I picked up a novel that looked interesting at the library last week. By checking it out (instead of the usual stack of board books or parenting tomes or cookbooks) I dared myself to try to find a moment in which I might lose myself in it. That is the problem of late. Novels require a little investment. You can't simply scan a few paragraphs on the toilet, or read a few snippets here & there. You must inhabit a novel & for those moments during which you are living in that other world you must be able to forget your own, at least in part. And it is impossible to forget a world in which a baby babbles & toddles & cries.
But I have managed it for the last few evenings, late night be damned, and there is something so amazing about the language of good fiction I swear to myself to will figure out how to read more of it...
Wednesday, March 31, 2010
Sunday, March 28, 2010
Monday, March 22, 2010
intruments of torture
Should waterboarding ever be tossed out once & for all as out-of-bounds (and it should be!), I would like to recommend a couple substitutes: the bulb syringe & the asthma inhaler. These seemingly harmless instruments are capable of producing the most blood-curdling screams. It really boggles the mind. The first few tries with the inhaler went swimmingly -X was too distracted by the novelty to notice that it pissed him off. But ever since those first instances, he twists & turns & writhes around like I am trying to suffocate him with a pillow or something. The bulb syringe can be equally tortuous, although after a long bout of sniffles he does seem to come around to accepting the fact that he in fact feels better after he lets me suck massive wads of snot out of his head.Why are we applying these horrid instruments? -X caught a nasty chest cold last week that moved into his lungs, caused horrible wheezing (think Darth Vader), induced us to rush him to ER on a Sunday evening -and VIOLA! -we've got an asthma baby! Actually, no -that's jumping to conclusions. But according to statistics, he stands a 30% of one day developing asthma (his father had it). As for now, they are just calling this particular episode a case of "bronchiolitis," -an infection of the small airways of the lung. But we will worry if it happens again & again.
I am glad to have the inhaler -it at least makes me feel as though I have options at hand when my poor baby can't seem to catch his breath. Whether it is actually helpful or not is another story altogether. It gives me some small sense of power over circumstances that are entirely out of my control, and for that I am grateful -- the illusion of control is almost as nice as actually having control....but not quite...
Sunday, March 21, 2010
the first evening of spring
From The Death of the Heart by Elizabeth Bowen:
Early in March the crocuses crept alight, then blazed yellow & purple in the park. The whistle was blown later: it was possible to walk there after tea. In fact, it is about five o'clock in an evening that the first hour of spring strikes --autumn arrives in the early morning, bur spring at the close of a winter day. The air, about to darken, quickens and is run through with mysterious white light; the curtain of darkness is suspended, as though for some unprecedented event. There is perhaps no sunset, the trees are not yet budding --but the senses receive an intimation, an intimation so fine, yet striking in so directly, that this appears a movement in one's own spirit. This exalts whatever feeling is in the heart.
No moment in human experience approaches in its intensity this experience of the solitary earth's. The later phases of spring, when her foot is in at the door, are met with a conventional gaiety. But her first unavowed presence is disconcerting; silences fall in company --the wish to be either alone or with a lover is avowed by some look or some spontaneous movement --the window being thrown open, the glance away up the street. In cities the traffic lightens and quickens; even buildings take such feeling of depth that the streets might be rides cut through a wood. What is happening is only acknowledged between strangers, by looks, or between lovers. Unwritten poetry twists the hearts of people in their thirties. To the person out walking that first evening of spring, nothing appears inanimate, nothing not sentient: darkening chimneys, viaducts, villas, glass-and-steel factories, chain stores seem to strike as deep as natural rocks, seem not only to exist but to dream. Atoms of light quiver between the branches of stretching-up black trees. It is in this unearthly first hour of spring twilight that earth's almost agonized livingness is most felt. This hour is so dreadful to some people that they hurry indoors and turn on the lights -they are pursued by the scent of violets sold sold on the curb.
(italics mine)
Early in March the crocuses crept alight, then blazed yellow & purple in the park. The whistle was blown later: it was possible to walk there after tea. In fact, it is about five o'clock in an evening that the first hour of spring strikes --autumn arrives in the early morning, bur spring at the close of a winter day. The air, about to darken, quickens and is run through with mysterious white light; the curtain of darkness is suspended, as though for some unprecedented event. There is perhaps no sunset, the trees are not yet budding --but the senses receive an intimation, an intimation so fine, yet striking in so directly, that this appears a movement in one's own spirit. This exalts whatever feeling is in the heart.
No moment in human experience approaches in its intensity this experience of the solitary earth's. The later phases of spring, when her foot is in at the door, are met with a conventional gaiety. But her first unavowed presence is disconcerting; silences fall in company --the wish to be either alone or with a lover is avowed by some look or some spontaneous movement --the window being thrown open, the glance away up the street. In cities the traffic lightens and quickens; even buildings take such feeling of depth that the streets might be rides cut through a wood. What is happening is only acknowledged between strangers, by looks, or between lovers. Unwritten poetry twists the hearts of people in their thirties. To the person out walking that first evening of spring, nothing appears inanimate, nothing not sentient: darkening chimneys, viaducts, villas, glass-and-steel factories, chain stores seem to strike as deep as natural rocks, seem not only to exist but to dream. Atoms of light quiver between the branches of stretching-up black trees. It is in this unearthly first hour of spring twilight that earth's almost agonized livingness is most felt. This hour is so dreadful to some people that they hurry indoors and turn on the lights -they are pursued by the scent of violets sold sold on the curb.
(italics mine)
Saturday, March 20, 2010
Friday, March 19, 2010
Monday, March 15, 2010
wild & free
I couldn't resist snapping up this t-shirt for X as we meandered by the stall at the Saturday Market last weekend. It's logo sums up precisely why we uprooted ourselves from our stodgy, comfortable, complaisant & dull lives in Middle America & headed West, like so many before us. It amuses me to consider that my child will be born & bred a Westerner, with the West in his blood & a part of his earliest history. How different his experience will be from mine simply on account of his environment. I never stop thanking my lucky stars that we chose to move to Portland (of all possible places!...I should tell the story of how we wound up here...) .
Sunday, March 14, 2010
Tuesday, March 9, 2010
Monday, March 8, 2010
Sunday, March 7, 2010
birthday joy
My son is such an amazing, sensitive, little human being. This photo says it all, captured at the apex of his joy.We had a lovely party for him today. All our friends were here & X had a blast, crawling around in between people's legs & generally seeming just as at home in our living room as he ever does (at one point he crawled over to the shelf & pulled out some books -chaos surrounds him, & Mr. Chill wants to read My Favorite Pets?). And after the gifts had been destroyed, the happy crowd broke into a spontaneous rendition of "Happy Birthday." X looked around & listened while we sang, smiling, clapping & enjoying the noise. But at a certain point, I am not sure when -but most likely when we said "Happy birthday, dear Xavier," he seemed to realize that everyone was singing at the top of their voices for him.
And while I can't say with any certainty that I know & understand what was going on in his little head, I would almost swear he was moved -and moved near to tears. He began to giggle uncontrollably, a broad, crazy smile covering his face. His eyes welled up with tears & he turned to face me & for one split second I thought he might lose it. The expression on his face at that moment was so incredibly full -full of joy, of amazement, of the rich complexity of human emotion. He kept it together, miraculously, clapping his hands & smiling with all his strength. I feel so fortunate to get to witness each moment as he becomes the beautiful person that he is.
Saturday, March 6, 2010
happy birthday, my beautiful son!
How on earth could I have ever imagined the world without you in it? -What a desolate, quiet, lonely place it must have been before you busted up the calm with your wails, your giggles, & your endless chatter. I feel so lucky to be your mother, & also so terribly out of my league. Your glittering, shiny perfection casts a garish light on my many flaws. I want to be the best for you. I am getting better. You are making me perfect like you.There are so many things I would like to tell you on this day, but my heart is so filled up with such enormous joy I am having a hard time making sense of it all. Happy 1st birthday, beautiful boy. I suspect you may never know what happiness you bring to me, and also what anguish --anguish because I cannot protect you from all the harm the world may do to you, sorrow because one day you won't permit me to hold you & comfort you as you do today, sweet sadness that there is not a thing I can do to hold on to these memories as they slide away & fade fast.
I have never loved anyone as I love you.
I love the fact that you still know only one word, Mama, & that you repeat it all day long like a mantra you are chanting. You so desperately want to be talking. I will be a tiny bit sad when you learn more words & my name wanes in significance, replaced by boat & duck & dog.
I love the way you poke at my nipples with your fingertips & laugh when I say "milk." This nursing relationship has been for me the greatest challenge & the purest joy. I both love & loathe the crazy intimacy it yields but I would not have it any other way. I have danced along the limits of my patience while you trespass all my boundaries day and night.
