Monday, March 1, 2010
Ten Months and A Birth Story
This time last year I was counting the weeks until Sam was due, waiting, waiting for her arrival. Now I am trying to plan her first birthday party. I can't decide what to do for it, as the yard isn't ready for entertainment, the deck is lacking furniture, the house itself doesn't have enough seating for everyone in one room, and Sam gets rather overwhelmed when there are too many people about. She is used to it just being the three of us, with others visiting a few at a time. I alternate between wondering what to do about her party and thinking about how much she has grown - how much we have all grown - in the course of ten short months. Which then leads me back to thinking about her birthing day, and the birth story I have yet to write.
I have a block, to be sure. Sam's birth is not what I wanted it to be. It didn't go as I had planned or hoped or ever expected. To this day I cry when I think about her birth.
Every year, on the day before my husband's birthday he receives a call from his mom telling him she has gone into labor. He is her firstborn, the one who led the way, the baby who taught my mother-in-law how to be a mom. I love that she calls him on his birthday eve to tell him she has gone into labor. It is a way of sharing with him a grand event that they starred in together yet only she remembers. It is a tradition I wanted to continue with my child, as well as retelling her birth story every birthday, sharing the love and joy that I was sure the day would be filled with.
Instead, I have a story I don't know how to tell. I don't know where to start, what to say.
Being a Goddess woman I knew I would not become pregnant until the time was right, until I was ready. Two months after getting married to the man of my dreams (truly) I became pregnant. We had talked about "trying" for a baby the following year but Goddess had a different schedule. On my friend Jen's suggestion we took a HypnoBirthing class. It is a method of self-hypnosis for labor and delivery to have a pain-free natural birth. I also chose a hospital with a birthing tub, and an excellent team of midwives to assist me in this journey. The tub and the midwives were suggestions my own mom had made years ago. We took the birthing class offered by the hospital as well, to better educate ourselves on this journey.
As first children are generally late and my due-dates were March 31, April 1 and April 3 (depending on who was spinning the little Wheel of Gestation) I decided our child would be born on April 7 or 8 - the full moon. I even entered this date on my calendar. As the day grew nearer and I grew larger and more uncomfortable, I decided that I didn't want to wait until April 7 and wouldn't the equinox make a great birthday? March 21 it was!
My bag was packed, the pack and play bassinet was set up, her room was ready. Every night I went to bed wondering if this was it, and every morning I woke up disappointed. March 21 came and went, as did March 31, April 1, and April 3. On April 8 I awoke still pregnant and went to my midwife appointment, where I was told to get a post-date sonogram to see how the baby was. The heartbeat was still good but I wasn't contracting. At all. April 13 found us in Radiology getting a sonogram, where we were told the baby was measuring to weigh about nine pounds, ten ounces. Excuse me, what was that again? 9, 10? The sonogram tech assured us that there was a one-pound variable. Oh, so she could weigh 8, 10 or 10, 10? I started freaking out. The smallest this baby could be was almost nine pounds?
April 15 I am back at the midwives' and am told that variable aside, they are pretty sure Baby Girl is 9, 10 and growing. Sure, I had gained about 38 pounds and was almost all baby (and some legs to hold up that big belly) but somehow that didn't translate, in my head, to a large baby. More importantly to the midwives, I am now at 42 weeks and they are getting concerned. It is the age of the placenta, you see. It has an expiration date. An old placenta doesn't work properly. It doesn't make enough fluid, it doesn't clean the fluid properly, it will eventually fail to support the life of the fetus, the very life it was created to sustain. The midwives ask me to check into the hospital the next evening, to be induced. I resist. This isn't the birth I want, you see. Induction is not natural. It isn't the wake in the middle of the night in labor take a bath to ease the surges wait until the surges are a few minutes apart and then drive the mile to the hospital where I get into a tub and effortlessly breath the baby down the birthing canal into the waiting hands of a caring midwife birth that I had dreamed of. Induction isn't any of those things.
I ask for an internal, to see how things are. Rachel is my attending midwife this day, and she has the tiniest little hands (to go with her tiny little body). Dilation is measured by fingers of course, with each finger being a centimeter. Never mind we all have different sized fingers. With Rachel's tiny hands I am barely a centimeter dilated, and not at all effaced. This is not good. She checks with the other midwives and reports back that they are willing to give me an extra day, I can wait until Friday to be induced. I want to think about it, talk it over with J, do anything I can to get this baby born on her own.
