Thursday, April 21, 2011

Willow's birth story

Born Sunday, December 19th at 9:08 p.m.
7 pounds, 15 ounces; 20.25 inches

On Friday, December 17th, Mark and I attended the movie Black Swan while River enjoyed some free childcare at my gym. A loud scene from the movie took place in a disco. At that point, I felt a kick more powerful than anything I’d felt so far. It was so hard that Mark could feel the reverberations in the next seat. Looking back, I wonder if that was her announcement that she was on her way.

On the morning of Saturday the 18th, I took River to the gym, where I walked on the treadmill. Then we attended a holiday cookie exchange. I brought the speculaas (St. Nicholas) cookies I’d spent the entire previous day making, we visited with friends, sampled homemade treats and brought home at least six dozen of them. While Mark put River down for his nap I got a haircut, then came home to work on my statistics final exam.

While working on the exam that evening, trying to finish it by Monday, I noticed something I thought might be contractions. They weren’t very painful, but they seemed to come with some consistency, about once every 10 to 20 minutes. I had seen some cervical mucus for the few preceding days and it had continued throughout Saturday, leading me to think that it was possible she was coming soon.
I became distracted from the exam and began to google topics such as “what does a contraction feel like?” and “how long can contractions precede labor?” When I saw the real (vs. Braxton Hicks) contractions described as something that comes in a wave and becomes progressively more frequent and stronger, I felt the wave was an accurate description. I began to note the time to see if they were getting progressively closer and stronger. I decided not to wait until the Monday due date for my exam, but aimed to try to finish it by Sunday. It was possible that she was going to come soon so I warned Mark’s mom, and our doula, Rita.

I became stressed about what priority was most important to pursue – getting rest while I could, finishing my exam so it wouldn’t be hanging over my head, or getting essential preparations, like packing a hospital bag, taken care of. Mark told me to stop stressing and do one of the three things.

I put off the stats exam in favor of packing the most critical things and then getting some rest. I asked for Mark’s help to care for River on Sunday so that I could focus fully on trying to get the exam done that day. I told him if I was still pregnant on Monday, I’d make up the hours to him then. He agreed.

On Saturday night, I took my regular two Tylenol p.m.s and was able to get a good night’s sleep. I thought there might be a sign in the morning, such as blood-tinged mucus or perhaps my water breaking. But there was nothing obvious, making me think perhaps I had been mistaken. Nevertheless, I was still committed to trying to finish my exam that day and began working on it at 8 a.m. I had a Whole Foods golden-graham-type cereal for breakfast, tea with milk and some holiday cookies.

Mark took River out for lunch so I could focus on my exam. They went to a local restaurant and Mark used his Droid to send me photos of River with Santa Claus and River proudly holding a candy cane over his burger.

By the time they came back, bringing me a takeout burger, I wasn’t feeling so good. At 12:30 I let Mark’s parents know I was having contractions 10-20 minutes apart. I hid in my room while Mark put River down for his nap. I nibbled at the cheeseburger, but only found the pickle appetizing. Instead, I wanted to curl up in a ball and cry. For me, labor brings on feelings of despair and inadequacy. I dreaded going through the pain again. But I had to hold myself together because we had a pre-scheduled meeting with our student doula at 1.

When River went down for his nap, I kissed him with an intense feeling of nostalgia, knowing it was probably the last moment I’d see him as my only child. I told him that when he woke up, some friends would probably be here to play with him, and then grandma and grandpa would be coming.

When our doula, Rita, came, I tried to listen to her politely, but wasn’t very engaged. Her friendly chatter didn’t help my scared and depressed state. Every so often I’d double over as a wave of pain washed over me. I asked what she suggested doing and she said I should do whatever I could to get my mind off of labor. She said she went to the zoo and that her daughter pointing out monkeys made her forget about her contractions. She suggested I head out to a place like Toys R Us, where I’d be distracted by the crowds of holiday shoppers.

I could see walking around the neighborhood in better weather. But to take a big trip out to a zoo or a shopping center when labor had already begun? It didn’t feel like the right thing for me.

She said she had another appointment scheduled from 4-6, but we could call her if we needed her before then.  She offered to stay with us until her appointment, but I said no. Of course I took her off guard. She was expecting to just come and discuss the birth, not to find her first-ever client in labor. But her excited and nonchalant manner didn’t work so well with my fear and sadness.