I love the way you hoover up all the blueberries on your tray first thing. And when they are all gone you sit & wait for more for a few quiet moments before you give up & finally, reluctantly, tuck in to the sweet potatoes, green beans & beets. If I would permit it, you would eat blueberries for every meal.
I love your fierce right-handedness -the way your left hand hovers uselessly in the air while you palm a ball, or figure a puzzle, or push a truck across the living room floor.
I love the way you clap your hands for everything: hooray for milkie! -hooray for a clean diaper! -hooray for papa coming home! (or when you heard me reading this aloud just now!)
I love your kisses, open-mouthed & soggy & a little cross-eyed (focus, aim) & always on cue.
I love how you will get some random tool clutched tight in your grasp (a pen or spoon, the glockenspiel mallet, your wooden knife) & then carry it around with you pointlessly as you crawl from room to room, as if you might need it eventually.
I love the way you toss & turn & kick & spin in your sleep. I love the sound of your little head whacking the wall as you worm your way up into the corner of the bed where the two walls meet. You toss your head from side to side (Whack! -Whump!), whimpering occasionally, but mostly sleeping through the violence. It always makes us giggle.
I love how obviously fascinating the mechanics of everything is to you, - the way you will open & close a book, or a cabinet, or the dishwasher, over & over, staring into the gears, trying to make sense of it all.
I love how when we ask you "how old you are?" you immediately reach your hands up & look to the sky. It doesn't make any sense, but it is perfectly awesome anyhow.
I love the way you point at all the pictures in a book, as if to ask "what's this?" But you never wait long enough for the answer. You are too busy pointing & pointing & pointing.
I love your smile: the sweet, sly curve of your lips when I look down & catch you watching me, the dazzled, glowing eager smile when I strike a match, the big, goobery, cackling smile when something (anything?!) strikes you as funny, the flirtatious, squinty-eyed, charming smile that you've only lately discovered. So long as you keep smiling, I suspect I will always be happy.
I love how much pure & unadulterated joy you get from a boring old game of peekaboo. Your capacity for elation shames me. I am less of a cynic since I met you.
I love the way your entire body quivers with excitement when you realize we are about to go outside.
I love the way you hold our hands & lead us around as we help you learn to walk. You march back & forth across the living room floor, ducking into bedrooms, turning on a dime willy-nilly. You are our master & we obey your every command.
I love the way you giggle uncontrollably when I stop to disentangle our gripping fingers & ask, "do you wanna take some steps by yourself?" You have a strange, giddy anxiety about letting go of my hand & walking off alone (into the sunset, without me). It's like you realize what it means for you to be able to walk away & it makes you feel both mirthful & mournful & a little weird. I want you to know it makes me feel the exact same way.
Happy 1st Birthday, sweet baby X!Friday, March 5, 2010
my birth story
It is the eve of my son's 1st birthday & the one year anniversary of my birthing day. As the last few days have plodded past, I have found myself reflecting on the crazy events of a year ago, wondering where I was at a given time, what my thoughts & feelings were, what stage of labor I was in? I made it a goal this week to finish writing my birth story before his birthday, and I accomplished it, albeit in the wee hours. I am publishing it here because I need to get it off my chest once & for all. I do not want to carry it with me forever, although I suspect I will in part (but hopefully less & less of the grieving part as time goes by). It is long & intimate & probably somewhat disturbing. Don't read it unless you're up for that. If you are...well...have at it:
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What started on a Monday and ended on a Friday with the birth of my son was not just my labor and birth experience, it was a test of my strength and endurance. It took the measure of my husband's love for me. It revealed the heights to which my optimism aspired and the depths into which my disappointment could plunge.
I had thought my labor started around midnight on Monday, March 2nd, but when I reflect I believe it actually started earlier, but it is was so mild and strange I was not aware of what I was feeling.
I went to work on Monday after visiting with one of the OHSU midwives, Penny Harmon. At my appointment, Penny poked around and noted that my baby's head had not yet engaged in the pelvis -he was still riding quite high. She informed me he was ROA (Right Occiput Anterior) and when I asked her about the problems with this positioning (another midwife, Linda Glenn, was very hung up on positioning and had informed me previously that ROA makes for a "roller-coaster of a labor.") she discounted the importance and seemed to think the baby had plenty of time to turn around. Based on the fact this was my first baby, I was given every reason to believe I had at least a week, but probably two weeks before my boy would make his long-awaited appearance.
At work, I sat at my desk and tried to focus on the job at hand, but my maternity skirt was driving me nuts. The waistband seemed tighter than it had before and I was endlessly bothered such that I decided to cut my losses and finish the day working in the comfort of my own home. I wrestled the skirt off immediately upon arriving home, called up my friend K who came over in short order. I remember laying on my side on the futon as we chatted, adjusting my position this way and that, trying to get comfortable. I had a low, dull ache in my lower back that would not subside. It was puzzling since I hadn't suffered any real pain or similar annoyances during my entire pregnancy. I recalled that I had cut a walk short the evening before for the same reason -lower back pain that would not permit me to remain long on my feet. Now that I know what exactly followed on, I realize this was the beginning of my long labor.
At midnight on Monday night, things really kicked in. At first, I mistook the sensation for a really bad case of diarrhea. But after a few minutes I realized this was no indigestion -this was the real thing. The trouble was, there was no pattern to the madness. The contractions came quickly when I moved about, but slowed dramatically when I rested. This non-pattern would repeat itself for the duration of my labor (even after modern medicine intervened). The pain was centralized in my hips and lower back, and not in the lower abdomen as I had expected. I was anticipating something akin to menstrual cramps. I never felt that sort of pain. I did not recognize it for what it was at the time, but soon discovered I was having textbook "back labor."
We waited the night through and I tried to nap between contractions, with little success. A few times, I filled the bathtub and laid down in the shallow water. M lit candles and burned incense and pressed into my lower back and did everything he could to help relieve my suffering. The warm water was relaxing and helped ease the intense pain of the contractions. The following afternoon (Tuesday, March 3rd), the contractions had sped up and when I was active they were coming every 2 minutes and lasting for about a minute. They did not feel as painful or intense as I expected contractions to feel were my labor truly advancing and were I actually dilating. It was confusing. I called OHSU and spoke with the midwife on-call, Penny Harmon. She listened to my story and suggested that perhaps I was in what she termed "pre-labor" -or "false labor" -and she said I could come in and get some IV fluids and hopefully slow things down so that I could get a break. The thinking was that perhaps my uterus was simply irritated and needed to be settled. Based on how erratic things were, she did not think it sounded like "real labor." She said that if it were "false labor" the IV fluids would stop it. If it were the real thing, nothing would. However, as we would soon discover, it was real labor -just the sort one has when carrying a fully posterior baby.
I arrived at OHSU on Tuesday afternoon. We accidentally entered via the emergency entrance. I was greeted promptly by a staff person who asked me if I was having a baby. I tried to explain to her that I didn't really think I was having a baby, despite appearances, and that I had been asked to come in by the midwife. She insisted that since I had entered through the emergency room door i needed to wait and take a wheelchair up the 9th floor L&D. I tried to demure, but she would not permit me to leave. She stuffed me into a chair. Now, if there is anything worse for back labor -or any kind of labor -it is being asked to sit still in a chair. I sat for a moment, but rose for every contraction (and they were coming quite swiftly at this time owing to my increased activity). M and I stood around for a few long minutes waiting for an orderly. None appeared. Finally, we turned and left and jogged around the building to the main hospital entrance, hoping we wouldn't be chased down by hospital staff desperate to abide by the rules, however stupid. We made our way to the 9th floor and found a nurse (Marj) who showed us to the room that Penny had saved for us.
After the routine question and answer bit, a nurse accompanied by another girl entered the room. The nurse advised me I would be getting my IV inserted by a medical student. Anxious to please, I said that would be fine with me and asked if the girl felt comfortable doing so. She said she was, but proceeded to stick me 3 times before actually find a vein (the bruises from this IV took weeks to recede). M said later that he was prepared to tell her to forget it had she been unable to properly locate my vein by the 4th attempt. It struck me as sweet that he was so protective of me, even in something so minor.
Penny checked my cervix and much to my chagrin I had only dilated 1 centimeter in almost 24 hours of steady labor. I spent hours and hours rigged up to the IV as fluid flooded my veins and my contractions gradually slowed from 2 minutes apart to around 10 minutes by the time we finally left. Somewhat encouraged, I hoped we had finally settled things and I might get some rest and hopefully begin my "real" labor at a later date. No such luck was to be mine.