I start walking more. We walked almost a mile to Denny's that night for dinner. The next night we walked to a fish place for clams. I got evening primrose oil pills. I think there were other things, I can no longer remember. I was in a panic and trying anything I could to get labor started at home. Nothing worked. I gave up and agreed to the induction, for the safety and well-being of our baby. I didn't want to wait until her life was in peril and then be forced into having a c-section.
Friday night, April 17 J & I checked into the hospital with the understanding that we weren't going home until we were a family of three. We were nervous but hopeful. I had opted for the Miso- method in which I took some pills and was hooked up to the fetal monitor for 90 minutes, and then was free for another 90 minutes until the next treatment. During the free periods we went for walks around the hospital grounds, enjoying the warm weather and each other's company. I had three treatments that night, and was contracting mildly. We went to bed, still contracting. I was confident this was the kick-start that was needed, and things would progress on their own from here on.
Saturday morning I woke up and got another pelvic exam. I was now a good centimeter dilated. Not quite the good news I was hoping for. The midwife on duty, Nina, wanted to put in a foley bulb to dilate my cervix more. It was uncomfortable but I was still mobile, and she was hoping this would help my body do its thing. By late afternoon the foley bulb had done its job and I was 3 centimeters dilated. Nina was happy with the progress, I was disappointed. Meanwhile the contractions had subsided. Our next move was Pitocin. I didn't want it. We had learned about Pitocin in birthing class and I didn't want any part of it. But I gave in as there weren't any other options and I was still aiming for a tub birth. Three hours of Pitocin that night, from 7 until 10. Pitocin requires an IV and constant fetal monitoring. Every time I had to use the bathroom (and being so enormously pregnant that was every half hour, if I held it) I had to buzz the nurses' station to tell them, as I had to take off the monitor. Nina wanted me to have a good night's sleep so she talked the OB on duty into letting me off the Pit for the night, with the agreement I would be back on it at 8am the next day.
Sunday, April 19 finds me in a foul mood. I am tired, I am uncomfortable, I miss my home and my bed and my kitties and I don't want to be here anymore. We've been here for 2 days and I am still not in labor and I just want to go home. I changed my mind, I want to wait until Baby Girl shows up on her own. As fate would have it, one of the nurses on staff that day was Luanne, our birthing class instructor. She listened to me complain and talked me out of leaving. I got to sleep for another two hours before restarting the Pitocin, and Luanne dealt with the OB for me. The midwives are Certified Nurse Midwives, essentially RNs with extra schooling in Midwifery, but they still work with and report to an OB as the OB is the one with the medical license.
We are told that on April 19 the previous year one of the midwives had given birth in our room, Birthing Center room 7. The room next to the tub room. Room 7 has a double shower, which we chose as showers can be helpful for contraction pain before one is far enough along to get into the tub. This is a lucky day, then.
Sitting in bed hooked up to an IV and monitors gets old fast. I am so large that once I get up out of bed the monitor slips and we lose the fetal heartbeat. So all I do is sit. Sit and wait. We listen to Baby Girl's heartbeat. 155 and steady. Boom boom boom boom. I can still hear it in my memory. Boom boom boom boom. Steady and strong. In the evening J goes home to feed the cats, as he has done every day. I walk around the room a little, holding the monitor in place. I start doing hip swirls, like I learned in the two bellydancing classes I went to years earlier. And I feel a little pop, followed by liquid pouring down my leg. I had just used the bathroom so I was pretty sure this wasn't loss of bladder control, and call for a nurse. Tanya comes in, takes a look at the puddle (small but clear) and calls the midwife on duty. Today's midwife is Vanessa, one of my favorite midwives. I am typing a text to J when Vanessa shows up so Tanya finishes it for me, and I get evaluated on whether that was in fact my water breaking. A tear, they decided, hence the small puddle. They have a three-test system which I eventually pass and then the contractions start for real. By now J is back and has called our moms to share the water-breaking news.
