I was likely going to be induced on Christmas Eve, since that marked the day I would be 42 weeks along in the pregnancy. I wasn’t especially happy about the idea of induction based only on the due date, since if both woman and baby are fine and there is no medical indication of distress on either end, it is generally best to let babies pick their own birthdays. However, given the special circumstance that this was a surrogacy, I was willing to agree to the induction at that time, although it would have been a tough pill for me to swallow.
On Wednesday the 23rd I had an appointment with my doctor, my amazing doula and friend, Jackie, and Mateo’s family. During the ultrasound, the doctor was not seeing as much amniotic fluid as he would have liked to see, especially compared to just 2 days earlier, when it had been normal. He told me it wasn’t a rush to the hospital, that I could go home and get my things, but that we would need to begin induction that day, rather than waiting till the next day.
So, Jackie dropped me off at home, I got all my stuff in my car, then headed to grab a good meal with Chad, the boys and my brother, to give me some energy for the task ahead. I picked up Jackie on my way to the hospital and we checked in around 5:30 or 6. I felt so much more relieved to begin an induction for a medical reason, rather than just the arbitrary cutoff date.
I found out that I would have to have continuous fetal monitoring, due to the low fluid, which I knew would greatly limit my ability to move around freely during labor. I prefer to have the option of moving as much as possible, as it is helpful for allowing labor to progress, as well as an excellent tool for women to be more more comfortable during labor. Because of this, I decided to have a second ultrasound done, to confirm the fluid level was indeed low, since amniotic fluid is constantly being produced, and maybe it would be better a few hours later. They like to see fluid levels of 5 cm or above, but unfortunately, the fluid was still very low, just over 2 cm. Although continuous monitoring was unfortunately required, I felt more comfortable with it, since I knew it was for a good reason, as opposed to just standard procedure.
This all took a bit of time, and we were finally able to start the pitocin (a synthetic version of oxytocin, the hormone that brings on contractions) around 9 pm. Jackie and I decided to try to sleep for a little bit. I got a bit of sleep, but was a little too excited and in my head to fully relax as I should have. My body responded very well to the pitocin and was having regular contractions at a very minimal dose, which was great, because the more pitocin that is used, the more intense and frequent the contractions can be, compared to a labor that begins and continues on its own with natural hormones. My body went back and forth between doing a great job on its own, to needing a little help from the pitocin, so at some points the pitocin was stopped completely and my body labored on its own, and at one point the pitocin was turned up to a 5, which is still very low, as the highest they typically do is 20.
I texted Chad around 12:15 am that contractions were getting stronger, but I still was doing fine and didn’t need additional support yet. Then around 4:40 I called and told him I was ready for him to come. Thank goodness my brother was home and open to staying with the boys.
Catie (an amazing birth photographer and friend, who shot Mateo’s big sister’s birth story 3 years ago) and the dads got to the hospital sometime around 5:30 am I would say. My pitocin had been off for a while at that point, and I think the fun distraction of my loved ones pulled me a little out of labor land. So, soon after, everyone but Jackie and Chad stepped out to grab some breakfast, I started back up on pitocin and labor picked up again.
My body continued to respond to the pitocin, I was dilating and working through contractions well. Sometime later that morning, I would guess between 10 and 10:30, we decided to break the bag of waters in hopes that would help me dilate completely and allow me to begin pushing, which my body really wanted to start doing. It worked and around 11 am I began pushing. At first, pushing with the contractions helped a lot and the contractions were more tolerable, but after about an hour and 45 minutes, in many different positions to encourage baby to get into a good position and move down, but still without much decent from baby, and a lot of swelling in my pelvic floor resulting in a lot of pain, I just felt very strongly that I wouldn’t be able to continue on in this way. Given my previous birth experiences, I knew that I was capable of pushing effectively, but I also knew that sometimes I could push for a long time without progress, and I just felt strongly that even if I kept going and tried every position in the book, this was just not going to be effective given how exhausted I was and how much pain I was in. I decided to have an epidural so that my body could rest, and my uterus could continue working to push baby down a little further and we could try pushing again a bit later.
It was very hard to sit still through contractions to have the epidural placed, but the anesthesiologist was amazing and got the job done as quickly as she could. When I got up, to change position in bed, we noticed I had leaked some fluid, and that it contained meconium (baby’s poop). It is not uncommon for a baby at 42 weeks to pass meconium in utero, but it can be a sign of distress during labor. It was fairly light, so the nurse wasn’t overly concerned, but was definitely keeping a close eye on things.
