Our birthing experience

Minutes after Alice was born. She was immediately placed on me for skin to skin.

Our birthing experience started a long time before my due date - Sept 16. 

Having a high risk pregnancy with type 1 diabetes, we were in discussion with our OB about the hospital protocol for type 1 pregnancies. 

I would be giving birth at UCLA Ronald Reagan Medical Center in Westwood Los Angeles. 

Their protocol was to induce someone like me at 39 weeks if their were no complications earlier. I was at higher risk for pre-eclampsia and still birth as a diabetic. To be honest at first I thought that it was okay to be induced. I didn't challenge anything and understood this to be my option. 

Once we started our Bradley Method (natural childbirth) classes, we came to learn that even with a high risk pregnancy we still had options. Our teacher Susan really opened our eyes up to this and encouraged us to discuss options further with our OB - which we did. 

And to make things better, she was really open to everything. At one appointment she said "most things are compromisable" and encouraged me to bring in a copy of my birth plan for her to review. 

This was around my 34 week scan. 

From there, we didn't set an induction date and just continued with the bi-monthly ultrasound appointments and weekly non-stress tests. 

We passed everything with flying colors. Our OBs only concern was that the baby was measuring larger than normal from 37 weeks onwards. She took a huge jump in size from 34-37 weeks. 

We ended up setting my induction date for Sept 14 - 2 days before my due date. The week leading up to my induction I was stressed and anxious and ended up messaging my OB and asking if we can push my induction to the 16th. Our official due date. 

I really wanted to give my body enough time to be as prepared as possible in the hope to either avoid induction or limit intervention if required. She was open to it, let me know the risk and then said the decision was completely ours.

The two weeks prior to the 16th, I really did a lot to try and induce labor naturally. I continued daily walking, bouncing each night on the birthing ball squats, eating dates and pineapple, drinking raspberry leaf tea and taking evening primrose oil capsules. And in Week 39 I did acupuncture and drank a drink called the MidWives Brew. Both of these were stronger ways to induce labor.  

We had a false labor alarm on Saturday Sept 12th. I had a large amount of fluid come out after we went for a morning walk followed by some consistent contractions -  it seemed like my water broke. So on Sunday we went into the hospital to get checked, thinking that we may have a new family member on Monday. 

I was checked twice in triage and they couldn't confirm there was amniotic fluid so they sent me home. This was a blessing in disguise although I was disappointed we weren’t quite ready.

Monday I went to acupuncture and drank the Midwives brew. 

I had stomach cramps or contractions from the drink - it contains castor oil. 

By the afternoon I wasn’t sure if I should show up to my acupuncture appointment but I didn’t want to miss the opportunity for it to potentially help things to move along.

10pm that night I couldn’t sleep or rest. The regular contractions started. About 10 mins apart.

The pain I felt was much stronger than the pain I’d felt a couple of days before. So I knew this was a good sign.

Throughout my sleepless night I tried to stay calm, relaxed and get some sort of rest.

By morning time the contractions had picked up. I tried to eat a very small amount of breakfast which came back up pretty quickly. This was the start of continuous vomiting during labor.

During the morning I showered, Alex helped finish packing most things for the hospital and he worked with me during different positions to work through the contractions. Everything we had learnt during our Bradley birthing classes.

The contractions were slowly getting stronger and closer together - settling at about 5-7 mins apart for a long time.

Yuki ゆき our pup wasn’t sure what was happening but stayed out of the process unless I was vomiting then she wanted to smell me ... gross. 

We were deciding when we should head to the hospital. 

We were trying to labor at home for as long as possible but it was approaching 21 hrs and I was concerned about getting to the hospital with enough time. 

We arrived at UCLA Ronald Regan around 5pm that afternoon.

I had to go through the same triage process that I had done on Sunday except they confirmed my water had broken and I would be admitted as a patient.

The hospital is a teaching hospital so the staff always worked with residents. I would see a lot of people during my stay - both students and doctors.

The doctor checked me. I was 2cm dilated, 80% effaced and the baby was at a -2 station. 

I was slightly disappointed I hadn’t progressed far during all the laboring at home.

The nurses set me up in my room. Alex came upstairs with our stuff and we began our hospital labor.

They set me up with intermittent monitoring so I didn’t have to be strapped to machines and they put in an IV fluid drip - I was so grateful for this. I had vomited multiple times and was so dehydrated. I couldn’t even keep water down. 

They also connected my insulin drip.

All the drips I had connected during my labor in hospital - IV fluids and insulin.