I try the birthing ball now to relieve the pain but the monitor won't stay on and I need to hear that heartbeat. The pain is almost unbearable now and I am crying. I tell Tanya that whenever it is appropriate I would like the epidural. J is concerned, this wasn't part of our birth plan. Our birth plan included a request that pain medication not be offered, that the word pain not even be used, and a hundred other requests that didn't pan out either. I know he is thinking I am giving up but the pain is too much. I am sobbing now with every contraction, barely able to breathe, trying not to scream. It is back labor, you see. The baby is so big she is on her side instead of posterior, and she is pressing against my spine with every contraction. Tanya tells me of another option, a short-term pain medication that won't prevent me from using the tub. I agree, and she gets the order from Vanessa. The med hits and I am good. Floating good. Is this stuff a street drug, I wonder? It is wonderful! Forty minutes later my haze has worn off and the pain is back. Vanessa is also back and tells J to press against my lower back with each contraction, to help alleviate the pain. I have to wait another twenty minutes for the next dose of pain med. This is too much for me to handle, I ask for the epidural. It will take a half-hour for that to get set up so in the meantime I get another dose of the med. This dose lasts 30 minutes.
I get up to use the bathroom for possibly the last time before getting the epidural and the IV pops off. IV fluid is spraying everywhere. This is the second time it has popped off this day. Tanya tries to fix it and realizes it is faulty. I need a new IV. The epidural is delayed so I get another dose of the other med, which lasts only 20 minutes this time. The nursing shift is changing and Kim is now on duty. She gives me a new IV and I wait for the anesthesiologist to show. J is pressing into my lower back with all of his might as each contraction hits. I am a sobbing mess, trying to deal with this pain, waiting for the hour to be up so I can get the epidural, doing my best to breath through all of this.
The hour is up and the anesthesiologist is here. I have to sit up on the side of the bed so he can insert the epidural. The contractions keep coming but with the promise of anesthesia I deal with it. The epidural is in and the medicine is dripped down into my back. It feels icy cool and I can finally relax. I lay on my right side as instructed and I see Kim running for the wall, to the oxygen mask. I look at Vanessa and she is watching the monitor, as she has been for the past hour and she looks worried. Kim puts the O2 mask on me and I continue watching Vanessa, who then relaxes. I find out the baby's heartbeat, so strong and steady for 3 days, dropped when the medicine hit. I had thought to question the O2 mask before it was put on but my trust in these women is absolute and this baby's well-being is the only thing I care about.
The epidural is only running down one leg so the anesthesiologist pulls it out and takes a look. It is faulty, only has a hole on one side. He puts in a new one and I get another pelvic exam. An internal fetal monitor is put in. I don't remember where I was at this point - 6 centimeters? Something like that.
It is now about 1 am and everything is finally taken care of for the night. The anesthesiologist has packed up his stuff and gone, I have been cleaned up, the room is being tidied and J's parents arrive. They drove from Mt Laurel, NJ to Holyoke, MA when they learned my water had broke, expecting it wouldn't be long now. I hadn't wanted them there yet but when MaF stood by my bed, holding my hand I was so glad for her presence. They left to find a hotel, and we turned off the lights to get some sleep. Nurse Kim stayed in our room for hours, writing up her notes of the night and keeping an eye on me. At 3 am she put in a catheter, as for the first time in my life I couldn't pee due to the anesthesia. I declared there would be no more visitors, now that I had a bag of pee hanging off the side of the bed.
Sleeping was challenging with either one leg or the other being completely leaden and daylight eventually came. The day progressed in a haze, with another dose of anesthesia being administered by a new anesthesiologist. This man was the first medical personnel that didn't seem to have an easy-going rapport with the others. I asked the afternoon/evening nurse (Lisa) about him, as she was the only one who seemed at ease around him. I forget her answer except that she liked him, he was just a little reserved. I tried to get a third dose of anesthesia that day but was finally at nine centimeters and Dr Tim refused, as he was concerned I would have trouble pushing.
It was around 5pm when at long last I achieved ten centimeters, and the baby was in a plus 3 position. I asked J to bring me a soapy washcloth and my toothbrush so I could clean up a bit. I brushed my hair too, and redid my ponytail. It had been 35 hours since I had showered but I wanted to be as clean as possible when we finally met our daughter.
Rachel and Lisa came in to assist me in delivering, and I started my HypnoBirthing breathing. Nothing happened. I was instructed to push, which I first argued against and then gave in. Nothing happened. They brought in a bar for me to brace against, I tried numerous different positions, nothing happened. After an hour and a half no progress had been made. Try as I might she wasn't coming out.