Thinking we were in the clear, at least momentarily, we stopped at New Seasons grocery on the way home. We had no food in the house and if the labor was not letting up as we had hoped I needed to get one last good protein-rich meal in me before I began the truly difficult work of bringing the baby into the world. The contractions had picked up as soon as I began moving about upon leaving the hospital (as were their habit, I was learning). We loitered in the car in the New Season's parking lot for a while while I debated whether I wanted to go into the store or not. Trouble was, I felt particular and wanted to select something myself from the deli. It is hilarious to think now in retrospect that I wandered around New Seasons while in labor. The pain of contractions is hardly something one can easily disguise. Each contraction hit and I squatted to the ground and waited it out, my face twisted into a pained grimace. I attempted to tightly control my features and give nothing away, but it was to no avail. Several patrons stopped and asked if I were alright. I smiled wryly and informed them of the nature of my problem. "Congratulations!" they would exclaim, surprised to see someone in my state out and about in public. As we were leaving the store, the manager approached me and inquired as to my welfare. I assured him in jest that I would certainly not be having a baby in his store and that he ought not worry. He wished me luck as we headed home to pass another long night in labor.
As noted, we hoped things were slowing down -and they seemed to be for a time. I ate my deli take-away food in between well-spaced contractions and hoped that sleep was in the cards in the near term. At this point, at 10PM on Tuesday night, I had been several days without sleep and was growing desperately tired. Thankfully, I was able to nap between contractions for a couple of hours, but around 2AM the contractions picked back up and resumed their steady 2-5 minute pattern and sleep was out of the question. I struggled with the pain of them alone this time -and for hours. M had been so faithful all the while. He pressed my lower back when I needed it and fetched me water and attended on me with devotion. He would need the rest if this were indeed the real thing (as was becoming painfully clear). Given that we'd already spent several days this way, I had reason to believe I had "miles to go before I'd sleep" and I wanted M to get what rest he could.
Things plodded on this way for all of Wednesday. Again, I drew a bath several times in hopes it would relax me and ease my pain. We lit candles in the bathroom & I curled on my side in a foot of water & hoped for some relief. The pain was intensifying over time and each contraction forced me to drop to my knees wherever it caught me -in the living room, on the toilet. If I moved, they came one on top of the other. It was growing far more difficult and I began to grow frightened. Sometime on Wednesday night (around 8 or 9PM), we phoned OHSU and spoke with the midwife on call -this time, my favorite, Linda Glenn. M told her how I was feeling and she asked to speak to me. I remembered her saying in the water birth class that she always asked to speak to the ailing mother since she could tell from the sound of her voice whether her time was ripe or not. We spoke briefly and I described to her the intensity and locality of the pain. She advised me that I was suffering from severe back labor (the first to tell me so) and that I should come in and get checked.
By now the contractions were something quite fierce. I instructed M to get everything into the car -both our labor and post-labor bags, and anything he might need to get through the coming days. I tried to get into some clothes and make myself somewhat decent, but the pain was too incredible to allow for much fussing. Once the car was fully loaded, I darted from the house to the car between contractions and got into position on my hands and knees on the floor of the backseat. I had been dreading this trip to the hospital throughout my pregnancy, but I was remarkably able to deal with the pain and found a position that provided me some relief. M drove carefully and I advised him to take corner and bumps easily. We wound our way up the hill to OHSU.
I refused to subject myself to the wheelchair treatment in Emergency again, so M dropped me off and I dragged myself up the stairs and into the elevator to make my way alone to L&D. M was right behind me with our things. I got a few strange looks from others along the way & in the elevator as I crouched from time to time in order to manage another painful contraction.
I made my way slowly to L&D from the elevator and a nurse met me at the desk & directed me to a room. I continued to deal with the contractions as I had to date: carefully, stopping whenever possible to let them take me over. It hurt so much more when they caught me unawares.
They checked me in (probably around 10pm), took my vitals & I changed into my labor gown (specially selected) and the white footies C gave me (thanks, C). Linda Glenn was busy with other deliveries when we arrived, so we waited around in our room & M helped me through a series of intensifying contractions. Linda arrived eventually, felt my abdomen, reviewed the details of the previous several days of labor, asked me a number of questions and then she leveled with me: my baby was very probably in a posterior position, which would explain the prolonged labor, severe back pain, erratic contractions & extremely slow progress.
She showed us a series of exercises that we needed to do to assist the baby in turning. One involved lunging to the side repeatedly in between contractions (with one foot elevated on a chair), much like one might do in aerobics class to strengthen the quads. Another more painful exercise required me to stand erect against a wall during a contraction while someone repeatedly massaged upwards on my belly. The hope was that we might be able to nudge the baby up with elbow grease and the force of a contraction might turn him around magically. This was incredible painful, since all the labor pain was felt in my lower back. I really wanted more than anything to be on my hands & knees. And I should note, I had been laboring without sleep for 3 days already -I was in no shape for a hard-core workout, but it seemed that was what was required of me.
We suddenly remembered that we had engaged a student doula via Mothertree the previous week and decided to call her. Iris arrived to help us around 1:30AM Thursday morning. We had resisted a cervical check since we had arrived that evening, but Linda convinced us that after so many days of labor already, it was necessary to check my dilation in order to gauge my progress. We relented & were thrilled to discover that I was dilated to 6 centimeters at 2AM. We felt we were making great progress, despite how long I had been laboring. At least it wasn't completely stalled. Iris helped with the painful exercises and I labored hard for another 6 hours, all the while going through the baby-moving routine (lunges, lifts, etc). It was incredibly hard labor. At one point, around 7AM I asked for another bath -I just needed to relax for a bit & try to get a little rest. I got into the bathtub, but promptly wanted out. It just was not at all comfortable. I remember that as I was getting out of the tub another severe contraction overtook me. I almost lost my nerve &, near tears, I told M I didn't think I could keep going much longer. I felt I was nearing the end of my strength & was starting to lose hope that I would be able to last as long as my labor.
Linda saw that my energy & optimism were flagging, and suggested that we do another cervical check to see how far I had gone in the intervening hours & hours of hard labor. I was shattered to discover that I had not progressed one bit, despite all the terrible exercises & extremely intense contractions. I lost whatever reserve of calm I had with the news & started to cry. I had now been laboring for 3 days without rest and I seemed to have stalled out utterly. I felt certain that all our exercises were working. I wanted to believe I was going to be able to push my baby out naturally. Those dreams were starting to seem less & less likely as time went on.
After the dismal news that I was essentially "failing to progress," Linda took M into the hall for a very serious talk (I did not know this until much later). She was recommending pitocin & an epidural as soon as possible so I could get some rest & hopefully get the contractions going a little more seriously. She told him that when she was a midwife in rural North Carolina in the 60s & 70s, she used to work with a low-income African-American population, many of whom were barred from being treated at various all-white hospitals. She had seen this situation before -the women would labor for days & days as I had with no hope of a hospital delivery or assistance from any other than a lay midwife. M asked her what happened in those circumstances & in a rather ominous way she told him it was not good. Linda has her own home-birth practice in Portland, in addition to the work she does with OHSU. M asked her what she would tell her home-birth client in such a situation as mine. She said she would advise they head directly to the hospital for pitocin & an epidural.
She returned to discuss my situation with me. I recall I was hunched over the end of the bed, on my knees, gripping the edges of the mattress, wincing through contractions as we talked. Linda was nose to nose with me, staring into my eyes, watching my fear & gauging the depths of my sorrow. She told me in a calm, clear voice that while I had a lovely birth plan, things weren't really going according to any sort of plan whatsoever. She told me that it was her opinion that I needed to get pitocin & an epidural. She told me that she knew that was not what I wanted to hear & she understood my disappointment. She said that because of the baby's position, my cervix was not dilating -there was simply not enough pressure on it from the baby's head. There was no telling how long the labor would take if left utterly to nature. She was seriously concerned about my health, my mental state, & the fact that I hadn't rested whatsoever since Monday morning (it was now Thursday morning around 8:30AM).
It started to occur to me at this moment that I might well be headed for a cesarean section. I think up until this point I hadn't realized the seriousness of what was happening. I knew I was dog-tired, but somehow I thought I would be giving birth shortly (despite the failure to progress) & that it would all be over soon enough. I hadn't really considered the possibility that perhaps the baby would never turn. I had not thought about the fact that I really could not labor indefinitely -that I would eventually (and soon) run out of steam. I looked at M, and nodded my agreement. I would turn my back on my ideal birth experience because there was simply no other choice.
When the anesthesiology team arrived they were a jolly bunch. I am certain they were not accustomed to seeing a woman so angry & hesitant & unwelcoming -most are probably delighted to see the end of suffering. Not I. I sobbed as they swabbed my back & made their marks for the needle's entry. I was so disappointed & upset to lose the natural childbirth experience of my dreams. The pain of the contractions was never unbearable for me. I simply did not have the strength, however, to labor for weeks on end. Something had to give.
