Part 1: Before
It all started in Ecuador. Rachael and I took a South American vacation last May, visiting an old friend, climbing a mountain, hiking through the cloud forest, and swimming with penguins in the Galapagos Islands. We originally intended to visit the Amazon, too, but we ran out of time. That meant we didn’t need to take the malaria medicine we’d brought. And that meant we didn’t need to worry about the recommendation that women on malaria medicine not become pregnant. A few weeks later, after three home pregnancy tests to make absolutely sure, we were officially expecting.
Long before learning that I’d be a father in a matter of months, I’d put a lot of thought into what kind of dad I wanted to be. My own father had always made me feel like the most important thing in his life, and I wanted to do the same. I imagined reading my son or daughter books, teaching her how to play hide-and-seek, hosting pretend tea parties, and sharing my love of sports and the outdoors. But one thing I hadn’t considered much at all was labor and delivery—the process by which my child would actually arrive. Rachael, I soon learned, had thought about it quite a bit and had very specific ideas about how she wanted to give birth.
For starters, she wanted to go all natural—no drugs and no medical interventions unless absolutely necessary. Because this was our first child, and we were anxious about the possibility that something might go wrong, we agreed that she should give birth at a hospital with a doctor, rather than at home with a midwife (though we might consider that route for a possible future second child). Then Rachael suggested we look into the Bradley Method of “husband-coached natural childbirth.” My gut reaction was a mix of surprise, fear, and panic. But if I wanted to be a supportive, involved father, I figured I should start now. So I said sure.
Usually, Bradley classes comprise 12 weekly sessions, but that wouldn’t work with our busy schedules. Instead, we hired teacher Jackie Smiley to condense the class into three hours-long one-on-two sessions at our house. We covered topics including exercises Rachael could do to move the baby into the best head-down position and to prepare herself for the stresses of labor (a lot of squats and pelvic rocks); relaxation techniques that I could coach Rachael through during contractions (for some reason a technique in which you think of things that are various colors became a running joke); and how to survive each distinct stage of labor. I took pages of meticulous notes, which eventually became an invaluable resource during Rachael’s delivery.
Meanwhile, at the doctor’s office, we learned through genetic testing at 10 weeks that we were having a girl (and that she probably wouldn’t have any major genetic disorders). Several weeks later, an ultrasound revealed that Rachael was placenta previa, meaning that her placenta was between the baby and the cervix. This is bad because if the placenta comes out before the baby, it leaves the little one scuba diving in the womb without her air tank, so to speak. This threatened all our plans for a natural birth, but Rachael’s aptly named OB, Dr. David Super, reassured her that in 95 percent of cases the placenta moves out of the way on its own. His calmness reduced our panic. Sure enough, after a few more weeks and a couple more ultrasounds, the problem solved itself. That behind us, Super seemed super supportive of the natural plan.
Other than that one minor hiccup, Rachael handled being pregnant extraordinarily well. After a little initial morning sickness, she spent most of her pregnancy eating normally, without any strange aversions or cravings. She stayed active, hiking and going for long walks right up until (and even past) her due date. And she was really in a pretty good mood the whole time. All of this conspired to make the pregnancy seem somehow less real, like the fact that she wasn’t suffering now meant the suffering to come might not be that bad, either. Not true.
Part 2: During
Rachael went into labor at 2 a.m. on Sunday, February 28. At first, she thought it was just the back pain that came with being a week past her due date. But the pain started to pulse, getting worse then better then worse again. At around 4 a.m., she woke me up, and we started to try to time her contractions, even though we weren’t sure whether they were actually contractions at all.
Our Bradley class taught us the 3-1-1 rule, which advises not to go to the hospital until the contractions are three minutes apart, last at least a minute each, and continue that way for at least an hour. But timing this back pain was next to impossible. Sometimes it would last for a full minute, other times a few seconds. Sometimes there were five minutes between waves, other times only one or two. Rachael called the after-hours number for her doctor, and the nurse told her that what she was experiencing was called back labor. Somehow, we went nine months without knowing such a thing existed. We headed for the hospital.
On the way to Mercy, we stopped by my office to print out our birth plan. Between our Bradley class and The Business of Being Born, a documentary produced by Ricki Lake, we’d become somewhat skeptical of hospitals. America’s C-section rate is much higher than other developed countries, and our infant mortality rate is higher, too. The more time you spend in a hospital, the more likely it becomes that your doctors will want to meddle. A little pitocin to speed up the contractions makes the pain worse, which leads to an epidural to numb the pain, which slows the contractions back down and requires more pitocin, a never-ending cycle of ever-escalating interventions. So our birth plan was mostly a list of things Rachael didn’t want: epidural, forceps, vacuum extraction, episiotomy…
With all that in our minds, we arrived at the hospital basically ready to fight for the right to have a natural childbirth. Instead, we found that everyone at Mercy was totally supportive. The nurse who checked us in made sure to put us in one of the rooms with a tub, in case Rachael wanted to labor in the water. And our nurse in the room had four of her own children naturally and talked at length about how much she admired women like Rachael.
