On Monday, August 4th I suddenly felt nervous about the delivery. Until then, I had been blithely confident that John and I could do it, just the two of us. In fact I got a last-minute pedicure and the woman asked me if I was nervous. I said "No! what's the point? The baby will come out somehow." She worked on my nails a bit, then said thoughtfully: "You're not nervous because it is your first. You don't know." Even that didn't really put a damper on my confidence.

We had decided that we didn't want our families to come visit us until a couple of weeks after the birth, so that we would have a little time to find our own feet as parents, and I still felt that was right, but I suddenly wanted to cry all the time, feeling like the two of us was just such a small number. I emailed our birthing class instructor, Kate, who is also a labor assistant, and asked if she could support us at the hospital. She said she would be honored to be with us, and asked for me to send our birthplan, so I quickly wrote one and sent it on Tuesday, the 5th. This was our plan:

    Birth Plan: Rose Dakin and John Gravois, Due Date: August 8, 2008 at Corniche hospital, Abu Dhabi.
    We want our baby’s birth to be natural and drug-free. We understand that in certain circumstances this may not be  possible, and the situation could change at any time, either to protect my health or the baby’s, and that’s fine too.

    Labor
    We’d like to stay home as long as possible through the first stage of labor, and use aromatherapy, TNS, and calcium     supplements for pain. (And distraction.)
    Once at the hospital, I want to be able to move around and change position at will. I would prefer to keep the number of cervix exams to a minimum. I may want to have gas and air for pain. I don’t want continuous fetal monitoring unless it is required by the condition of the baby.

    Labor Augmentation/Induction
    I would prefer to try all other methods of stimulating oxytocin before pitocin is administered.

    Anesthesia
    I don’t want any kind of anesthesia offered to me during labor, though would like it available if I specifically request it.

    Cesarean
    If my care provider determines that an emergency cesarean delivery is needed, I would like my husband present at all times. I wish to have an epidural or spinal block for anesthesia. Our baby should be given to John immediately after birth, and then to me for skin-to-skin contact.

    Delivery
    I would like my husband, Kate and the midwife to support me during the pushing stage.
    I would like a mirror available so I can see our baby’s head when it crowns. I’d like to have our baby placed on my stomach/chest immediately after delivery.

    After Delivery
    I would like to delay the cord cutting until it has stopped pulsing. I would like to have our baby examined and bathed in my presence, or else have John go with him/her to the nursery. If our baby must be taken from me to receive medical treatment, my husband should accompany him/her. After the birth, I would prefer to be given a few moments of privacy with John and the baby.

    Vaccinations/Vitamin K supplement
    We do not want the HepB vaccine for our baby, but we don’t mind the Vitamin K supplement or the BCG vaccine.

On Wednesday, the 6th, I woke up early (7 is early for me) and thought, this has gone on long enough. I'm going to start exercising. John had been up till 2am working on a story, and had gotten up before me to finish it, so I left him and drove our rental car out to the boardwalk on Salam street near the mangroves. I intended to walk for 90 minutes (very slowly) but I was sweating heavily in five. I kept pushing myself until I'd been out for 45 minutes. I drove home, made tea and defrosted some muffins, and fell fast asleep on the couch. John finished his story (about spending 19 consecutive hours attending church services in an Abu Dhabi Christian compound) by 2pm and went to the office to work out edits.  I scrounged around for food and found some old leftovers of mashed potatoes and chicken. I couldn't remember how old they were. I didn't care; I was hungry and they looked fine! I microwaved them and gobbled them up. I was again overcome with sleepiness and took another nap. I woke up around 4 and wrote some emails, transferred money from here to there, paid my credit card bill and another outstanding bill from ages ago, and thought: now I'm ready. At 6:21 I started feeling cramps, like period cramps but intermittent. Still, they were faster than I'd heard they were supposed to be for early labor. I ignored them. At 7, John called while walking home. He sounded a little delirious from lack of sleep, so I felt guilty with the news that maybe, maybe labor had started. As soon as he was home the cramps got worse. I thought it was too soon to be this fast, my body must be tricking me, and John needed a nap if we were going to get through the night. I said, "quick, take a nap!" but he only laughed. We set up the TNS machine (electro pulses to interrupt pain signals), I took a tylenol and liquid calcium. He started timing the contractions. They were every 1-2 minutes apart, lasting from 1 to 5 minutes long – they were coming fast enough that John had a hard time keeping up with watching the clock and recording each contraction's duration. I started throwing up. Maybe from the pain? I didn't know. I couldn't keep anything down. At 10pm we called Kate and she was over by 11, and we all decided then, because the contractions seemed so strong and close together, that we should go to the hospital. We thought labor was progressing quickly, that we were almost there! I was feeling weak. The car ride was hard.