The epidural worked quickly. Soon, I was a slack-legged, useless woman. I could do nothing for myself & needed help even turning around in bed. I could not imagine choosing an epidural on purpose, simply for pain relief. It made the labor so much more difficult, and I should note, it only dulled the piercing back pain & did not truly relieve it altogether. Of course, since I was on an epidural & pitocin, I needed a heart monitor, a catheter, etc. It was ridiculous. There were wires coming out of me from all sides. I made M take photos of me all plugged in to the birth machine. I tried my best to make a joke of it, since there was nothing I could do to change the course I was now on.
I passed the better part of the day this way. I tried my best to doze when I could, but it was difficult since the pain was still with me, although to a far lesser degree. The contractions intensified & I prayed they were having some effect on my dilation, but they remained totally irregular- the answer to which was to repeatedly up the pitocin levels. I had to keep turning around & around since the weight of my body was putting stress on the baby & causing his heart beat to do strange things. I tried to lay on my belly with my leg cocked up as much as I could, per the midwife's advice. We were still trying to turn this baby, although my ability to help matters was much reduced owing to the numbness in my lower body. About 8 hours later (around 3PM on Thursday), the midwife, Ellen Tilden checked me again (Linda had gone home). Again, I was dismayed to find that despite the pitocin I had still not dilated much beyond 6 or maybe 7 centimeters.
They upped my pitocin dosage & the contractions intensified. Around 5PM they decided to insert a catheter monitor so they could get a more precise idea of the strength of the contractions. Again, they checked me & discovered (yet again) that I had failed to progress whatsoever. They checked me at 9pm -7 centimeters, and then at 10PM -still 7 centimeters. Nothing was happening & that was bad news for me.
Meanwhile, I was unable to eat anything of substance all the while. I had a few high-protein Special K drinks & a few cups of miso soup. But I was obviously lacking in sustenance, especially considering the long hours of hard work I had been putting in. The baby's heart monitor kept acting weird & there was concern that all was not right inside my womb. I had to turn around a lot since it kept flagging & showing signs of distress (something called "persistent late deceleration"). After suffering almost 4 days of constant contractions, it was conceivable that my poor baby boy was getting worn out from his long passage. I was given an oxygen mask to wear in order to promote oxygenation to the placenta.
I had now been laboring for over 72 hours without rest, food or any sign that the end was in sight. It was growing hard to keep my eyes open and my focus was lost. I could hardly finish a sentence, I was so exhausted. Contant checks kept confirming our worst fears: that the baby simply was not turning. At this point it was becoming painfully clear that even if the baby turned & by some miracle I began to head towards full dilation, I may be unable to push him out owing to my great fatigue. If the baby did not turn & I dilated fully, there was no way on earth I would be able to push for the necessary hours & hours required to remove a backwards baby. I was running out of options.
We had one last ace-in-the-hole: we could rupture my bag of waters. Yes, by some miracle my waters had remained in tact all the while. This was an amazing stroke of luck as it allowed me to labor for as long as I had without fear of uterine infection. But now, with time running out, we decided to see if we could speed things along by breaking the waters. If the pitocin wasn't going to do it, maybe that would. And so, at 10:30PM the midwives finally ruptured my waters. Much to our dismay, there was a fair amount meconium in the water, further signs that my baby was suffering some distress & a fact which heightened our already considerable sense of urgency.
Another hour passed & there was no real sign that breaking the waters was having any effect. The contractions were still clearly in my lower back & while they were more intense, I was still far from feeling like I needed to push. Finally, at 11:30PM, Dr. Roseanne Botha (an obstetrician at OHSU) offered to try to manually turn the baby with her hand. She said she had had some success in the past and was willing to give it a try if I was willing. After so many days of pain, so many interventions, so many people wandering in & out of my hospital room, another totally invasive option seemed like no big deal. The doctor told me I would feel some discomfort when her hand went through my cervix. After what I had been through, I felt like nothing would bother me ever again. She inserted her hand, gripped his head & I could feel the tension in her arm as she tried like hell to twist his little body into a proper position. She tried several times, each time straining & working, her face tight with concentration. Each time she reported that she was able to twist him a bit, but that as soon as she loosened her grasp, he returned to his original position. This baby just was not interested in moving.
Finally, she offered to do a quick ultrasound to confirm what we all feared -that he was now fully posterior. The nurses dragged in a mobile unit and they lubed me up with jelly, much like in the past visits (those all seemed such a long-ago dream from this strange point of view). It was so odd to see my baby squirming around on the screen when within hours I would be meeting him face to face. I could hardly tell what was what since he was filling his tiny space entirely. The doc picked out arms, legs, abdomen and confirmed what we now knew to be true. He was completely backwards & all the efforts we had made to turn him (with exercises or with brute force) had been completely ineffective.
We waited several hours longer, hoping things would pick up but admitting to ourselves as each uneventful hour crept past that a vaginal birth was a lost cause. Finally, the midwives and obstetricians advised a cesarean section. They argued that while we could wait until it was an emergency, but it would be easier & quicker & safer to just schedule it as soon as possible. The baby's vitals were flagging, I was quickly turning into a comatose zombie, and there was really nothing else to be done. One last check told us all we needed to know. It was over.
Around 1AM Friday morning, March 6th, they wheeled me into the operating room. A massive dose of anesthesia through the epidural had left my entire body as limp as a wet rag. I felt heavy, cold and dull. My eyes were unfocused and blurry and I could hardly keep from unconsciousness from sheer exhaustion. The doctors hoisted me from my dolly onto a cold table. I was freezing cold & shivered violently, partially from the cold air but also I am guessing from the fatigue and shock at what I had been through. They lowered a blue screen in front of my face and told me to hold my arms akimbo. M was with me at my head, along with a midwife apprentice who was describing for me what she saw as we went along. I was told that they were ready to begin & that I would feel a little tugging. I could feel the sharp pierce of the scalpel and cried out that I could feel it. The anesthesiologist was at my head as well, and I could hear him scurrying around, upping my levels to kill the pain. I remember that M had the camera. I was insisting for some strange reason that he not watch, although I am glad that he did. It just seemed so terrible at the time. I did not want him to see me like that, all splayed open & bloodied.
The doctor told me that I would feel a little pressure. M told me after that it took three doctors to hold the wall of my abdomen open, each pulling with all their might on a great metal hook (this explains the horrible muscular pain after!). One of the doctors pulled my baby from my body. Once they removed him, the doctors informed M that he could go around to the foot of the operating table where he could see the baby. But the baby did not cry at all. The doctors rushed him over to a small table off to the side where M saw them administering mechanical resuscitation -some sort of pump-device to revive him. M says that he felt very tense at this moment and felt a great deal of tension in the room. I asked what was going on, since I could not hear my baby. The midwife told me that he had lots of hair. The baby finally gasped for breath & there was some indication from the doctors that he was indeed breathing fine...finally. M observed them perform the APGAR tests, the first in which he did somewhat poorly, & the second in which he passed with flying colors. All the while, the baby only cried once -one tiny cry. They bundled him up tight & handed him to M who brought him promptly around to the head of the table where I lay awaiting the first sight of my child.
I can hardly remember that moment -the moment when I first saw my baby. According to M, I was totally wasted. I remember trying to touch him, but he was so fully swaddled I could not get at him. I thought he was beautiful, of course. It took a while to stitch me up & M held him there near me while we waited for a chance for me to finally hold him.
As soon as they finished with the stitching, I was wheeled into recovery where I was handed my baby for the very first time. I was anxious to get the nursing started, but I struggled to hold him close to me as my IVs & my epidural & my swollen, sore abdomen made it difficult. I was instructed to try holding him in a football hold to initiate nursing, but I could not seem to get it right. I felt so out of it, light headed, dizzy -as though I were going to pass out. All the sounds in the room receded & I felt like it was unsafe for me to be handling a baby in that condition. I urgently instructed M to take off his shirt & I handed the baby to him -hoping that at least this child could bond with his father since I was apparently not going to be able to manage it. I informed the nurse that I was feeling off. The nurse, who was monitoring my vitals noted that my blood pressure was 80/20, & called out anxiously for the anesthesiologist who came running. She was clearly concerned. The anesthesiologist came to my bedside & looked me over anxiously. He asked me to squeeze his finger, but I was unable to manage any grip whatsoever. He asked me: "are you squeezing it as hard as you can?" -and I was. My hand, my body, was very nearly lifeless. I felt myself fading out of consciousness. The nurse called my name several times to bring me back, & each time she did I came back gasping from where ever I was going -great, alarming, & desperate gasps of breath -as though I were surfacing after a long, deep, submersion under water. I heard the anesthesiologist holler for a nurse to hold a bag of a new IV, some other drug intended to boost my blood pressure. My blood pressure responded by shooting up & they seemed concerned yet again that it was now too high.
I remember watching M at the foot of my bed, holding the baby who was furiously suckling at his naked chest. I thought for a moment that I was never going to get to hold my baby, that I was perhaps leaving him alone in this world with none but his poor dad to watch over him.