While I wasn’t going to head out to a shopping mall, it was helpful to hear that I should try to keep my mind on other things. So I tried eating my cheeseburger and failed. Tried watching a movie and failed. But I did manage to get preparations underway – finalizing my suitcase, calling River’s caretakers to see if they were available, notifying my professor that I wouldn’t be able to finish my exam as I appeared to be in labor, canceling my appointments for the coming days.

I called Dr. G shortly after Rita left. Though my voice was calm (unlike the tearful voice I had when calling about my first delivery), Dr. G didn’t question me, but told me to come right in. He would be at the hospital that evening. I told him I needed some time to set up care for River and told him I’d call him when I was on my way. He gave me his cell phone number.

I called my friend Sarah and put her on guard, but tried to hold out as long as I could. I’d occasionally double over in pain, but it wasn’t unbearable and I was able to go about things. It was helpful to feel I was getting things in order. Mark kept asking me when I was going to tell Sarah to come and I’d reply, in a little while. I didn’t want to stay home until the last minute, but neither did I want to get to the hospital too early, as I feared there would be more chance of undesired interventions.

Around 3:30 I called Sarah and said she could come anytime. She arrived shortly after 4 with her husband and baby. I was still in good enough shape to show them around and to chat with them, though every so often I’d duck into the kitchen to get through a contraction.

Mark and I got in the car and stopped at the library to rent a DVD from RedBox. We hoped to rent The Kids Are Alright, but it wasn’t there. Last time we spent many calm hours after receiving the epidural and we expected it would be the same this time. Might as well get ourselves a movie. On the curb outside the library, I ran into the owner of the yoga studio where I took prenatal yoga. She was on her way out of town and handed me a coupon to a toy store, saying she wouldn’t be able to use it before Christmas. I don’t think she noticed I was in labor.

Mark offered to drop me off at the hospital front door, but I said I could walk from the parking lot with him. He grabbed the heavier bags, I grabbed a pillow and the lighter things and we walked in like normal visitors to the hospital, though we may have looked like we were moving in with all the stuff we were carrying.

We got to the hospital around 4:30. I knew Rita was meeting her other client at this point, so I sent her a text letting her know we were at labor and delivery.

Unlike last time, when I entered the emergency room in tears and doubled over in pain, this time I was able to walk in the front door and take the elevator up to maternity. We were buzzed in and led immediately to our room. They appeared to be waiting for us and that was a pleasant first impression.

A nurse, Pam, gave me a gown and told me to change. I took my time unpacking while I still had normal clothing on, preparing things for the post-epidural relaxation. I’d bend over with a contraction every so often, but was still doing remarkably well, enough to smile and chat with the nurse when she came in.

Pam started to ask me questions and typed the answers into a computer screen. I expected this would be short, since I’d already filled out the pre-registration paperwork. But it took over an hour, during which time the contractions strengthened considerably and I became anxious and irritable, asking her how much longer it was going to take and when I could get the epidural.

When she finally finished all the questions and hooked me up to a fetal heart rate monitor, she said that I couldn’t have an epidural until they did a blood test, so they’d have to get a phlebotomist to draw blood. I had just had a platelet count not long before and Dr. G told me that was to ensure my levels were high enough to be able to get an epidural. I wasn’t expecting to do yet another one at the hospital, but apparently the anesthesiologist required it since my platelet counts had been on the low side of normal.

If one needed blood drawn in a hurry, you might think a hospital would be a good place to find someone capable of doing it. But there was no phlebotomist to be found. I waited over a half hour before they could find one, by which point I was bent over sobbing with each contraction. They were coming rapidly, were very painful, and I feared the quick labor combined with the slow hospital services would prevent me from getting an epidural. The last thing I wanted was to push out what I expected would be a large baby without medication. A half hour doesn’t seem long in retrospect, but with contractions coming every two minutes, that was a lot of extra pain.

Around this time, Rita called Mark, but I asked him to ignore it. I didn’t think her presence would help me at this painful and stressful time and I preferred Mark be there for me rather than providing her instructions on how to get in. I suggested we get in touch with her once I had the epidural and the situation was calmer. The doctor had promised me less pain than I experienced last time and he occasionally came in, looking concerned. Later he told me he was about to wring the necks of the people who couldn’t arrange to get my blood drawn. Why a doctor or nurse couldn’t do it, I don’t know. He offered me an IV to relieve pain, but I wasn’t familiar with what it was, what the effects would be, or how it might affect my ability to get an epidural. So I held off a bit and finally, someone came to take my blood.