I had officially handed over my diabetes management to the hospital endocrine team and the nurses.

My blood glucose levels (Bgls) had been great up to this point. I had pretty much a straight line during my at-home labor and was nervous to see if things would stay that way. 

My BGLs during my labor at home - range on my CGM was 70-130.

Once I was switched to the insulin drip I didn’t know that some of the fluids had glucose in them. I watched as my bgls rose to the 190 range. 

Goal range during labor was 80-110. I was well above that.

I shared my stresses with the nurses and they got to making adjustments to the drip settings immediately. 

I patiently let them do their thing and watched my bgls slowly come back into range. 

4 more hours of labor went by. Similar to that of home and my contractions weren’t getting any closer together albeit getting stronger. 

The resident OB came into the room and did another check. I was 4cm dilated, 80% effaced and baby still at station -2.

At this point the resident shared his concern as my water had broken over 24 hours ago and the risk for infection can increase.

He wanted to start me on the drug Pitocin, a synthetic version of oxytocin. I had done plenty of research on this drug and as I wanted minimal intervention I declined the Pitocin at this stage and said I wanted to wait longer.

About an hour later the OB on call that night came in with the resident and wanted to discuss Pitocin more. 

She was strongly encouraging starting on it. It was a little uncomfortable and I felt a little bullied into a situation I didn’t want to be in.

Later on I would understand the benefits of starting on Pitocin.

I agreed to start on the lowest dose possible - 0.5 micro units per minute.

They would slowly titrate the dose up to create contractions that were stronger, longer and closer together. 

I felt prepared for more pain but I don’t think much can prepare you for the contractions caused by Pitocin.

I asked for the Pitocin to be titrated slower than their usual protocol. 1 unit every hour knowing I’d be checked again in 4 hours. Their protocol was to increase by 2.5 units every 30 mins. Thank god I didn’t do that. 

By this time it was a switch over of the nursing and OB teams.

My regular OB was working out of the Santa Monica clinic that day so I sadly knew she wouldn’t be able to be there for the labor.

The new teams that came on were great. The nurses were incredible. Willing to discuss my control over the Pitocin dosing and helping out with labor positions and encouraging me to move around. 

Everything that they recommended was helping. Although using the peanut ball in the side lying position was so excruciating. I couldn’t do that for more than a couple of contractions. 

The new OB team came with 2 residents and the OB. They came in, introduced themselves then let me get back to laboring on my own.

Tired and worn out. Smiling in between contractions.

Alex had his work cut out for him from the get go. He was either putting pressure on my back, getting me sips of water, the vomit bag or helping me maneuver with my IV to the bathroom. 

Before I was on Pitocin he was able to take a quick nap on the lounge which I’m so grateful for as I would need him physically to hold on to once the P contractions started.

After about 3-hrs on Pitocin, pain so intense nothing could prepare you for I felt an urge to push. I had so much pressure in my pelvis and the strong contractions came and the need to push was strong. 

I called the nurse and asked if I could be checked by the doctor. It was about 1-hr before they were scheduled to check me again. 

The OB checked and I was 8cm dilated, 90% effaced and baby was at -2 station.

Thank god. I was so relieved I actually cried. And threw up again from the pain of the contraction. 

I had made progress. I was almost there. I could tolerate the pain for a little longer.

All I had to do was go back to focusing on breathing through each painful contraction of my uterus for another 2 hrs when the OBs would come back and check for me.

For these next two hours I would look up at the hospital clock on the wall and 10 mins would feel like 30 mins and all I could do was count down through each contraction as I was holding on for dear life to Alex’s arm as he bent over to hold me up. 

I knew his back was hurting but the position I was in was the only way I could get through the pain. I didn’t hear one complaint from him even though I knew he wanted to sit down so badly.

90 mins after I was last checked the strongest urge possible came to push. I could not stop it. I had to push. It was an overwhelmingly strong sensation. I told Alex and he said, try and hold it for 30 more mins. 

I couldn’t. 

I buzzed the nurse and she came in and said she would get the doctors.

When they came in the room I just kept telling them I needed to push and I couldn’t stop. 

Inside my head I was nervous that maybe I wouldn’t be fully dilated. How much longer could I endure the pain? 

I lay down for the check and all I heard was fully dilated, 90% effaced and -1 station.

You’re meant to be 100% effaced to start pushing. The cervix should be completely shortened.

The OB said we can work around the effacement and I can start pushing. It was such a relief to know it was go time.

She checked my pushing technique and along with the nurses coached me in pushing deep into my rectum.