After several minutes of close monitoring, my vitals finally stabilized. I remember being intensely thirsty, but being told I could not have anything to drink until a certain number of minutes had passes. I was given ice cubes instead which were so unsatisfying. I let them melt & drank the water left behind, even though I was not supposed to. After an hour or so in recovery, we were informed that we were going to be moved. Unfortunately, all OHSU had available for us was a shared room.
We were horrified at the thought of sharing a room after what we'd been through. We so desperately needed some quiet & restful time alone together as a family. But the worst bit about having a shared room was not having to share the space with another family, it was the fact that hospital policy required that partners of new mothers in shared rooms leave the hospital at 10pm and spend the night elsewhere. In other words, M was not going be permitted to stay with me & assist me in those first difficult & crucial hours of motherhood. We pleaded with hospital staff to somehow find other arrangements for us.
We did manage to have the shared room to ourselves for those first few hours, however, so M was not made to leave immediately & we both did what we could to get some much needed rest. We were both so utterly shattered at this point -I don't think either of us have known exhaustion on this level -nor do we hope to again. Thankfully, the baby was as tired as we were. Poor M slept in a chair, all hunched over, while I slept in the bed, my brand new baby tucked in beside me sleeping peacefully.
When we awoke from our brief rest, we entertained our baby's very first visitor -B, our coworker & dear friend came to see us first thing. She brought with her a bag of treats -bagels & cream cheese from Noah's, a few cans of Guinness & a bag of Gummi Bears. We tucked right into the bagels since we were starving from our hard labor. I have so little memory of these events, however. I was in something of a wrecked daze, so much of what I am recounting here was told to me by M & B. B helped M dress Xavier for the very first time -a hospital photographer was scheduled to come & take his picture. I chose something for him to wear (the sleeper C gave me when I went to visit her pre-baby) & M gingerly wrangled wobbly limbs into arm & leg-holes & tried desperately not to break anything. It was clear by his gentle, wary hand that he had handled precious few babies in his time. B tells me that I showed off my beautiful little baby, exclaiming about how adorable he was & how over-cooked his hands & feet appeared (the guess was that he was actually overdue, despite arriving on my due date). I remember feeling so relieved that he was such a gorgeous baby -I know I would have loved him just the same had he come out strange looking, but it was delightful that he was so perfect. And because of the manner in which he met the world, his head & face was unmarred by a violent passage through the birth canal. He did not have the red bruises that are so common, nor the frightening conical shape to his head. He was perfect- a head full of thick, dark hair, a precious button nose, gigantic hands & feet & long, slender little fingers.
B didn't hang out long. She felt in the way, she said. The nurses were still fluttering around me, monitoring this & that. B said it was clear they were still somewhat concerned about my condition. She also said that we were still in something of a tizzy concerning our room situation, & she knew we needed to resolve that ASAP.
After she left, the charge nurse came in to our room to discuss the issue with us. I told her my long, dramatic story of protracted labor & a near-death experience. We informed her that it would be devastating for me to be left alone in such a vulnerable condition. She cried as she listened to me share my thoughts & recent experiences with her. It would be the first of many times I would tell my long & terrible tale. She managed to pull a few strings & in no time we were informed that a room had been arranged for us in a quiet, closed wing of the Mother-Baby unit. We were going to get our own room.
The room was a lovely, peaceful space with broad windows looking out over the hospital campus & a corner built-in cot for M to sleep on. We settled in & tried to get as much rest as we could.I was still hooked up to all sorts of wires & gadgets (the IV is left after c-sections in case an infection develops) & I stayed that way for a while. I wound up staying in the hospital for 5 days -the longest stay permitted. I felt like I needed that much time to come back to some semblance of normal after my intense & terrible ordeal. I needed to recuperate physically, but also emotionally. I needed someone to fetch me dinner & nurses to teach me how to get my baby to latch on properly (thankfully, nursing went swimmingly -I could not have dealt with difficulty in that arena after what I went through). I needed more rest than was possible, considering I was a new mother to a very needy baby.
As for baby X?- yes, I realize he's almost a bit player in this massive drama. And that is honestly how it felt at the time. He was so relaxed & peaceful, despite having gone through the ringer with me. He slept the bulk of his first 24 hours, prompting M to think we were home free. When X started fussing & crying & non-stop nursing during the second 24 hours, M seemed somewhat alarmed. But he was just doing the necessary work to get my milk production going. The hospital had a lactation consultant on staff that attended on us daily, observing how things were going, offering helpful tips to make things easier for us. The nurse came in hourly during those first endless nights & helped me sit up, turn over & get him latched on (moving at all was terribly difficult which obviously complicated everything).
I was quite heavily dosed with Percocet & Ibuprofin, so my recollection of those early days is terribly foggy & incomplete. I feel immense regret that this was the case. I have a few photographs that help to bring me back, but much of the sense of that precious time is lost to me completely.
And so I conclude this birth story. It is not the story I had hoped to tell. I have not had the heart to resurrect my pathetic birth plan to see how far my fantasies were from the facts on the ground. Nothing went according to the plan. It is a year on, almost to the day, that I write these concluding thoughts & while I have healed physically, I still have loads of healing to do in other areas. I dread contemplation of how we will bring baby #2 into this world (yes, there will be a #2). Will I attempt a VBAC? -Will I be allowed to do so naturally or will a loathsome epidural be required "in case" of emergency? Nothing would please me more than an opportunity to try again. A successful VBAC would be the most healing act imaginable, but I cannot count on it. I need to be prepared for the possibility of another miserable, disappointing & utterly frightening experience. And the thought that I might wind up in similar circumstances terrifies me, almost enough to want to skip another kid altogether. Almost, but not quite....
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What started on a Monday and ended on a Friday with the birth of my son was not just my labor and birth experience, it was a test of my strength and endurance. It took the measure of my husband's love for me. It revealed the heights to which my optimism aspired and the depths into which my disappointment could plunge.
I had thought my labor started around midnight on Monday, March 2nd, but when I reflect I believe it actually started earlier, but it is was so mild and strange I was not aware of what I was feeling.
I went to work on Monday after visiting with one of the OHSU midwives, Penny Harmon. At my appointment, Penny poked around and noted that my baby's head had not yet engaged in the pelvis -he was still riding quite high. She informed me he was ROA (Right Occiput Anterior) and when I asked her about the problems with this positioning (another midwife, Linda Glenn, was very hung up on positioning and had informed me previously that ROA makes for a "roller-coaster of a labor.") she discounted the importance and seemed to think the baby had plenty of time to turn around. Based on the fact this was my first baby, I was given every reason to believe I had at least a week, but probably two weeks before my boy would make his long-awaited appearance.
At work, I sat at my desk and tried to focus on the job at hand, but my maternity skirt was driving me nuts. The waistband seemed tighter than it had before and I was endlessly bothered such that I decided to cut my losses and finish the day working in the comfort of my own home. I wrestled the skirt off immediately upon arriving home, called up my friend K who came over in short order. I remember laying on my side on the futon as we chatted, adjusting my position this way and that, trying to get comfortable. I had a low, dull ache in my lower back that would not subside. It was puzzling since I hadn't suffered any real pain or similar annoyances during my entire pregnancy. I recalled that I had cut a walk short the evening before for the same reason -lower back pain that would not permit me to remain long on my feet. Now that I know what exactly followed on, I realize this was the beginning of my long labor.
At midnight on Monday night, things really kicked in. At first, I mistook the sensation for a really bad case of diarrhea. But after a few minutes I realized this was no indigestion -this was the real thing. The trouble was, there was no pattern to the madness. The contractions came quickly when I moved about, but slowed dramatically when I rested. This non-pattern would repeat itself for the duration of my labor (even after modern medicine intervened). The pain was centralized in my hips and lower back, and not in the lower abdomen as I had expected. I was anticipating something akin to menstrual cramps. I never felt that sort of pain. I did not recognize it for what it was at the time, but soon discovered I was having textbook "back labor."
We waited the night through and I tried to nap between contractions, with little success. A few times, I filled the bathtub and laid down in the shallow water. M lit candles and burned incense and pressed into my lower back and did everything he could to help relieve my suffering. The warm water was relaxing and helped ease the intense pain of the contractions. The following afternoon (Tuesday, March 3rd), the contractions had sped up and when I was active they were coming every 2 minutes and lasting for about a minute. They did not feel as painful or intense as I expected contractions to feel were my labor truly advancing and were I actually dilating. It was confusing. I called OHSU and spoke with the midwife on-call, Penny Harmon. She listened to my story and suggested that perhaps I was in what she termed "pre-labor" -or "false labor" -and she said I could come in and get some IV fluids and hopefully slow things down so that I could get a break. The thinking was that perhaps my uterus was simply irritated and needed to be settled. Based on how erratic things were, she did not think it sounded like "real labor." She said that if it were "false labor" the IV fluids would stop it. If it were the real thing, nothing would. However, as we would soon discover, it was real labor -just the sort one has when carrying a fully posterior baby.