At the hospital the nurses noticed that Iola's heartbeat was elevated, hovering around 170, and they asked if I was sick, if I'd eaten anything that might have given me food poisoning. I eventually remembered the chicken, sheepishly. The doctor said a stomach ailment could aggravate contractions, which was apparently why they were coming so fast. I was still in very early labor, it turned out, and here I was, sick and in the hospital (first divergence from plan). They wouldn't take me into the labor ward because I was only 2cm dilated, but they also wanted to monitor Iola's heartbeat continuously (second divergence from plan), so they compromised by monitoring her for about an hour and then letting me decide what to do. I just wanted to lay on my side and be alone with my contractions. I also wanted the IV fluids; I felt them bringing me back to the present. I decided to stay in the recovery ward until I could go to the labor ward. John stretched out in a chair, and Kate went home at 3am. I tried to breathe as quietly as possible through the contractions. With the realization that this would be a very long haul, I wanted John to rest. I don't think he really did.

After a couple of hours they moved us to the labor ward. It was morning, but there were no windows in our room, so we spent the next 24 hours with no real concept of time. The midwives work 12 hour shifts, and we were there for three changes of the guard.  We had one lovely midwife, Ishbel. She was so wonderful that we almost wanted to name Iola after her. The hours passed, my contractions got stronger, I was using the "gas and air" mask (nitrous oxide and oxygen) through each one. John hadn't eaten anything except granola bars all day. He called Peter Baker and Jonathan Shainin, friends from work, who brought him a sandwich. They delivered it to the lobby. Ishbel got me a chocolate bar, but I couldn't eat it. I was sipping milky tea, but also throwing up every couple hours. I had dilated to 4cm, and no amount of mind games or visual imagery could speed it up (third divergence from plan). I was chanting to my cervix, until I got discouraged at its obstinance, and then I just resorted to counting my breaths in Hindi. I knew when I got to twenty the pain would lessen, and a different language helped occupy my mind. I can count to twenty really fast now: ek do tin char panch che sat aat nau das gyarah barah tereh chaudahpandrehsolahsatarahatarahunnisbis. Sometimes I would have to start over. I got messed up if I tried to go into the twenties, it didn't work with the rhythm of things. John was also pressing on my back through the contractions. There were a couple hours when we moved around on the floor, using the birth ball and mat. Sometimes a team of doctors in headscarves would drop in.

In the evening we called Kate and she came. I mostly remember that she put hot compresses on my forehead, which felt really good. John tried to take a nap. Ishbel's shift was up, and the next midwife was not nearly as nice, she seemed nervous. I decided to ignore her; luckily Kate and John were nicer. The doctors wanted to break my waters to increase the strength of the contractions. I said ok, better than pitocin, but I was still a little surprised when it actually happened. I noticed the increasing strength of contractions, and decided to take a tranquilizer/muscle relaxer so I could sleep between them. I also noticed they felt different, expulsive, like my insides were trying to be outside – a sign of progress, Ishbel said. I slept for an hour, maybe two. At the next exam I had dilated to 8cm; we were so thrilled! But the exam was extremely painful. Two hours later, my cervix was back down to 6cm. It had swollen. The doctor who had conducted both exams, Dr. Hanna, said this could have been caused by an abrasion or obstruction. She said I needed a c-section.

Kate and John asked all sorts of questions; they were my advocates when I was too fuzzy-headed and tired. But Dr. Hanna said didn't know of anything that could reverse the swelling and open up the cervix again. The only thing I remembered to ask was whether John could be with me. Dr. Hanna said yes. I turned to John and said I was ok with it. I just wanted to see the baby. We had labored for a long time.

Within minutes I was being wheeled away, getting the spinal block, watching all the activity around me, talking with the nurses. The nurses told me everything that was about to happen, exactly what I would feel. The pain relief was almost instantaneous and total, and the lack of pain was like a flood of happiness and relief, all those endorphins accumulated from 35 hours of labor -- I was ecstatic. Dr. Hannah was so eager I had to stop her from making an incision while we waited for John -- she made a half-hearted threat that the pain relief would wear off if we waited too long. It doesn't matter, I said, let it wear off (it was, at most, a three minute wait!). He came in, sat by my head, and the rest is told in pictures. She was 8 pounds 4 ounces. We forgot to ask about her height, and now I can't find our measuring tape. I'll just bring her to the Azad Kashmir tailor and get her measured (a couple weeks ago I went to him to get my belly measured: 43 inches) (now I'm back from getting her measured: 21 inches). And this is her birth certificate:



                               

Three photos by Lauren Lancaster, at six days old, getting her heliotherapy:
 
you thought she was all sleep and smiles... it turns out she's also a rock star

 

At ten days she sleeps 18 hours a day, nurses for 4, and is cranky unless dancing with John or going on errands for 2.