Taking BART and the shuttle to the hospital turned out to be an interesting choice. We got on the wrong shuttle initially from Ashby BART (the hospital has 3 campuses, and there are shuttles to each and between them as well). The inside of the shuttle was all decked out for Christmas - ornaments, garlands, fake snow on the windows, pop renditions of carols blaring on the stereo, and the driver wore a red sweater and reindeer antlers. As the shuttle turned in the direction of the wrong campus, and I had a contraction, I started thinking that if I believed in hell, it would be a lot like that. Unfortunately, this was not the worst part of the day.
We got on a shuttle to the correct hospital campus, and got checked in. We were assigned a room, we met our nurse L., we got bracelets put on, we signed a bunch of paperwork, I had blood samples taken, I had my temperature taken, and I got hooked up to an external fetal monitor and blood pressure cuff. It turns out that one bright spot of being a Hep B carrier is that internal fetal monitoring is not recommended because of the risk of exposing the baby to hepatitis. I was still having contractions, but they weren't as strong or frequent as they'd been before we left home. At this point, I felt like contractions were probably a 4 or a 5 on the pain scale (of 0-10) and I felt only about a 1 between contractions. So it was fairly easy to be comfortable, but it turned out that comfortable was not what they wanted right then. I needed to get into more active labor and soon, or I was going to end up with pitocin for induction / augmentation of labor. The next few hours were spent walking around the halls, over and over again. Even though I saw the same stuff many times, I was totally disoriented, and never knew how to get back to the room once we'd gone more than a few steps. It was a good thing that Ben still had his sense of direction.
We'd head back to the room at intervals, and I'd usually have several strong contractions, drink water, use the bathroom, and get monitored for a while. The monitoring wasn't bad in and of itself (I hadn't minded it at all during the non-stress test the previous night), but it made it hard to move around during contractions, and I couldn't get up and go to the bathroom, which I wanted to do probably every 15 minutes! Likewise, getting my temperature taken wasn't bad on its own, but it meant that I couldn't drink anything for about 10 minutes beforehand so that the measurement would be accurate.
I met Dr. H after I'd been there a few hours, and she examined my cervix. I was dilated to about 3, fully effaced, and the baby was at the 0 station. She stretched my cervix a little bit to help speed up labor. Having your cervix stretched even a little bit is rough. I was really disappointed to hear "3", but everyone else was very encouraging - I was definitely in active labor and making progress. Dr. H had good advice too - basically that the contractions were a good thing and to think about opening up and making progress.
Another couple of hours of walking passed. At this point, my legs were so tired and weak, but I didn't feel like I could get comfortable in any position that wasn't standing. I mostly stood and leaned over during contractions. Ben rubbed my back and kept plying me with Gatorade and water. It was good that he was keeping me hydrated, but I was getting really sick of the Gatorade, and I was very hungry.
Another exam a couple of hours later, I was feeling like I wasn't really sure I could keep dealing with the pain. I was getting up to about an 8 on the pain scale during contractions, but in between, it was only going down to a 4 or 5. I got checked again by Dr. H. and had made more progress - dilated to 5, and the baby was at +1 station. L told me the I was starting transition, and that the next bit of dilation should be quicker - soon I'd be ready to push. Dr. H. told me to try thinking about the baby coming down as I stretched out during the contractions.
The next phase (maybe an hour?) was like the eye of the storm. I was still lying in the bed from being examined, and Ben joined me. We held each other, and he talked to me to get me to open up and relax during the contractions. He was so loving, and sweet, and I was so glad to have him there. His voice was quiet, and calm, and he sounded so confident in me, and amazed that I was doing this. One nice thing about this time, was that everyone else there (I think L was there as well as the nurse coming on duty, C) was very quiet and left us alone. I think I heard L whisper something about how I had really awesome support from Ben during this. This part of labor wasn't painful - I felt my cervix stretching open during the contractions, and I felt crampy in between, but it wasn't anything I couldn't deal with. And it was so nice to give my legs a rest. I wish, wish, wish that my water hadn't broken first and that I hadn't needed to try so hard to bring on labor earlier. I would've been in so much better shape later on (for the pushing part) if I could've done this during most of the labor and had a rest.