It was so nice to not be in pain and be able to rest. Baby was doing well for a while, but then his heart rate started showing less variability. It didn’t drop to a dangerous level, but they like to see his heart rate fluctuate and not stay super consistent, as a heart rate with little variability indicates that the baby is having a harder time tolerating labor. That combined with the meconium gave the doctor and nurse a slight cause for concern and they decided it would be best to try pushing again, sooner rather than later, to monitor 2 things. One, that his heart rate would indicate whether or not he could tolerate labor and pushing any longer and Two, if so, would his head move down any more with further pushing.
So, around 3:30 we did some more pushing. The people supporting, watching and cheering me on assured me that I was pushing effectively with the right muscles to help bring a baby down, but unfortunately he still wasn’t descending at all. And although his heart rate looked great when we first started pushing again, after about 30-40 minutes, it began having more decelerations than they would like to see, and the meconium was still coming out and getting thicker. All signs that he was beginning to have a harder time tolerating labor.
The doctor was amazing and said that we could continue to try pushing for a little longer, but given the circumstances, it would definitely be best not to try for too much longer, that Mateo would need to be born sooner rather than later. I knew immediately that I had given it a great effort, with my amazing birth team by my side, but that I had tried everything I could, with more signs of red flags than success, and I just knew in my heart that I couldn’t risk anything happening to this sweet baby boy. The dads and I talked and cried and hugged and decided quickly that it would be best to opt for a cesarean.
Everyone knew how badly I wanted to avoid a cesarean unless absolutely necessary, and I am so thankful that the dads, even knowing how important it was that their baby be born soon, were still willing to let me choose what I wanted to do as the woman giving birth. I felt so supported and respected and loved by everyone in the room. It made the choice and situation much less traumatic and I was honestly instantly at peace with it. I did joke that I would like to bring al 5 of my support people into the OR with me, but obviously that was not an option. So the doctor told me he would ask the anesthesiologist if I could bring 2 people in, but to count on only one person and think about who I wanted it to be, as 2 support people in the OR is practically unheard of.
Obviously I wanted the dads to be in the room for their baby’s birth, and of course, with their hearts of gold, they insisted that Chad be the one to join me, as they knew how much his support means to me and would help me through the surgery. And Chad, with his equally kind heart insisted it be one of the dads. Luckily, the anesthesiologist was very understanding, she agreed to allow 2 people to join me for surgery. It was decided that Fernando would come to be there with Mateo as soon as he was born, and Chad would come to be my moral support. As a bonus, Catie gave Chad her camera to capture some shots of Mateo’s grand entrance into the world, which he did amazingly. Soon I will have photos of the labor and birth to share. They are so beautiful and truly capture all of the love and hard work everyone gave to bring this baby into the world.
Surgery was straight forward, and not as horrible as I thought it would be. It was uncomfortable and strange being awake and able to sort of feel what was going on, but thankfully without any pain. Mateo was out in no time, in fact he was almost all the way out when Chad and Fernando got into the OR. He came out screaming and healthy as can be. The hold up on his ability to descend into my pelvis appears to be that instead of his face being towards my back with the narrowest part of his head presenting, he was facing one of my sides, and the presentation of his head was much wider than my cervix was willing to let pass down any further.
Mateo was born on Christmas Eve, at 4:51 pm. He weighed 8 pounds 3 ounces and was 20 inches long. I was so happy that he was born safely and healthy as can be to his amazing daddies 😊
The repair took longer than I expected, but I am happy that the doctor took such time and care to put me back together. I am really sore, but getting better every day.
Although the birth took many turns that I never expected it to, I am at peace with the way things unfolded. I am happy that Mateo was giving us so many signs that it made me feel completely comfortable with every choice I made during the labor and delivery and I have no regrets looking back. I fully believe that I did all that I could, with the most amazingly supportive birth team, doctor and nurses I could have ever hoped for. Feeling so loved, cared for and respected by everyone there truly made all the difference in me being able to look back on Mateo’s birth with happiness at the amazing experience it was, rather than with sadness and regret that it didn’t go as I originally hoped and expected it to.
If you made it through this whole story, wow and thanks for taking the time. And thank you for all your support and kind words throughout this entire surrogacy journey. It has been one of the most amazing experiences to have had the privilege and honor of helping a family bring such a wanted and loved baby into the world. I really can’t express how happy I am to see them all together. And although I wasn’t sure how I would really feel at the end of this experience, not having a baby in my arms, it has been surprisingly much easier emotionally that I ever expected. I knew in my mind that he wasn’t my baby to be giving away, but rather their baby that I had the honor of keeping safe and healthy and growing until he was ready to be born and go with his family. However, our logical minds are entirely different than our emotional hearts, especially when you throw postpartum hormones into the mix. I am relieved to feel no sadness whatsoever at him not being mine to keep, but rather joy that I got to play a part in his life and in bringing him to his family. And I’m not going to lie, the sleep has been amazing 😉
Guest post by Amy Bethine Wells