When the nurse checked, Rachael was only two centimeters dilated (the baby wouldn’t come until she reached 10). This was somewhat disappointing news, because it meant that we probably could have stayed home longer and that we might be in for a long day. We worked out a schedule with the nurse where Rachael would be in bed on the fetal monitor for an hour, then we’d have an hour or two where she could move around.
We turned all the lights down low, and I started up the Spotify playlist I’d made for the occasion, full of relaxing tunes. In between monitoring, Rachael would bounce on the birth ball or we’d walk up and down the hall, pausing whenever she had a contraction. We’d hug and sway side to side, a sort of birthing slow dance, until the pain passed. I did my best to help her relax, mostly by reminding her to breathe and reiterating that each passing contraction was one less contraction between us and meeting our daughter.
After three more hours or so, Rachael was up to three centimeters. We ordered lunch. We walked the halls a few more times. She tried out the tub, though ultimately she preferred the shower, since the jets hit her back right where it hurt. The nurse said the back pain was likely because the baby’s head was facing the wrong direction, so Rachael spent some time on all fours in hopes of letting gravity pull the head down.
The monitor showed that her contractions were becoming longer, bigger, and more regular. But progress was slow. Another three hours passed, and she only moved another inch. By the time she reached five, we’d walked approximately 50 laps of the hallways (perhaps overdoing it just a bit), ordered and eaten dinner, and survived what felt like 100,000 contractions, each one representing one less till the end, even if it didn’t feel that way.
Because it was the weekend, Dr. Super was off duty and another doctor from his practice, Dr. Renee Stein, was on call. She remained steadfast in her support of continuing with natural childbirth, as long as the baby’s heartbeat looked good on the monitor, even as we approached 18 hours of labor. She did suggest breaking Rachael’s water to speed the process up, which the nurses had previously suggested. Speaking of the nurses, a brief aside: They were spectacular. Every time we wanted an extra pillow or another gown or some ice or some whatever, they went running. I realize that’s their job, but I would imagine that if I were trained as a healthcare professional, I’d eventually get a little sick of acting as a gofer. But the nurses at Mercy were consistently pleasant, accommodating, and supportive.
As the clock neared 11 p.m., with both Rachael and I (but mostly Rachael, of course) feeling completely exhausted, we discussed the pros and cons of breaking the water. It would make labor go faster, but it would also be more intense. If things didn’t progress after the water broke, Rachael would be put on the clock, and after 12 to 24 hours, they’d have to induce her. But at this point, she was so tired, having not slept at all the night before, that we weren’t sure she could make it another 12 hours anyway. Over what we imagined were the objections of Dr. Bradley, we decided to go ahead with breaking the water. At that point, Rachael was a six. We were both so tired, we promptly passed out, Rachael sleeping for a minute or two between contractions while I took a 30-minute nap.
I woke maybe a little after midnight to Rachael screaming in pain. Suddenly, her contractions were much, much worse. And there was practically no time between them. She was ready to quit. But this is when my Bradley training actually came in handy. I remembered that in the stages of labor, what Rachael was experiencing was called transition. It was the worst part, but also the shortest. Best of all, it came right before pushing. I told Rachael if she could survive another 15 minutes, the baby would be ready to come.
When the nurse returned to check, Rachael was a full 10 centimeters dilated. It was time to call the doctor (or really more like past time to call the doctor). The nurses advised to hold off on pushing for a few minutes, while the doctor rushed to the hospital. It was about 2 a.m., 24 hours since this ordeal had started. The nurses all told Rachael she was handling the pain much better than most women. I hope they say that to everyone.
When Rachael first went past her due date, we started to think about the possibility that our daughter might be born on February 29, Leap Day. We were initially opposed, thinking it would stink to have a birthday only once every four years. But Rachael’s mom pointed out that it’s the least common birthday, something special and unique. At this point in the night (morning?), we were ready for her to be born, and we didn’t care what day it was.
Dr. Stein arrived, and suddenly the room sprung to action. Instead of one nurse, there were now three or four, plus a resident. Stein, a mother herself, was the best pushing coach imaginable. She climbed in bed with Rachael to show her the best position, explaining in detail the difference between a productive and unproductive push. (You’re supposed to hold your breath and bear down, not do that stupid shallow breathing from the stereotypical TV birth.) About 30 minutes later, I saw the top of our baby’s head poking through. As an infant, Rachael was bald, clear up to age three. So when Dr. Stein told her the head was covered in hair, Rachael paused for a second to celebrate. A few hard pushes later, and suddenly our baby came whoosing out, much bigger than I would have imagined could possibly fit inside my wife.