After a while though, the contractions got to the point where I couldn't relax through them anymore. I really couldn't help tensing up and sort of pushing during them. I got checked again, this time by C, and I'd gone to an 8. This was encouraging in that I'd made tons of progress during that relatively easy hour, but so discouraging that I wasn't supposed to push yet even though I was really feeling the urge. The next hour or so was really hard. I vomitted a few times (Gatorade tastes exactly the same coming back up as going down. Vile stuff.) I was trying to keep myself from pushing during contractions, but I really couldn't. I kept peeing by accident, and I was kind of crying and apologizing for it over and over. I spent a lot of this hour sitting on the toilet, just because I couldn't help the peeing part. Ben was encouraging me to push a bit, because it was so obviously what my body wanted to do. I was trying not to though because I was afraid of tiring myself out needlessly or, worse, tearing my cervix. Then there was the monitor, which was really sucking at this point. I should point out that throughout all of this, Iris's heartrate was really good (mostly around 140, with some variability), and I could feel her moving. It was reassuring to see that she was doing okay, but I would've liked a lot less monitoring because it kept me from moving around. If I moved much, the monitor would stop picking her up for a bit (and worse - it would sometimes pick up my heartrate instead), which would of course look bad.
After a while, I kept wanting to push, and C checked me again, said I could and called for the doctor. I started pushing as directed - on my back with my knees up towards the sides of my belly. I'd take a deep breath at the beginning of a contraction, and then another deep breath and hold it and push while Ben (who was holding my feet) counted to 10. Two more breaths and pushes per contraction. Dr. H said I was making great progress, and encouraged me to feel the top of Iris's head. Wow! It was so close, and oddly squishy. (I mean, it was probably perfectly normal for it to feel squishy, but it surprised me). That was so encouraging. :-) I kept at the pushing, and Dr. H said that she was going off shift now, but that she wouldn't be surprised if we could see the baby in half an hour. I originally interpreted this as "the baby would probably be out in half an hour" and this was really encouraging. I kept looking at the clock and imagining being done with this and having a baby in my arms (and also fantasizing about eating dinner). In retrospect, she probably meant that the baby's head would be visible in half an hour, which it was.
Dr. R. came on shift then and looked in to see how I was doing. The first thing I noticed was that he was male, and I was disappointed by this. Not that I think men can't be good obstetricians, but I was just disappointed that it wasn't going to be one of the doctors I'd seen before (I'd been going to an all-female practice), and that it was going to be someone who hadn't given birth. He said something along the lines of "she's probably going to have a 6.5 lb baby", and I really wasn't so happy then. (I thought she was going to be bigger and was right - by 2 POUNDS. My family doesn't have 6 pound babies.)
I kept going with the pushing for a while. I couldn't really even tell when contractions were starting or stopping. The pushing was hard work, but it wasn't really painful. More like pressure-full, I guess. One thing that really helped was when Ben would lock eyes with me as I was pushing and he counted 10. That was awesome. In the background, a couple of other nurses were bringing in things for the baby (clothes, warm blankets, a bathtub etc.) and getting the warmer turned on. It felt kind of surreal that they really expected there to be baby soon. I felt like I was never going to be done.
Dr. R came back in after a while, and decided I was pretty close to crowning and it was time to get the baby out. The nurses broke the bed down, put up the stirrups, and put a trashcan at the foot of the bed for all of the bloody stuff that was going to come out. Dr R. put some mineral oil on / in me, and Ben massaged my perineum in between contractions. As her head started crowning, Dr. R would reach inside me to try and pull her out. THAT HURT! He and the nurse were encouraging me to push harder and harder, more pushes per contraction, and to just push through the pain as he tried to reach in and grab the baby. This is another thing I really didn't like. Obviously, he was doing the right thing if the baby had been in trouble (which she wasn't - the damn monitor said her heartrate was just fine, and I could feel her moving) or if I'd stalled out in pushing and wasn't going to be able to get her out on my own (also not the case). I think having his hands in there may have caused my vaginal tear or made it worse than it otherwise would've been. I held my clit while I was pushing Iris out - I did NOT want to tear in that direction, and nothing the doctor said about moving my hand away was going to convince me otherwise.
