Friday, March 20, 2015

Part IV: Delivery

A couple years ago, when Beyonce had Blue Ivy, I read that JayZ got her a "push present" to thank her for having his baby and all. I thought it was kind of weird and kind of sexist. "Ooh, you made me a baby--here's a present." Anyway, when it was all over and I was sweaty, weeping, covered in unspeakable slime, incredibly sore and exhausted, I didn't know much, but I knew that I was getting myself a freakin push present.

After the swab turned blue, things happened very fast for a while. I was hustled back to a room and swapped all my clothes for a hospital gown. I would never see my clothes again. (Seriously, they threw them away or something--it was a sad, sad turn of events).

I hopped into bed. Just kidding, remember how I was in such bad shape? It was more of a sad beached-whale roll.

They hooked up the monitors. Baby was still doing her merry dance--meaning she was unwilling to hold still and I kept having to have the monitor adjusted. Over and over. My IV was installed without violating the cruel and unusual punishment clause.

My birth plan came out again. Oh, sad, sad birth plan. Brandon's gonna cut the cord. I'm gonna keep the placenta and plant it at the base of a santa rose plum tree in the Spring. I'm gonna do kangaroo care for at least an hour after birth and begin breastfeeding. I'm gonna help deliver my own baby. I'm not gonna have my baby under a heater. I'm not going to formula feed my baby. I'm gonna watch my own delivery with a mirror....I did get the mirror!

It was about 8pm or so when I was finally all snug in my bed. They had talked about maybe having to induce me if I didn't progress, but by the time they checked my cervix, I was already a 5! I was shocked to learn that I was actually having contractions because I really wasn't feeling them. But apparently, they were there, and regular. Take that, basically everything that was said to me last episode during all my false labors!

I waited around, but the contractions never really got that bad. Some were stronger than others. But none were really unpleasant. I was just so happy to be there actually having the baby.

I was really scared of missing my window to get the epidural. Really really scared. Every time we'd been to the L&D we'd heard at least a couple of people who had waited too long to get the epidural (though they were planning on it). The screams were horrible! It is so terrifying to listen to someone clearly in the most pain they've ever been in and to think to yourself, this is gonna be me in a few days!

The nurses said that you had to be able to hold still for 15 minutes to get the epidural so the cut off point was when you couldn't hold still for that long. So as soon as the contractions got strongish, I asked for the anesthesiologist.

I got two! One was a resident and one was an attending. They did not get along. Brandon had to leave the room because it was a sterile procedure. I sat on the edge of my bed and they lifted the bed way up so my back was level with the eyes of the anesthesiologist standing on the other side of the bed. The resident was nice. The attending was not. She kept telling me to shift left and I was trying but I was still a beached whale and was apparently not quick enough for her. She kept saying "No! Go left!" So one of us was messed up on that, too.
The nurse put a rolling stool under my feet and I had to curl myself around a pillow. I had a blue surgical cap on. The nurse had a cap and a mask. I don't know what the anesthesiologists had on because I wasn't supposed to look back there on pain of paralysis. It was a scary and uncomfortable set up. And that was before the anesthesiologists started arguing.

First they injected lidocane. It burned a little going in and was unpleasant but I was just thinking don't move don't move don't move don't move don't move the whole time. They made several injections up and down the spinal column. The anesthesiologists argued over whether the resident was actually shooting the stuff right in the center and I had to tell them whether or not it was center or right or left. I learned that the back is not a precision sensory instrument.

The attending would yell at me if I didn't tell her fast enough or loud enough, even though my face was muffled in a pillow. She yelled at the resident that he wasn't centered enough, who would snarl back that he was fine. Because the attending was stressing so much, I was freaking out and maintained a running dialogue of where I felt sensations.
Me: I think it might be slightly to the right...
Attending: WHERE?!
Me: "Um...very, very slightly to the right--but really really close to the center."
Attending: "WHERE?"
Me: "Um...still a tiny bit rightish."
Me: "Right, I guess."
Resident: Okay. I moved it.
Attending: IS IT CENTERED?
Resident: It's centered.
Attending: It looks slightly to the right.
Attending: IS IT CENTERED?
Me: Me? Oh, yeah...I think it's centered now.
Me: Uh.......
Me inside my head: I'm paralyzed, I'm paralyzed, I'm paralyzed, I'm paralyzed, I'm paralyzed, I'm paralyzed.