I arrived at OHSU on Tuesday afternoon. We accidentally entered via the emergency entrance. I was greeted promptly by a staff person who asked me if I was having a baby. I tried to explain to her that I didn't really think I was having a baby, despite appearances, and that I had been asked to come in by the midwife. She insisted that since I had entered through the emergency room door i needed to wait and take a wheelchair up the 9th floor L&D. I tried to demure, but she would not permit me to leave. She stuffed me into a chair. Now, if there is anything worse for back labor -or any kind of labor -it is being asked to sit still in a chair. I sat for a moment, but rose for every contraction (and they were coming quite swiftly at this time owing to my increased activity). M and I stood around for a few long minutes waiting for an orderly. None appeared. Finally, we turned and left and jogged around the building to the main hospital entrance, hoping we wouldn't be chased down by hospital staff desperate to abide by the rules, however stupid. We made our way to the 9th floor and found a nurse (Marj) who showed us to the room that Penny had saved for us.
After the routine question and answer bit, a nurse accompanied by another girl entered the room. The nurse advised me I would be getting my IV inserted by a medical student. Anxious to please, I said that would be fine with me and asked if the girl felt comfortable doing so. She said she was, but proceeded to stick me 3 times before actually find a vein (the bruises from this IV took weeks to recede). M said later that he was prepared to tell her to forget it had she been unable to properly locate my vein by the 4th attempt. It struck me as sweet that he was so protective of me, even in something so minor.
Penny checked my cervix and much to my chagrin I had only dilated 1 centimeter in almost 24 hours of steady labor. I spent hours and hours rigged up to the IV as fluid flooded my veins and my contractions gradually slowed from 2 minutes apart to around 10 minutes by the time we finally left. Somewhat encouraged, I hoped we had finally settled things and I might get some rest and hopefully begin my "real" labor at a later date. No such luck was to be mine.
Thinking we were in the clear, at least momentarily, we stopped at New Seasons grocery on the way home. We had no food in the house and if the labor was not letting up as we had hoped I needed to get one last good protein-rich meal in me before I began the truly difficult work of bringing the baby into the world. The contractions had picked up as soon as I began moving about upon leaving the hospital (as were their habit, I was learning). We loitered in the car in the New Season's parking lot for a while while I debated whether I wanted to go into the store or not. Trouble was, I felt particular and wanted to select something myself from the deli. It is hilarious to think now in retrospect that I wandered around New Seasons while in labor. The pain of contractions is hardly something one can easily disguise. Each contraction hit and I squatted to the ground and waited it out, my face twisted into a pained grimace. I attempted to tightly control my features and give nothing away, but it was to no avail. Several patrons stopped and asked if I were alright. I smiled wryly and informed them of the nature of my problem. "Congratulations!" they would exclaim, surprised to see someone in my state out and about in public. As we were leaving the store, the manager approached me and inquired as to my welfare. I assured him in jest that I would certainly not be having a baby in his store and that he ought not worry. He wished me luck as we headed home to pass another long night in labor.
As noted, we hoped things were slowing down -and they seemed to be for a time. I ate my deli take-away food in between well-spaced contractions and hoped that sleep was in the cards in the near term. At this point, at 10PM on Tuesday night, I had been several days without sleep and was growing desperately tired. Thankfully, I was able to nap between contractions for a couple of hours, but around 2AM the contractions picked back up and resumed their steady 2-5 minute pattern and sleep was out of the question. I struggled with the pain of them alone this time -and for hours. M had been so faithful all the while. He pressed my lower back when I needed it and fetched me water and attended on me with devotion. He would need the rest if this were indeed the real thing (as was becoming painfully clear). Given that we'd already spent several days this way, I had reason to believe I had "miles to go before I'd sleep" and I wanted M to get what rest he could.
Things plodded on this way for all of Wednesday. Again, I drew a bath several times in hopes it would relax me and ease my pain. We lit candles in the bathroom & I curled on my side in a foot of water & hoped for some relief. The pain was intensifying over time and each contraction forced me to drop to my knees wherever it caught me -in the living room, on the toilet. If I moved, they came one on top of the other. It was growing far more difficult and I began to grow frightened. Sometime on Wednesday night (around 8 or 9PM), we phoned OHSU and spoke with the midwife on call -this time, my favorite, Linda Glenn. M told her how I was feeling and she asked to speak to me. I remembered her saying in the water birth class that she always asked to speak to the ailing mother since she could tell from the sound of her voice whether her time was ripe or not. We spoke briefly and I described to her the intensity and locality of the pain. She advised me that I was suffering from severe back labor (the first to tell me so) and that I should come in and get checked.
By now the contractions were something quite fierce. I instructed M to get everything into the car -both our labor and post-labor bags, and anything he might need to get through the coming days. I tried to get into some clothes and make myself somewhat decent, but the pain was too incredible to allow for much fussing. Once the car was fully loaded, I darted from the house to the car between contractions and got into position on my hands and knees on the floor of the backseat. I had been dreading this trip to the hospital throughout my pregnancy, but I was remarkably able to deal with the pain and found a position that provided me some relief. M drove carefully and I advised him to take corner and bumps easily. We wound our way up the hill to OHSU.
I refused to subject myself to the wheelchair treatment in Emergency again, so M dropped me off and I dragged myself up the stairs and into the elevator to make my way alone to L&D. M was right behind me with our things. I got a few strange looks from others along the way & in the elevator as I crouched from time to time in order to manage another painful contraction.
I made my way slowly to L&D from the elevator and a nurse met me at the desk & directed me to a room. I continued to deal with the contractions as I had to date: carefully, stopping whenever possible to let them take me over. It hurt so much more when they caught me unawares.
They checked me in (probably around 10pm), took my vitals & I changed into my labor gown (specially selected) and the white footies C gave me (thanks, C). Linda Glenn was busy with other deliveries when we arrived, so we waited around in our room & M helped me through a series of intensifying contractions. Linda arrived eventually, felt my abdomen, reviewed the details of the previous several days of labor, asked me a number of questions and then she leveled with me: my baby was very probably in a posterior position, which would explain the prolonged labor, severe back pain, erratic contractions & extremely slow progress.
She showed us a series of exercises that we needed to do to assist the baby in turning. One involved lunging to the side repeatedly in between contractions (with one foot elevated on a chair), much like one might do in aerobics class to strengthen the quads. Another more painful exercise required me to stand erect against a wall during a contraction while someone repeatedly massaged upwards on my belly. The hope was that we might be able to nudge the baby up with elbow grease and the force of a contraction might turn him around magically. This was incredible painful, since all the labor pain was felt in my lower back. I really wanted more than anything to be on my hands & knees. And I should note, I had been laboring without sleep for 3 days already -I was in no shape for a hard-core workout, but it seemed that was what was required of me.
We suddenly remembered that we had engaged a student doula via Mothertree the previous week and decided to call her. Iris arrived to help us around 1:30AM Thursday morning. We had resisted a cervical check since we had arrived that evening, but Linda convinced us that after so many days of labor already, it was necessary to check my dilation in order to gauge my progress. We relented & were thrilled to discover that I was dilated to 6 centimeters at 2AM. We felt we were making great progress, despite how long I had been laboring. At least it wasn't completely stalled. Iris helped with the painful exercises and I labored hard for another 6 hours, all the while going through the baby-moving routine (lunges, lifts, etc). It was incredibly hard labor. At one point, around 7AM I asked for another bath -I just needed to relax for a bit & try to get a little rest. I got into the bathtub, but promptly wanted out. It just was not at all comfortable. I remember that as I was getting out of the tub another severe contraction overtook me. I almost lost my nerve &, near tears, I told M I didn't think I could keep going much longer. I felt I was nearing the end of my strength & was starting to lose hope that I would be able to last as long as my labor.
Linda saw that my energy & optimism were flagging, and suggested that we do another cervical check to see how far I had gone in the intervening hours & hours of hard labor. I was shattered to discover that I had not progressed one bit, despite all the terrible exercises & extremely intense contractions. I lost whatever reserve of calm I had with the news & started to cry. I had now been laboring for 3 days without rest and I seemed to have stalled out utterly. I felt certain that all our exercises were working. I wanted to believe I was going to be able to push my baby out naturally. Those dreams were starting to seem less & less likely as time went on.