Compared to breathing through contractions, pushing through them was a relief on the body. It was so much less painful then not pushing. 

I started out in a squatting position on the bed. It felt good but I couldn’t sustain the strength to hold myself up for long. The head nurse suggested trying all fours as the next position. This worked well. I stayed there for a few more rounds of contractions.

Time to push - on bed squatting position.

Next we tried the side lying position to try and get the baby in position and further in the pelvis.

I didn’t like lying my whole labor. It was painful and uncomfortable but pushing in this position wasn’t too bad. I switched from one side to the other. 

The OB then wanted to try with me lying on my back. I mentioned that lying on my back might close the opening in my pelvis. She politely encouraged me to try it and see how I felt.

So I did. 

Alex was right by my side this whole time. Encouraging me to push when I had the urge. 

The nurses and doctors also encouraged me to push when I wanted to vs when they wanted me to.

I was so exhausted at the time and almost delirious. I would close my eyes during and in between contractions.

They gave me some oxygen as I progressed with my pushing. I welcomed the feeling of being able to breathe a little better.

Alex told me he could see the head coming through. The doctors and nurses were encouraging me to push and occasionally telling me to slow things down and breathe through a few contractions.

I was asked if I wanted to feel the head. I reached down and touched a small soft pile of hair.

I still had a long way to go.

The OB and resident scrubbed up at this point, putting on their surgical like clothing and their face shields.

Everyone else was wearing a surgical mask the entire time. Including Alex! 

The OB was doing an incredible job of putting warm compresses and oil on my perineum to help me avoid a tear or episiotomy. 

She was telling the resident that she was avoiding having to do an episiotomy. I was so exhausted by this stage I said to her “if you need to do one I’m okay with that”.

She said she would only recommend doing one if the baby was in distress or if I was completely exhausted. In my head I was like “I am”! 

We kept trying for another 30 mins of pushing, massage and the baby’s head crowning more and more. 

The OB then suggested a very small cut to help her come out. She said if we do a small cut she will come out in the next couple of pushes. I was ready and agreed.

3 pushes later as Alex described it, the baby’s head came out and she turned her shoulders on her own and the rest of her body immediately followed. 

Alice Lynette Carrion had arrived earth side at 5:13pm Sept 16 - her due date.

My delivery room was full of people. I recall about 12 in total.

2 OBs, 4 nurses, 3 people from the NICU team (partially because of my diabetes and partially because I had meconium in my waters the 2nd time they broke) and then 3 other people in the other back corner of the room observing - most likely students. 

I didn’t mind that everyone was there.

As soon as Alice was out they placed her on top of me, unwound the umbilical cord that was around her neck and suctioned the fluid out of her mouth while she was lying on me. 

They did exactly everything I had asked for. 

They left the umbilical cord attached and pulsing for at least 5 mins until my placenta started to detach from the uterine wall. 

Alex was crying, he was so overjoyed and I was too. I was also relieved. Alice was finally here. She was healthy, on me and crying up a storm. 

The whole hospital delivery team had been incredible. 

I was so elated in those moments after birth.

The NICU team left with no need to check Alice or intervene. 

The head nurse showed me how to help Alice latch and to hand express my colostrum into her mouth as she crawled her way up my chest to my breast. 

She latched straight away for successful breastfeeding.

It was so surreal and magical. 

I didn’t even notice the anesthesiologist  come and give me some medication so the resident (guided by the OB) to put a few stitches on the tear - I only needed 2. 

The nurse team who were almost ending their shift came in and gave Alex and I the biggest compliment of working together as a team. They said they hadn’t seen anything like that. 

It was so nice to hear as we did truly work as a team to bring Alice into the world. 

More than 2 hours after giving birth they weighed Alice, tested her bgls - higher risk for low bgls in babies born to diabetic mothers, gave her vitamin K injection and the eye drops. 

Official - 8lbs and 15oz. 2+ hours after birth.

We were then ready to move to the maternity ward.

My diabetes management during the whole labor was in range. Handing over my control to someone else was not easy to do but completely worth it. 

After the initial spike in my bgls I did not experience another bgl over 110 and that was a testament to a protocol that emphasized best patient outcomes. 

My BGLs during my labor at there hospital. I delivered at 5.13pm and my BGLs spiked once I switched from the insulin drip back to my insulin pump.

We nestled into our maternity ward for the night. Alex finally got some sleep and I did too, in between feedings and bgl checks on both Alice and I. 

We had done it. Every moment was completely worth it. 

Snuggle time in the maternity ward.