Rachel calmly told me that it was time for a c-section. I freaked. She retells it as me calmly saying I wanted to keep trying. In reality I started hysterically crying. I had agreed to the induction, I had spent three days undergoing all sorts of different types of medical interventions to avoid this very thing and it was all for nothing. I gave up my home labor, my tub birth, and all but two of my wishes on my birth plan and in the end I was getting the most medically invasive procedure? I was inconsolable. I begged for another option. What about the suction thing? Can't we try that? If the head can't make it through on its own the shoulders can't either, and she'll end up with shoulder dysplasia. We tried for another half hour, to no end. I agreed to the section, and the OB was called. J called my parents to give them the update, and went out to speak with his own parents, who had spent the day in the waiting room. I gave up one of the two things from our birth plan that I had been able to hold onto - my own clothes - and was put in a johnny. J was given scrubs and Dr. Tim was back. I was wheeled down the hall to the OR, passing J's parents as they watched me go, and I started crying again. Our hospital has an OR in the Birthing Center so we were still in the same area. I was prepped - strapped to the table, covered in a sheet with a hole in the middle, and pumped full of drugs. J was called in to be with me. Dr. Tim talked me through the entire operation, telling me what I should feel, or could feel, and what was going on.
I felt the incision, and a lot of tugging. And then I heard crying, which lasted only a few moments. And "Look at that hair!" "And those eyelashes!" Then she was out completely, and brought to the warming table. She was crying something fierce! J was talking to me, stroking my head but all I could hear was our baby screaming. So I told him to go talk to her, she knows his voice. Which he did, and she quieted right down. Every night when we were in bed, J would lay his head by my belly and tell Baby Girl about his day. She would be moving and dancing, and wiggling all over the place until she heard his voice, and then she would lay still. Just like she did in the OR that night.
They were putting me back together when I got feeling in my abdomen back. So J was banished from the room and I was knocked out medically. Next thing I know I am getting wheeled back into my room, which I no longer recognize, and I discover the baby is laying next to me. I am in pain and it is overwhelming. I get a shot of something and it feels like nothing. I beg for more but am told they have to wait 5 minutes between doses. It is the same pain killer I received when the back labor started but this time it does nothing. I spend the next four minutes begging for more pain killer, and then get another shot. I continue to beg for pain killers for the next 10 minutes until finally I get relief. During this time I cannot deal with our child, someone else has her, I don't even know who. I cannot even think of anything other than the pain until the medicine finally takes hold and I can begin to relax again.
Now I want our baby, I want to hold her and look at her. She has a mop of black hair over a scrunched up red face, and she looks oh-so-unhappy. I open my johnny to nurse her and she latches on immediately. She is a strong little girl, she even lifts up her head for a moment, showing neck strength I didn't know was possible for a brand-new baby. I have heard of counting fingers and toes but she is swaddled in several blankets and I am sure the nurses have already counted such things so I leave her be and just hold her as she nurses, so glad she is finally here.
I learned the next day, when the Dr. Jones (the OB) came to check on me that Sam was kind of stuck. Her head was wedged in my pelvis and once Dr. Jones finally got that free she had to really tug to get Sam's shoulders out. Sam was born 9, 13 and 23 inches. Physically too big for my body to deliver. She was lying on her side in utero because she couldn't fit in my body posteriorly. Dr. Jones informed me it was impossible for me to deliver Sam, and that had she been posterior the head would have come through but the shoulders wouldn't have made it. Shoulder dysplasia. I have since looked up this term and learned that while we both would have lived, my pelvis would have likely been broken to get Sam out, who would have suffered some serious physical trauma as well. Having a cesarean section seems pretty mild in comparison.
This is our story. Not the story I wanted, but the story we got. It could have been worse, it could have been a thousand times worse. Our story has a happy ending, the best ending anyone could hope for: a healthy mom and baby. I remember saying that after everything that happened Monday, April 20, 2009 was still the best day of my life. And here we are, over ten months later, still happy and healthy and doing well. Sam is walking now, getting into everything, and is eating finger foods. She is smart and clever and very, very strong. When I think of how far we have come in ten short months I am overwhelmed with love and admiration for this little girl who has taken over our lives. And I couldn't be happier.