Mara Elizabeth Powell was born at 2:59 a.m. on February 29. She weighed 7 pounds, 15 ounces, and was 21.5 inches long. She was purple and had a cone head. And she was beautiful.
Part 3: After
The best moment of my life came about 30 minutes after Mara was born. Part of our birth plan was that rather than the nurses taking her away to wash and weigh her, she would be left with Rachael for some quality skin-to-skin time and for a first breastfeeding. Unfortunately, that first meeting was cut short because our girl’s entrance into the world was rough. Our efforts to turn her during labor only half worked, so she came out sideways. She swallowed a bunch of fluid, and the umbilical cord was wrapped around her neck. This meant her lungs needed to be suctioned out by the nurses, at their station on the other side of the room. When they brought her back, Rachael was still being stitched up, so I jumped at the chance to hold Mara. I figured that if skin-to-skin helped form a bond for moms, it would work for dads, too, so I ripped off my shirt and pressed my daughter to my chest. Shortly after, she went back to mom and breastfed for the first time, just for a few seconds.
At that point, we were told that her breathing was a little heavy, so the nurses would need to take her for a few extra tests. When a nurse took Mara out of Rachael’s arms, she promised to bring her right back. Little did any of us know, Rachael wouldn’t get to hold her again for another two days. The tests showed that not only was her breathing way too fast (150 breaths per minute instead of 50), but her blood sugar was way too low (a score of 15 instead of 80). She’d need to be taken to the neonatal intensive care unit for oxygen and an IV.
The worst moment of my life came about 30 minutes after the best one. Because Rachael wasn’t ready to get out of bed, I went with Mara to the NICU. She was placed in a bassinet and hooked to a bunch of monitors. The nurse who tried to put in her IV struggled, sticking her once, twice, three times with a needle before finally getting it to stick. They pricked her heel several times to take blood samples. An oxygen mask was strapped to her face. Her troubling respiration rate flashed on the monitor overhead in yellow numbers.
I hadn’t slept in nearly three days, and watching my brand new daughter get poked and prodded felt like being stabbed in the heart. I turned my face to stone, too ashamed to burst into tears. I just stared at the monitor, hoping her breathing would slow. It didn’t.
Eventually, Rachael arrived in a wheelchair, and I went to her postpartum room to take a nap. I didn’t sleep. I wept.
Over the next few days, we sat by Mara’s side as she slowly, steadily improved. (Well, Monday night we were both so exhausted, we crashed in Rachael’s room while nurses tended to our little girl. But thereafter, we mostly stayed with her in the NICU.) She was weaned off the flow of oxygen bit by bit as her breathing slowed. Getting her off the IV proved more difficult. They wanted her to eat as they reduced the flow, but she wasn’t hungry because of the IV, a sort of catch-22. A happy moment came when they let us hold her, so long as we were careful not to pull out any of her many cords.
We were told from the start that it’s much easier to enter the NICU than to exit it. That’s because every NICU baby has to pass the same bevy of tests before being discharged, no matter how severe or how minor their condition (and we were constantly reassured that Mara’s condition, which had a name I don’t remember, was minor and would have no lasting effects). I’m fairly convinced that we’d still be in the NICU to this day if not for a wonderful overnight nurse named Karen, who was so kind and helpful, she might have been a real angel. On Tuesday night, she helped us give Mara her first ever bath, instructing us on the proper order in which to wash her tiny body parts. (Even now, Mara is happiest when we’re washing her hair.)
On Wednesday night, Karen made it her personal mission to have Mara discharged. She weaned her off the IV, dropping it a bit every hour, so long as her blood sugar stayed high. She ran our car seat test, for which Mara had to be strapped in for an hour without her blood oxygen dropping below 90. And she scheduled a hearing test for the morning. By the middle of Thursday afternoon, we were finally loading up the car and heading for home. After three days in the NICU, it was amazing that they let us just take Mara home without any supervision by medical experts.
Looking back now, it seems silly that we were ever so worried. Mara is doing just fine. She breastfeeds like a champ and has been growing like a weed. She’s four months old and is growing out of six-month clothes. At her most recent doctor’s appointment, she was above the 9oth percentile for both height and weight. She loves to read books (or at least look at the pictures while we read them) and stare at faces and hold this little green ball (a present from the wonderful Kevin Roberts) and chew on stuff (teeth coming soon) and roll over and go for walks and watch Slider and I could go on and on.
Being a parent is difficult. It takes up basically all of your time. Sometimes, Mara screams at me for an hours straight for no reason. But overall, it’s the most rewarding thing I’ve ever done. That might sound corny, but it’s the truth. Before I had kids, I used to get annoyed when parents would say, “You don’t understand what it’s like until you have kids of you own.” Well, you really don’t know what it’s like until you have kids of your own.