After the dismal news that I was essentially "failing to progress," Linda took M into the hall for a very serious talk (I did not know this until much later). She was recommending pitocin & an epidural as soon as possible so I could get some rest & hopefully get the contractions going a little more seriously. She told him that when she was a midwife in rural North Carolina in the 60s & 70s, she used to work with a low-income African-American population, many of whom were barred from being treated at various all-white hospitals. She had seen this situation before -the women would labor for days & days as I had with no hope of a hospital delivery or assistance from any other than a lay midwife. M asked her what happened in those circumstances & in a rather ominous way she told him it was not good. Linda has her own home-birth practice in Portland, in addition to the work she does with OHSU. M asked her what she would tell her home-birth client in such a situation as mine. She said she would advise they head directly to the hospital for pitocin & an epidural.
She returned to discuss my situation with me. I recall I was hunched over the end of the bed, on my knees, gripping the edges of the mattress, wincing through contractions as we talked. Linda was nose to nose with me, staring into my eyes, watching my fear & gauging the depths of my sorrow. She told me in a calm, clear voice that while I had a lovely birth plan, things weren't really going according to any sort of plan whatsoever. She told me that it was her opinion that I needed to get pitocin & an epidural. She told me that she knew that was not what I wanted to hear & she understood my disappointment. She said that because of the baby's position, my cervix was not dilating -there was simply not enough pressure on it from the baby's head. There was no telling how long the labor would take if left utterly to nature. She was seriously concerned about my health, my mental state, & the fact that I hadn't rested whatsoever since Monday morning (it was now Thursday morning around 8:30AM).
It started to occur to me at this moment that I might well be headed for a cesarean section. I think up until this point I hadn't realized the seriousness of what was happening. I knew I was dog-tired, but somehow I thought I would be giving birth shortly (despite the failure to progress) & that it would all be over soon enough. I hadn't really considered the possibility that perhaps the baby would never turn. I had not thought about the fact that I really could not labor indefinitely -that I would eventually (and soon) run out of steam. I looked at M, and nodded my agreement. I would turn my back on my ideal birth experience because there was simply no other choice.
When the anesthesiology team arrived they were a jolly bunch. I am certain they were not accustomed to seeing a woman so angry & hesitant & unwelcoming -most are probably delighted to see the end of suffering. Not I. I sobbed as they swabbed my back & made their marks for the needle's entry. I was so disappointed & upset to lose the natural childbirth experience of my dreams. The pain of the contractions was never unbearable for me. I simply did not have the strength, however, to labor for weeks on end. Something had to give.
The epidural worked quickly. Soon, I was a slack-legged, useless woman. I could do nothing for myself & needed help even turning around in bed. I could not imagine choosing an epidural on purpose, simply for pain relief. It made the labor so much more difficult, and I should note, it only dulled the piercing back pain & did not truly relieve it altogether. Of course, since I was on an epidural & pitocin, I needed a heart monitor, a catheter, etc. It was ridiculous. There were wires coming out of me from all sides. I made M take photos of me all plugged in to the birth machine. I tried my best to make a joke of it, since there was nothing I could do to change the course I was now on.
I passed the better part of the day this way. I tried my best to doze when I could, but it was difficult since the pain was still with me, although to a far lesser degree. The contractions intensified & I prayed they were having some effect on my dilation, but they remained totally irregular- the answer to which was to repeatedly up the pitocin levels. I had to keep turning around & around since the weight of my body was putting stress on the baby & causing his heart beat to do strange things. I tried to lay on my belly with my leg cocked up as much as I could, per the midwife's advice. We were still trying to turn this baby, although my ability to help matters was much reduced owing to the numbness in my lower body. About 8 hours later (around 3PM on Thursday), the midwife, Ellen Tilden checked me again (Linda had gone home). Again, I was dismayed to find that despite the pitocin I had still not dilated much beyond 6 or maybe 7 centimeters.
They upped my pitocin dosage & the contractions intensified. Around 5PM they decided to insert a catheter monitor so they could get a more precise idea of the strength of the contractions. Again, they checked me & discovered (yet again) that I had failed to progress whatsoever. They checked me at 9pm -7 centimeters, and then at 10PM -still 7 centimeters. Nothing was happening & that was bad news for me.
Meanwhile, I was unable to eat anything of substance all the while. I had a few high-protein Special K drinks & a few cups of miso soup. But I was obviously lacking in sustenance, especially considering the long hours of hard work I had been putting in. The baby's heart monitor kept acting weird & there was concern that all was not right inside my womb. I had to turn around a lot since it kept flagging & showing signs of distress (something called "persistent late deceleration"). After suffering almost 4 days of constant contractions, it was conceivable that my poor baby boy was getting worn out from his long passage. I was given an oxygen mask to wear in order to promote oxygenation to the placenta.
I had now been laboring for over 72 hours without rest, food or any sign that the end was in sight. It was growing hard to keep my eyes open and my focus was lost. I could hardly finish a sentence, I was so exhausted. Contant checks kept confirming our worst fears: that the baby simply was not turning. At this point it was becoming painfully clear that even if the baby turned & by some miracle I began to head towards full dilation, I may be unable to push him out owing to my great fatigue. If the baby did not turn & I dilated fully, there was no way on earth I would be able to push for the necessary hours & hours required to remove a backwards baby. I was running out of options.
We had one last ace-in-the-hole: we could rupture my bag of waters. Yes, by some miracle my waters had remained in tact all the while. This was an amazing stroke of luck as it allowed me to labor for as long as I had without fear of uterine infection. But now, with time running out, we decided to see if we could speed things along by breaking the waters. If the pitocin wasn't going to do it, maybe that would. And so, at 10:30PM the midwives finally ruptured my waters. Much to our dismay, there was a fair amount meconium in the water, further signs that my baby was suffering some distress & a fact which heightened our already considerable sense of urgency.
Another hour passed & there was no real sign that breaking the waters was having any effect. The contractions were still clearly in my lower back & while they were more intense, I was still far from feeling like I needed to push. Finally, at 11:30PM, Dr. Roseanne Botha (an obstetrician at OHSU) offered to try to manually turn the baby with her hand. She said she had had some success in the past and was willing to give it a try if I was willing. After so many days of pain, so many interventions, so many people wandering in & out of my hospital room, another totally invasive option seemed like no big deal. The doctor told me I would feel some discomfort when her hand went through my cervix. After what I had been through, I felt like nothing would bother me ever again. She inserted her hand, gripped his head & I could feel the tension in her arm as she tried like hell to twist his little body into a proper position. She tried several times, each time straining & working, her face tight with concentration. Each time she reported that she was able to twist him a bit, but that as soon as she loosened her grasp, he returned to his original position. This baby just was not interested in moving.
Finally, she offered to do a quick ultrasound to confirm what we all feared -that he was now fully posterior. The nurses dragged in a mobile unit and they lubed me up with jelly, much like in the past visits (those all seemed such a long-ago dream from this strange point of view). It was so odd to see my baby squirming around on the screen when within hours I would be meeting him face to face. I could hardly tell what was what since he was filling his tiny space entirely. The doc picked out arms, legs, abdomen and confirmed what we now knew to be true. He was completely backwards & all the efforts we had made to turn him (with exercises or with brute force) had been completely ineffective.
We waited several hours longer, hoping things would pick up but admitting to ourselves as each uneventful hour crept past that a vaginal birth was a lost cause. Finally, the midwives and obstetricians advised a cesarean section. They argued that while we could wait until it was an emergency, but it would be easier & quicker & safer to just schedule it as soon as possible. The baby's vitals were flagging, I was quickly turning into a comatose zombie, and there was really nothing else to be done. One last check told us all we needed to know. It was over.
Around 1AM Friday morning, March 6th, they wheeled me into the operating room. A massive dose of anesthesia through the epidural had left my entire body as limp as a wet rag. I felt heavy, cold and dull. My eyes were unfocused and blurry and I could hardly keep from unconsciousness from sheer exhaustion. The doctors hoisted me from my dolly onto a cold table. I was freezing cold & shivered violently, partially from the cold air but also I am guessing from the fatigue and shock at what I had been through. They lowered a blue screen in front of my face and told me to hold my arms akimbo. M was with me at my head, along with a midwife apprentice who was describing for me what she saw as we went along. I was told that they were ready to begin & that I would feel a little tugging. I could feel the sharp pierce of the scalpel and cried out that I could feel it. The anesthesiologist was at my head as well, and I could hear him scurrying around, upping my levels to kill the pain. I remember that M had the camera. I was insisting for some strange reason that he not watch, although I am glad that he did. It just seemed so terrible at the time. I did not want him to see me like that, all splayed open & bloodied.