Once the thing was in, it was a little bit better, but they still fought over everything. Because of this fighting, I thought for sure I was gonna leave the room in a body bag. At one point, while they were fighting over the placement of the sticker thing that holds the epidural needle in, I thought about turning around and yelling at them that there was only supposed to be one baby in the room and she wasn't here yet. But I was afraid the attending would choke me to death if I didn't shut up and squeeze my pillow.

At last, they finished. I had had to hold still for like 45 minutes. It wasn't that hard because the terror kept any contraction pain at bay. I resettled myself in bed. The epidural was uncomfortable--mainly because of the big sticker that pulled at my skin when I laid down. I ended up having a wicked-looking bruise. Well, actually, it looked like the outline of racist Indians' mascot Chief Wahoo. But other than that, no lingering effects.

The attending left and I asked the resident how soon I would know if I had nerve damage from the epidural. He reassured me and then tested my pain response with this little plastic pokey thing. The goal is "pressure, not pain." Later the attending came back. She asked me if the resident had done the poker thing. I said he had. She said, "The pain dampening works from the outside in. If I were to poke your vagina with that tool, you'd still feel the sharp pain." She was a nice lady.

I'd probably do the epidural again, though maybe later on in the process, and I'd definitely ask who the anesthesiologist was, first.

Then came the waiting. I slowed waaay down. They started me on pitocin. They took me off of pitocin because Jelly's heart rate was decelerating. They started me up again. They stopped me. They gave me some extra fluids. They stopped me. They checked me. I was progressing so slowly. So so so slowly.

They came in and broke my water. I know, my water was broken already--but it was like a little bulging side sac and the baby was holding the rest of the sac shut (or something like that--I'd been very hungry and watching Brandon eat a box of triscuits while he walked around the room for like 10 hours straight). So they used a little crochet-hook-looking thing to break it. There was the big gush. It was so gross. Later, when one of my nurses was reassuring me that I did still want to have a baby, she sat on the bed and got it on her bottom! They kept having to change my sheets over and over. Baby would make more amniotic fluid (they said she was peeing) and it would gush out every once in a while. I'm only telling you this because nobody warned me to bring a poncho to the hospital.

So there I am, wet, gross, tired, and not progressing. And then I get chills. They started small and then they started to grow until my whole body was spasming uncontrollably. I was freaking out. The nurses said it was normal and I knew this could be transition, but it was so scary. I had Brandon fetch my mouth guard because my teeth were chattering so much I was afraid I was going to grind my teeth up.

Turns out I had a fever. The docs guessed that I had a uterine infection because my water had been broken for so long. That meant goodbye placenta. Goodbye kangaroo care. And goodbye (temporarily) Jelly, because she'd have to go to the NICU to be evaluated. This was a bummer.

Despite this emotional setback, I was physically so broken down by this point that when they suggested I would get a C-section if I didn't progress in the next hour, I was actually kind of relieved. In the mean time, they wanted to get my fever down. When I first had the chills so badly, I curled up in my bed and had Brandon put extra blankets on me. I was afraid I couldn't go on. I was ready to go home and try again another day. Or just raise Jelly inside my belly.

I was crying and so scared and shaking so hard. The lights were off in the room and I just felt so alone. Brandon asked what he could do, and even though he'd had extensive practice with massage and coaching, the only thing that helped was very gently rubbing me on one shoulder while I was huddled up. Somehow, this was so soothing. But what really calmed me down was when I started talking to the baby. I told her that I was sorry, but I was sick, and I needed her to be strong and come out soon. I talked and talked. I explained the altered birth plan and how excited we were to see her and how I would try to be strong for her. Eventually I stopped talking out loud and just talked to her in my mind. Really feeling our new family dynamic for the first time, I felt like I could do it.

