. Huggins explained how the meconium in the fluid would mean that delayed clamping and laying the baby on Nicole's belly was no longer an option - the baby would have to be whisked over to the pediatric specialist's table so that the meconium could be suctioned out.  They were going to try to have the baby not cry during those first few moments, to avoid breathing the meconium into the lungs.

So, little items from our birth plan were dropping off rapidly, but this mattered little, as the excitement of the moment was building.  Rachel and Jamie were counting to 10 for Nicole for each extended push (Rachel doing a better job, Jamie sometimes losing track).  The baby's head would push through during the push, then fall back; but each time, it fell back less.  The doctor was actively pressing on Nicole's perinium, and doing other measures to prevent tearing.  The head began to stay out between contractions.  Jamie asked, "Can she touch it?", and the doctor told Nicole she could reach down and do so; the head felt slimy, and softer than Nicole expected.  Feeling the baby's head was encouraging - it gave Nicole confidence that her pushing was accomplishing something.

Here She Comes

Soon, the baby's whole head emerged.  What came next after the head looked strange to Jamie; it didn't look like a baby's shoulders ought to look, but instead looked strangely grey and veiny.  Before Jamie could even figure out what was going on, Dr. Huggins was calmly explaining that he would not be able to cut the cord, while she simultaneously clamped and cut the umbilical cord - which was wrapped around the baby's neck, twice.  

With the next contraction, the shoulders were clear, and then, the rest of her slithered out ("It felt like a snake").  At 9:35am, after 70 hours of labor without drugs, 3 hours with an epidural, and 20 minutes of pushing, our baby was born.  She was quickly whisked away to the pediatric station at the other end of the room.  Nicole caught a glimpse of her, and thought, "She must weigh 20 pounds.  I thought she looked huge!"  After about fifteen or twenty long seconds, we finally heard a reassuring little cry from the other end of the room.

Jamie touches his new daughter Jamie followed the baby over.  The pediatrician was suctioning greenish fluid from her nose and mouth; she was gradually turning a nice pink color.  The doctor told Jamie, "This is your daughter - you can touch her and talk to her."  Jamie could touch her, but found he couldn't talk; he was choked up with tears of joy at finally seeing his baby girl.  He did get a chance to symbolically "cut the cord", by cutting off the remaining few inches that were still attached to the baby.

Rosanna, Rachel, Jamie, Nicole, and Thumper Meanwhile, Nicole was delivering the placenta, and  getting stitched up after some minor tearing (still less severe than an episiotomy).  We did delay some of the procedures on the baby so that we could take her over to Nicole and try to establish breast feeding while the baby was still alert.  With Rosanna's help, Nicole soon managed to get a good latch-on.  The staff was very obliging in giving us a little while alone for this, before finishing up with their procedures and clean-up of the room.  This was a chance for the whole team - Nicole, Jamie, Rosanna, Rachel, and now Thumper - to breath a sigh of relief and congratulate ourselves on getting through the past few days.

Thumper Gets a Real Name

Stephanie, less than one day old

After giving us some time for Nicole and the baby to bond, the staff moved Nicole, Jamie, and Thumper up to the room in the maternity ward where we would spend two nights.  Now that we could look at our baby and interact with her, it seemed like it was time to decide on a name.  Nicole had always liked the name "Stephanie".  And since Jamie was a boy, he'd known that his parents, Dick and Kay, had picked out the name "Stephanie Lane Gray" as a girl's name in case any of their four children turned out to be a girl; they had 4 boys instead, and thus never used the name, but Jamie always thought it had a nice sound.  Jamie was also thinking about paying tribute to one of his dear grandmothers - "Laura" was on the list of names - and Lane was his mother's maiden name and Laura's married name. So, Stephanie Lane Gray it would be.

Conclusions and Observations

Here is where we dispense pithy observations and advice based on our experience of one single birth.


The Gray Family - Jamie, Stephanie, and Nicole