The doctor told me that I would feel a little pressure. M told me after that it took three doctors to hold the wall of my abdomen open, each pulling with all their might on a great metal hook (this explains the horrible muscular pain after!). One of the doctors pulled my baby from my body. Once they removed him, the doctors informed M that he could go around to the foot of the operating table where he could see the baby. But the baby did not cry at all. The doctors rushed him over to a small table off to the side where M saw them administering mechanical resuscitation -some sort of pump-device to revive him. M says that he felt very tense at this moment and felt a great deal of tension in the room. I asked what was going on, since I could not hear my baby. The midwife told me that he had lots of hair. The baby finally gasped for breath & there was some indication from the doctors that he was indeed breathing fine...finally. M observed them perform the APGAR tests, the first in which he did somewhat poorly, & the second in which he passed with flying colors. All the while, the baby only cried once -one tiny cry. They bundled him up tight & handed him to M who brought him promptly around to the head of the table where I lay awaiting the first sight of my child.
I can hardly remember that moment -the moment when I first saw my baby. According to M, I was totally wasted. I remember trying to touch him, but he was so fully swaddled I could not get at him. I thought he was beautiful, of course. It took a while to stitch me up & M held him there near me while we waited for a chance for me to finally hold him.
As soon as they finished with the stitching, I was wheeled into recovery where I was handed my baby for the very first time. I was anxious to get the nursing started, but I struggled to hold him close to me as my IVs & my epidural & my swollen, sore abdomen made it difficult. I was instructed to try holding him in a football hold to initiate nursing, but I could not seem to get it right. I felt so out of it, light headed, dizzy -as though I were going to pass out. All the sounds in the room receded & I felt like it was unsafe for me to be handling a baby in that condition. I urgently instructed M to take off his shirt & I handed the baby to him -hoping that at least this child could bond with his father since I was apparently not going to be able to manage it. I informed the nurse that I was feeling off. The nurse, who was monitoring my vitals noted that my blood pressure was 80/20, & called out anxiously for the anesthesiologist who came running. She was clearly concerned. The anesthesiologist came to my bedside & looked me over anxiously. He asked me to squeeze his finger, but I was unable to manage any grip whatsoever. He asked me: "are you squeezing it as hard as you can?" -and I was. My hand, my body, was very nearly lifeless. I felt myself fading out of consciousness. The nurse called my name several times to bring me back, & each time she did I came back gasping from where ever I was going -great, alarming, & desperate gasps of breath -as though I were surfacing after a long, deep, submersion under water. I heard the anesthesiologist holler for a nurse to hold a bag of a new IV, some other drug intended to boost my blood pressure. My blood pressure responded by shooting up & they seemed concerned yet again that it was now too high.
I remember watching M at the foot of my bed, holding the baby who was furiously suckling at his naked chest. I thought for a moment that I was never going to get to hold my baby, that I was perhaps leaving him alone in this world with none but his poor dad to watch over him.
After several minutes of close monitoring, my vitals finally stabilized. I remember being intensely thirsty, but being told I could not have anything to drink until a certain number of minutes had passes. I was given ice cubes instead which were so unsatisfying. I let them melt & drank the water left behind, even though I was not supposed to. After an hour or so in recovery, we were informed that we were going to be moved. Unfortunately, all OHSU had available for us was a shared room.
We were horrified at the thought of sharing a room after what we'd been through. We so desperately needed some quiet & restful time alone together as a family. But the worst bit about having a shared room was not having to share the space with another family, it was the fact that hospital policy required that partners of new mothers in shared rooms leave the hospital at 10pm and spend the night elsewhere. In other words, M was not going be permitted to stay with me & assist me in those first difficult & crucial hours of motherhood. We pleaded with hospital staff to somehow find other arrangements for us.
We did manage to have the shared room to ourselves for those first few hours, however, so M was not made to leave immediately & we both did what we could to get some much needed rest. We were both so utterly shattered at this point -I don't think either of us have known exhaustion on this level -nor do we hope to again. Thankfully, the baby was as tired as we were. Poor M slept in a chair, all hunched over, while I slept in the bed, my brand new baby tucked in beside me sleeping peacefully.
When we awoke from our brief rest, we entertained our baby's very first visitor -B, our coworker & dear friend came to see us first thing. She brought with her a bag of treats -bagels & cream cheese from Noah's, a few cans of Guinness & a bag of Gummi Bears. We tucked right into the bagels since we were starving from our hard labor. I have so little memory of these events, however. I was in something of a wrecked daze, so much of what I am recounting here was told to me by M & B. B helped M dress Xavier for the very first time -a hospital photographer was scheduled to come & take his picture. I chose something for him to wear (the sleeper C gave me when I went to visit her pre-baby) & M gingerly wrangled wobbly limbs into arm & leg-holes & tried desperately not to break anything. It was clear by his gentle, wary hand that he had handled precious few babies in his time. B tells me that I showed off my beautiful little baby, exclaiming about how adorable he was & how over-cooked his hands & feet appeared (the guess was that he was actually overdue, despite arriving on my due date). I remember feeling so relieved that he was such a gorgeous baby -I know I would have loved him just the same had he come out strange looking, but it was delightful that he was so perfect. And because of the manner in which he met the world, his head & face was unmarred by a violent passage through the birth canal. He did not have the red bruises that are so common, nor the frightening conical shape to his head. He was perfect- a head full of thick, dark hair, a precious button nose, gigantic hands & feet & long, slender little fingers.
B didn't hang out long. She felt in the way, she said. The nurses were still fluttering around me, monitoring this & that. B said it was clear they were still somewhat concerned about my condition. She also said that we were still in something of a tizzy concerning our room situation, & she knew we needed to resolve that ASAP.
After she left, the charge nurse came in to our room to discuss the issue with us. I told her my long, dramatic story of protracted labor & a near-death experience. We informed her that it would be devastating for me to be left alone in such a vulnerable condition. She cried as she listened to me share my thoughts & recent experiences with her. It would be the first of many times I would tell my long & terrible tale. She managed to pull a few strings & in no time we were informed that a room had been arranged for us in a quiet, closed wing of the Mother-Baby unit. We were going to get our own room.
The room was a lovely, peaceful space with broad windows looking out over the hospital campus & a corner built-in cot for M to sleep on. We settled in & tried to get as much rest as we could.I was still hooked up to all sorts of wires & gadgets (the IV is left after c-sections in case an infection develops) & I stayed that way for a while. I wound up staying in the hospital for 5 days -the longest stay permitted. I felt like I needed that much time to come back to some semblance of normal after my intense & terrible ordeal. I needed to recuperate physically, but also emotionally. I needed someone to fetch me dinner & nurses to teach me how to get my baby to latch on properly (thankfully, nursing went swimmingly -I could not have dealt with difficulty in that arena after what I went through). I needed more rest than was possible, considering I was a new mother to a very needy baby.
As for baby X?- yes, I realize he's almost a bit player in this massive drama. And that is honestly how it felt at the time. He was so relaxed & peaceful, despite having gone through the ringer with me. He slept the bulk of his first 24 hours, prompting M to think we were home free. When X started fussing & crying & non-stop nursing during the second 24 hours, M seemed somewhat alarmed. But he was just doing the necessary work to get my milk production going. The hospital had a lactation consultant on staff that attended on us daily, observing how things were going, offering helpful tips to make things easier for us. The nurse came in hourly during those first endless nights & helped me sit up, turn over & get him latched on (moving at all was terribly difficult which obviously complicated everything).
I was quite heavily dosed with Percocet & Ibuprofin, so my recollection of those early days is terribly foggy & incomplete. I feel immense regret that this was the case. I have a few photographs that help to bring me back, but much of the sense of that precious time is lost to me completely.
And so I conclude this birth story. It is not the story I had hoped to tell. I have not had the heart to resurrect my pathetic birth plan to see how far my fantasies were from the facts on the ground. Nothing went according to the plan. It is a year on, almost to the day, that I write these concluding thoughts & while I have healed physically, I still have loads of healing to do in other areas. I dread contemplation of how we will bring baby #2 into this world (yes, there will be a #2). Will I attempt a VBAC? -Will I be allowed to do so naturally or will a loathsome epidural be required "in case" of emergency? Nothing would please me more than an opportunity to try again. A successful VBAC would be the most healing act imaginable, but I cannot count on it. I need to be prepared for the possibility of another miserable, disappointing & utterly frightening experience. And the thought that I might wind up in similar circumstances terrifies me, almost enough to want to skip another kid altogether. Almost, but not quite....
Wednesday, March 3, 2010
Tuesday, March 2, 2010
the new swing
A big parcel arrived in the post today from my parents -a lovely, hand-made wooden swing. We knew it was coming & we could hardly wait to get it hung & give it a test run. I wrapped the cords around a few apple boughs, tried to level it as best I could (it is a little wobbly, I admit), & promptly stuffed X in to see how it played. He smiled from ear to ear as I pushed him back & forth & explained to him that now we didn't have to go all the way to the park to enjoy a little swinging -we could come outside any ol' time we wanted & give it a go. He spent more time in that swing today than you'd believe, & I suspect it will get a lot of use in the months to come. And it's beautiful to boot.
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