But there were two more really hard parts. The first was just after this, when they told me they needed to get my fever down so I could have the baby. They gave me antibiotics, and they gave the baby, through me, extra fluids. I had to start drinking lots of ice water. They took my blankets away. Then they told me I had to put ice packs under my arms to help cool off. I thought I had died and gone to hell.

I didn't think I could do it, but I did it because I had to. That became the theme for the rest of the evening.

There was a shift change and my OB came in! She was on call and was going to deliver my baby. At this point, she was more committed to my birth plan than I was. The resident had been somewhat conservative in her measurement of my cervix. I was like 9 and 9/10ths or something, with a tiny sliver of cervix left. My doctor said it was okay to start pushing.

This is where the nurses saved the day. All through this experience, they were there with pep talks, cold drinks and encouragement. When my OB left and everybody was getting ready for me to push, my nurses were just about to change shifts, too. One of my nurses was named Lauren. Brandon was in the bathroom and she was the only other person in the room. I started crying and told her I didn't think I could do it. It had been so hard. I was tired. I was sick. I couldn't push. My OB had said we'd push for 2 hours and then if I wasn't making any progress, I'd have a C-section. Even if I did progress, it could take two and a half to three hours to push the baby out.

I already felt like I had run a marathon. Now I had to sprint for three hours. I told Lauren how scared I was and how inadequate I felt. I told her how I just wanted a stupid C-section now, even though I really had wanted a vaginal delivery. She gave me the best pep-talk of my life. She sat on the bed and put her arms around me and told me I could do it. She said all I needed to do was focus. She was truly an angel. I am not much of a physical affection person; this is especially true with someone I don't know very well. But this moment was one of the most meaningful moments in my life. I will be forever grateful to her.

My OB came in and explained pushing. I was supposed to push like I was pooping, but the biggest poop ever. I would push for a ten-count during each contraction, and then rest. My incredibly versatile hospital bed was equipped with many ways to assist in this task.

"Ready?" She asked.
I was not. But I helped position my legs on the bar that had been assembled over the bed. My feet pushed against the bar, I curled my body around the baby and pulled my thighs toward me and I pushed the way everybody my whole life had told me not to push while I was pooping. It was weird to break my ingrained aversion to pushing this way. I could definitely feel the pressure when I pushed, but it took me a while to feel the contractions. The nurses would tell me one was coming, and then I'd take a deep breath and we'd all do the count of ten together. I wasn't supposed to breathe when I did this, so I counted in my head. They had wheeled a big mirror in front of me so I could see what I was doing, and it really helped me see where I needed to push.

I would push as hard as I could and then gasp in sobbing breaths of air. They had me on oxygen for baby and they'd take off the mask while I pushed and then place it back on my face when I rested. Sometimes I'd do two or three ten-counts per contraction. I eventually got to the point that I could feel the contractions--but I was still really unsure, so every single time I would say, "I'm going to push now?" and then my doc or a nurse would say, "okay" and then I'd go. Every. single. time. for an hour and forty minutes.

It was crazy. I kept thinking about what Lauren had said and made a conscious effort to focus. It was the only way to not just go insane and run screaming out of there with the baby half in and half out of me. I focused on each ten-second session like it was the only one I had to do. When I lost focus, I'd sit a contraction out.

I freaked out twice. The first time, the oxygen mask got to me. Brandon put it on me and it suddenly felt like I was suffocating, like he was grinding it into my face. I yelled and hurt his feelings. The second time happened after I switched pushing positions. They had pulled up handles for me to pull on when it was time to push. It really really helped, but I partially pulled out my own IV with my thigh! My forearm filled up with fluid and I couldn't bend my arm anymore. I gasp-yelled about it and kept gasp-yelling until they gave me a new IV in my upper arm on the other side. I was still pushing as it went in.

I pushed and pushed. For the first long while, nothing happened. I would watch in the mirror as I pushed and you couldn't even tell I was doing anything. I was working so hard and nothing was happening. I found myself repeating Lauren's mantra. Focus. Focus. You can do this.

