They say every birth is unique. Dion’s arrival proved that aphorism. His first brush with life came as a false alarm on 1 April when we sent an April Fool’s message to family announcing the arrival of Philippe Arsenio Kohl. The accompanying photo was supposed to demonstrate that the event was a joke, but not everyone was amused — though nearly everyone was caught off guard.
Months prior, we had been preparing for a natural birth. We studied Hypnobirthing — the use of visualization, relaxation, and trust that the body and baby knew how to give birth without the need for all of modern medicine’s tools and drugs. By eliminating fear and tension, the theory goes, very little pain results from labor and childbirth. But the birth didn’t go as we had planned.
Marisol entered labor at 1:47 am Sunday morning (April 30) and soon “surges” (Hypnobirthing folks use soothing vocabulary) rolled in every five minutes. But as the sun rose above the Carpintera Mountain of Tres Ríos, surge frequency subsided for most of the day. We entertained visitors and rechecked that we had all the many supplies we planned to bring to the hospital.
In Costa Rica only one doctor had the experience and mindset to support natural births. We learned of him through Costa Rica’s single Hypnobirthing teacher. Doctor Adam Paer even encouraged us to try a water birth, a technique we had seen on video during our Hypnobirthing course but had never fully considered.
After visitors departed, surges increased in frequency varying from 3 to 12 minutes. Marisol lay in bed, focusing her relaxation. Fernando, her brother, had come early that morning to drive us to the hospital and instead spent the day waiting. We played Vivaldi and Mozart CDs and kept the lights dim. Jon made Marisol drink a liter of red raspberry leaf ice tea.
Then around 10 pm the average surge dropped to 4-minute intervals and grew in intensity. We packed up our suitcases, birthing ball, Gatorade bottle, tripod, fan, and other tools of the trade We left the cats, Poe and Mae, a double-helping of dry food — then headed at 10:45 pm for Hospital Clínica Católica.
The maternity wing nurse evaluated Marisol. Dion’s heartbeat thumped at a healthy 150 beats per minute. Her surges came about every five minutes and reached 55% potency. The cervix had softened greatly and dilated to 6 cm.
Over the next couple of hours, we breathed and relaxed through the surges and made progress by the time Dr. Paer arrived at 1:30 am, morning of 1 May (24 hours after labor had begun), Marisol had reached 8 cm. Great progress!
But the next six hours marked a sharp turn in the road, a turn that eventually led us away from the route we had planned. At 3:30 am, when the doctor checked in again, he felt Marisol’s belly and knew the baby had not dropped. Upon measuring her cervix, he reported that it had not dilated any further, standing at 8-9 cm. The intensity of the surges had stalled but we knew patience was the order of the day. Hypnobirthing taught that the body and the baby knew what was best.
And the intensity of the surges grew. We tried the Jacuzzi, the bed, light-touch massage, bed and standing positions, birthing ball, everything in the book. Another two hours passed and nothing changed. Marisol grew exhausted and the intensity and frequency of the contractions increased further. They came on strong as we had hoped they would hours before. By now, however, Marisol hadn’t the strength to relax and absorb the increasing pressure. What should have been discomfort experienced by relaxed muscles, turned to pain.
And the baby still hadn’t dropped.
The doctor had gone home and by 6:00 am we demanded one final evaluation before making a decision. Her cervix still hadn’t dilated further and the baby hung high in the womb like a bat from cathedral rafters. The pain now was unbearable. Relaxation had completely dried up. We considered the options. An epidural would have stopped the pain and the labor too, before the baby had descended. We could have applied Pitocyn (hormone that brings on labor) but that would have made the contractions and pain even worse. By that time, the contractions were increasing anyway. Normally after two hours without progress, the doctor said, some kind of intervention is usually necessary.
We had already discarded our dream of a natural birth and now saught raw relief. Why the baby hadn’t dropped was of no interest to us. How we could minimize artificial intervention didn’t matter. By 6:30 am, Dr. Paer had arrived and emergency Caesarian was the only option.
Ironically we battled to avoid the very option that up to 80% of pregnant women who visit this hospital elect. Many women decide simply to take the easy way. People who opt for natural birth often do so not merely for the experience but because many allege that the drugs and equipment and procedures can damage children in subtle psychological ways. By 7:00 am we were well beyond that kind of debate. We were preparing for the operation room.
Jon stood outside of Room 3 with Dr. Paer as his crew prepared Marisol for surgery. Nurses tried to lay her down on her back to apply the epidural but it was simply too painful so they applied it to her sitting up. Paer observed, “This will be the last contraction she ever feels.”
After Jon put on his scrubs and nurses had prepped Marisol, Jon entered. At first he held Marisol’s hand and stood with her behind the tent that separated her from the operation. The epidural killed pain from the waist down but she could still feel contact and talk coherently throughout the operation.
Jon watched as the doctor pressed his scalpel to skin, cutting horizontally across her belly. Marisol asked me, “What’s going on?”
“You don't want to know.”
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Soon thereafter, staff moved Jon to the foot of the bed where he could film the birth of his son. Marisol agreed that capturing those first images transcended the need for moral support of standing by her side.
Weighing just over eight pounds, the doctor theorized that Dion’s size (he was a week and a half late) and a large fibroid embedded in the uterine wall impeded his descent. Thus, despite the efficiency of her contractions in the latter hours, nothing would have improved. The doctor sent Marisol home the very next day.
Although Jon’s mother (herself an alumna of C-sections) was shocked that a C-section mom could go home so soon, the doctor explained the customary practice in Costa Rica, because the hospital is so close to home and he would go to our house if ever a complication required.
One last irony impossible to ignore is that Dion was born on International Labor Day (not celebrated in the United States), a day marked by many hours of labor on all of our parts. But now he’s out and ready to start the rest of our lives.
Many thanks to Emilia who took most of the pictures in which Jon appears. She stayed with us throughout the night and earned the title adoptive aunt.