Not too long after that, around 6:15 p.m., the anesthesiologist came in. To me it looked like she wore a halo and radiated a golden light. I’d only been 3.5 centimeters at 5:30, the last time they checked before the epidural, but that was plenty of pain for me. I knew what the relief would be, so I didn’t care about any pain associated with the epidural. “Give me as much as you can,” I said. “Full power.”

Rita had arrived by then, so she, Mark and I settled in to wait for the contractions to progress. I pulled out my Brain, Child magazines, gave one to Rita, and began to read one myself. I was reading some funny segments aloud, about rules that parents never expected to have for their kids. One was a creative song about when you can pick your nose and when you can’t.

I thought I’d have several hours on the epidural and that the baby would be born the next day. I would have preferred for her to arrive after midnight. I liked the symmetry of a 12/20/10 birthday more than 12/19/10. Also, the difference of just a few hours would allow me an extra night in the hospital. Perhaps that is why they wanted to hurry it along. Or perhaps so the doctor could go home when he was done with me. Or because the shift change was at 7 a.m. and they wanted to have my case wrapped up by then. In any case, the nurse said this baby would definitely be born before midnight. Not long after the epidural, I’d gone from 3 to 5 centimeters. And less than an hour after that, just before 8 p.m., I was at 7.5-8 centimeters.

I was only on the first pages of the magazine, having enjoyed the effects of the epidural for less than an hour, when Dr. G came in. He said he saw a little irregularity in the heartbeat and so he wanted to tickle the baby’s head to make sure it was alright, a procedure I later found out is called a scalp stimulation test. Again, this was a moment in which it would have been nice to have an experienced doula around. Rita had never heard of this procedure, nor had we, so we had no choice but to trust him.

In order for him to tickle the head, he would have to first break my water. He’d seen some liquid earlier, so he wrote down that my water had broken. I told him it was probably just pee, which was probably correct because the amniotic fluids were something else entirely. They were so plentiful that upon breaking, they spewed out, soaking the doctor and the bed. It was both funny and amazing to see that sudden, powerful explosion and the sight of the doctor dripping with the fluid that sustained my baby, but it was also embarrassing. Just another one of those things you have to deal with, I tried to remember, as they lifted me up to change my bedsheets and the doctor went to change into new scrubs.

That marked the end of the comfort of my epidural. Within moments of the water breaking, I started to feel what is called pressure, but is really pain as the head began to descend. I quickly notified the doctor, since he said he could reduce my pain during this stage, and he gave me a shot which is called a pudendal block. Five minutes after the water broke, I was at 8.5 centimeters, having gone .5 or 1 cm in just five minutes. A half hour later, I was 10 cm dilated.

One issue last time was that the epidural numbed me down to the waist, but it didn’t numb my legs and I could feel everything as the baby was coming out. This time my legs were substantially number. But that meant I couldn’t do anything. Shit, I thought to myself. I should have tried to take a poop before I was immobile on the bed. I asked for a bedpan, but nothing came out and they had to use a catheter.

I tried to accept the indignities – my butt flared out to the world, people collecting my pee, the poop I knew would probably land on the table – as part of life and things that hospital staff see all the time. It would be nice to avoid them, but this was all part of getting the baby out and I’d do what I had to do. Luckily, I knew my disabilities would only be temporary and I’d soon return to normal. But I felt for the elderly who are subjected to such indignities for the remainder of their days.

When it came time to push, I asked for the bar that is placed over the bed. Last time I hung a towel from that and found it very helpful to hold on to as I pushed. The snippy nurse said there wasn’t one available as two other women were delivering at the same time.

Rita was most helpful at this point. She heated a lavender-scented sock filled with rice and placed it behind my back. The combination of the scent and the heat were calming. But still, I was freaked out about not having something above me to hold on to. Again, Rita came up with an acceptable solution, suggesting a scarf be used as a tug of war to simulate the straddle bar.

At the last minute, after I’d lost hope of getting one, someone came in with a bar and a wave of relief washed over me, as well as a little more confidence that I could do this.