I just kept pushing and pushing. I couldn't think about the end result. I just had to focus on the next ten seconds.

When her scalp finally started to show, it was fantastic. I was suddenly motivated to keep going and going. It was so exciting to see her progress further and further. Eventually, my OB asked if I wanted to touch baby's scalp. This was what almost derailed me. I started crying. My sweet baby was real, and she was almost here! I had to really, really pull myself back to focus.

The pressure was intense and it just kept growing and growing. At one point my doc had to step away and get ready to pull Jelly out. I didn't know if I could keep pushing. Nobody was at the station. Resisting against pushing was so hard. As much as I wanted a break, I really couldn't stop. The pressure was horrible when I pushed but I knew I was just one serious pain bout away from being done. But it was so hard. Her head just wasn't coming out.

The nurses switched. Lauren had stayed beyond the shift change until the new nurses were scrubbed in. I was sad she didn't get to see Jelly be born. I yelled my thanks as she left. I barely noticed the new nurses, except that one of them was way far off the count when I would start pushing. I had been breathing out slowly to sustain myself during the pushing. I would start my mental count, and when I would get to six (I was counting slowly, I swear!) the nurse would start counting "One...two...." It was horrible. I had no energy left or I would have smacked her. I also didn't have the energy to scream at my OB to just take the baby out. Her head was just stuck there for so long.

The nurses kept saying, "just a few more," and I kept pushing and pushing. Please. Please. Come out!! 

At some point, more people came in the room. I noticed them around the edges of the room. My legs got moved and I think about five or six people were holding each leg as I pushed.  It felt like they stretched on forever. One more huge huge push and I felt her squish out!

I missed it! I had had my eyes closed while I pushed, so I didn't see it in the mirror!

Here's the scary part. My OB said, "I'm just gonna cut the cord real quickly because she's a little stunned." As she said this, she cut the cord and handed a red-purple blob that I assumed was the baby off to the NICU team that had suddenly materialized in the room now that I didn't have to be focused on pushing. I was sobbing with relief that all the pressure was over.

But the baby didn't cry. I was waiting and waiting for that and she wasn't crying. I heard someone say, "she's not breathing." There was a crowd around her at the warming table. I couldn't see her. Someone else said, "I can't get the heart beat" and that was terrifying, but my OB told me it was because the heart rate machine was malfunctioning. The NICU folks muttered among themselves. The warming table blared an alarm. I kept sobbing out, "is she okay?" The room was very quiet. Then, "time of birth 7:54pm."

I started crying harder. She was alive.

We waved to her as they wheeled her off in the incubator.
We got to visit her that night. The next day, I was sleeping and Brandon went to see her. I got a call from the NICU. It was Brandon. He said, "I'm holding our baby." I got there as quickly as I could. She was beautiful. She was mine. She was here.

I haven't stopped marveling at my beautiful baby. It has not been an easy transition for me. I had debilitating anxiety in the beginning that still pops up in the evenings. I thought my body might be permanently destroyed, but once I shed the retained water, things started to get better. Becoming a stay-at-home Mom, at least for the time being, has been really hard. Breastfeeding did not go at all as planned. But at least once a day, I hold my miracle in my arms and marvel at the gift God has given me. My sweet girl. My lovely baby. My wonderful Amelia Margaret.


JerieH said...

Thank you for sharing! I cried, I laughed, and best of all I remembered my sweet babies births and now I am going to sneak into their rooms and snuggle them.

kjirsti said...

Thanks for sharing this, Anne. During one visit to my grandmother's she said "Every time I walked into the hospital to have one of my babies I would think "I may never come out of here." It's a bit of a morbid thought, but unfortunately a realistic one- especially in her day. Childbirth is really one of the more scary things most women experience, as you can bare witness. In wondering "why does it have to be so hard?" I can only think- because once you have been through that, you realize "I can do anything!"
You're powerful Anne. You're capable. You're dear.