Anyhow, Iris was soon pulled out of me and into the world. She started crying right away, and the nurses quickly wiped her off a little and put her on my chest. They immediately clamped her cord (I wish we'd said something ahead of time - I hadn't known they'd do it so soon), and handed Ben scissors to cut it. I tried to get her interested in nursing, but she wouldn't do much more than lick a little. We decided right away that she was definitely going to be named Iris, and I was holding her and kissing the top of her head and telling her how much I loved her already ("I love you I love you I love you I love you" over and over again). It's really an emotionally overwhelming experience. I was so tired and relieved and happy to be done, and so happy to have such a beautiful healthy baby.
Dr. R was pulling on the umbilical cord (the part hanging out of me) and I asked if we could wait a little bit on delivering the placenta. I think I meant that if I didn't push it out on my own in half an hour or so, he should go ahead and do whatever, but he didn't hear it that way, and pulled it out a minute or two later.
I started bleeding a lot, and he pressed on my uterus some and pronounced it boggy. I think at this point a nurse took Iris's temperature, decided she was too cold, and took her over to the warmer (in the same room). Ben went over there and held Iris's tiny hands as she got her first check-up, vitamin K shot, and eye ointment (which we didn't decline in time - I don't have chlamydia so there wasn't really any need for it). I got a shot in the leg of methergine, and another of pitocin. After a few minutes, my uterus still wasn't contracting much, and I was still bleeding too much. Dr. R stuck his hand up in my uterus and pulled out a bunch of big blood clots and there was blood gushing everywhere in between. It looked like something out of a horror movie. I was screaming from the pain. Ben saw the look on my face and told me to look at him, and said reassuring things. Dr. R also gave me some lidocaine (local anaesthetic) and stitched up the tear.
Every few minutes, someone would press on my uterus (ouch!) and say things about the amount of blood still coming out. They decided I needed an IV of pitocin, because I'd lost over a liter of blood at that point, and I was still bleeding. I was so dehydrated at that point (from the previous vomitting in addition to the blood loss), that the nurse couldn't quite get the IV in the first few times. I offered to drink a bunch of water, but it didn't seem like that would work quickly enough. I found out later that Ben was really worried at this point. I was less worried, because I figured I could drink water or whatever, and they could give me another shot of pitocin if it came to that. But she did manage to get the IV in and the pitocin stopped a lot of my bleeding.
At some point in here, Iris got her first bath. Unfortunately, it was by immersion (it hadn't occured to us that they'd actually put her in water instead of giving a sponge bath - if there's a next time, we agreed that we'd like for Ben to give her a sponge bath instead).
A little while later, C got me up to go to the bathroom. Of course I couldn't because I was really, really dehydrated. There was some mention of if I couldn't I might need a catheter, but I argued that I was dehydrated, and I was sure I'd be able to go if only there was something in my bladder. During the first few hours after birth, I felt really weird - shivery, cold, dizzy, and just out of it. I wasn't sure I could sit up without passing out - when I tried, I started getting some of the blacking out around the edges and tinny hearing that made me think I'd probably pass out if I pushed it, so I got wheeled to recovery still in bed, with Iris riding alongside, curled up in the crook of my arm.
There's more - this goes up to about 11pm Tuesday night, and we stayed in the hospital for another day or so. There's a lot that I'm still kind of conflicted about. Was the excess bleeding something that could've been avoided? (Perhaps by waiting for longer to cut the cord or deliver the placenta.) Or was it something that would've happened no matter what, and been really dangerous in a non-hospital setting? I wish there was a way to know the difference for sure.
One very good thing about having an unmedicated labor and birth, is that everything else seems easy by comparison. I found it weird that I was offered pain relievers many times afterwards (and that nurses were surprised I didn't want any). It wasn't that I was trying to be macho - just that it seemed minor and not worth bothering.
EDIT: a couple of details I remember now, but had forgotten to mention...
During active labor, my body sucked at temperature control - I felt way too hot during contractions, but almost shivering cold in between.
The hospital staff all respected my wishes to avoid induction/augmentation if possible and also to do this without pain medication. This was very, very helpful. I think if pain medications had been pushed / strongly suggested at all during the hardest parts of labor (mostly while I was going from 3 to 5), then I would've been likely to go for it