The pushing experience was distinct compared to last time. It lasted only 20 minutes, compared to an hour and 40 minutes. But I’d had a lot less time to prepare. Also, I felt less supported, with an inexperienced doula and a not very nice nurse, while last time I had an experienced doula and a friendly nurse. Last time there was no doctor though and this time the doctor was there.

I’m sure I pooed, though I made Mark promise not to tell me about it. I was extra conscious of it this time since the doctor had wanted me to get an enema to prevent it. But whatever. It’s part of the process and just another thing to endure and then move on. The two things I remember most about pushing were:

-The feeling of a lack of progress, as though it was going to take a long time. Last time they updated me on seeing River’s head. This time I think Mark was avoiding looking down there and no one else was providing updates.

-How upset I was at the nurse, who was pushing down on my stomach with the fetal heart rate monitor as I tried to push. I yelled at her to stop it, to stop touching me, to get the f*** off of me, but she said she had to monitor the baby’s heartbeat. “I’ll get it out a lot quicker if you’d stop touching me,” I said, but she wouldn’t stop. I don’t know whether the doctor ordered her to do this, or if he didn’t have the authority to get her to stop. But it added to the discomfort, distracted me, and ticked me off to be touched against my will, especially in a time like that. What was she going to do if she noticed something with the heartbeat – cut me open right there with the baby half out? It didn’t make sense.

It’s already hard to remember the moment she actually came out (it was 9:08 p.m.), except that there was a rush and a holy crap as the head, then the shoulders came through, then a large, bloody being was whisked over to the table. There was some initial concern about some fluid in the lungs due to the fast delivery and her first Apgar was an 8/9. But I was in too much shock at that point to pay much attention and just trusted them to do their jobs.

Unlike River, I had no preview of what she was going to look like. When she first came out, I thought she looked a bit like River. But upon closer inspection, she didn’t look much like anyone. This was a contrast to River, who was initially a clone of Mark, with some strong features of my father and my father’s father as well.

They worked on her in a clear bassinet to my right. I saw them suctioning something out of her mouth and doing whatever else they do while the doctor began to sew me up. He said I had one second degree tear and several small lacerations. I’d avoided an episiotomy, which I had last time.

I told the doctor it hurt so he gave me some local shots which really helped with the pain. I was able to let him go about his work while I stared at my new daughter and admired her beautiful, heart-shaped lips, her shock of dark hair (River was bald) and her dark eyes (River was born with blue eyes, which slowly changed to hazel, then brown). I saw the large red numbers 7 pounds 15 ounces light up when they placed her on the scale and I was surprised to have a baby under 8 pounds. This was a benefit of her arriving 10 days before the due date. The doctor said if she’d waited until full-term or longer, she could have easily reached 9 pounds.

I can’t remember when I first held her, but it seemed like it was quicker than last time. My repairs took 45 minutes this time, compared to over two hours with River. She latched onto the breast right away, and while it soon became very painful, I’m not sure that I remember the first time as being too painful.

I remember seeing my placenta placed into a blue container, which was taken away when I wasn’t paying attention. The snippy nurse later came back and told me she was sorry, but they’d put the placenta I’d requested into medical waste already and it was locked.

“Once it’s locked we can’t open it again. But even if we could, we couldn’t be certain which placenta is yours.”

I doubted there were too many placentas put in there in the last hour or two. I told her I’d be OK with taking the one on top, knowing that it was most likely mine.

“What do you want it for?” she asked. When she’d asked me before, when I’d made clear in my intake that I wanted to take it with me, I told her it was personal. Now she was threatening me with not being able to give it to me, I told her I wanted to bury it.

She came back later and said that they could not open it. It was gone. I was disappointed, and suspected that it was thrown out on purpose. I wanted my baby to have a small piece of land to come back to, a small plot of our first home, her first home, the home where she’d grow up, a space where a small part of her would remain wherever she might go. But instead it would be sold to cosmetics companies and applied to someone’s face.

I was sad about that, but there was nothing I could do. I turned my attention to my beautiful and healthy baby and my new family of four. Unlike last time, I wasn’t swollen and could smile with her, marking our first moments together with photos.

1 comment:

Cassie said...

I love reading birth stories, and yours is a great one with so many neat details. I'm sure Willow will love reading this someday.

I am sorry that you had to deal with a nurse who wasn't very nice, though, and that you lost the placenta.