Plans mean nothing. Welcome to parenthood.
I ended up using my “birth plan” to sweep the floor.
I was going to have the perfect pregnancy followed by the perfect all natural birth resulting in a perfect child. I was confident I had done everything right. I read all of the books. I knew the risks of every anesthesia option. I visualized my way through “hypnobirthing” classes. I have a team of doulas ready with birthing balls, acupressure massage techniques, and 1,001 ways to talk me out of an epidural. I knew things could go wrong but they weren’t going to go wrong at my birth. I’m the picture of perfect health after all.
The universe has a way of chopping off the over-confident at the knees.
Let’s start this birth story a few weeks ago, at my 36-week routine appointment. Mildly elevated protein levels were found in the cup I peed in, a sign of pre-eclampsia. I had no idea how they got there, since my blood pressure was the picture of normalcy at 118/70. The doctor ordered a blood workup to determine if my liver and kidneys were functioning correctly. The tests came back normal.
Except they couldn’t count my platelets. That part had to be rerun. But they were sure it would be fine.
At my 37-week appointment, protein again appeared in the cup. Again my blood pressure was normal. The doctor said some elevated protein levels are normal for the end of pregnancy. Oh and they still couldn’t get a platelet count. Would I go over to the hospital and have them draw the blood there?
Thursday, April 12. At my 38-week appointment, the protein count is very high. My blood pressure remains normal. My platelets are low. The doctor suspects HELLP syndrome, a severe form of pre-eclampsia which affects the mother’s ability to clot blood. She thinks the baby may have to come out sooner than expected, as this syndrome can lead to seizures in me and prevent the flow of oxygen and nutrients to the baby. She orders me to collect all of my pee in a jug for the next 24 hours, which I faithfully do and deliver dutifully to their lab on Friday afternoon.
Fearful of an induced labor, which can lead to all kinds of complications, I spend the weekend trying every old wives labor inducer in the book. Nothing happens.
Monday, April 16, I go back to the doctor. The nurse takes my blood pressure and immediately tells me to lie down on my left side. She takes it again. She tells me to stay put. The doctor comes in. I have ten times the legal limit of protein in my urine. A normal quantity is 300-400 mg in a 24-hour period. I have 4 GRAMS. In addition my BP is now 145/100.
Go to the hospital. Do not pass go. Do not stop at home to get your things. The baby is coming out NOW and if I’m lucky I won’t get killed in the process.
I get in the car and frantically call Todd. Come to the hospital now. Why? He asks. Why? Why do you think? I yell at him to just get there and hang up on him. I call my mother. I’m crying. I’m not ready to have the baby. I don’t know what will happen. I don’t know if everything will turn out ok.
I arrive at the hospital, walk up to labor and delivery, and check in. The doctor has called ahead and they are ready for me. They bring me to a room where I am promptly told to totally undress and leave a urine sample. There is a clear plastic basin at one end of the room which I know is to hold the baby. The baby goes there. MY baby goes there.
I sit on the bed for a few minutes until a nurse comes to take all of my vitals and draws blood. The on-call midwife from my OB practice comes in, examines me, and tells me I’m a good candidate for induction, as I’m already fairly far progressed, with my cervix dilated to 2.5-3 cm and 80-90% effaced. In fact, I’m almost at the end of the first phase of labor.
The nurse comes back and hooks me up to an IV. This is thing #1 on my birth plan that I didn’t want, because I wanted to be mobile to deal with the pain, and I also hate needles to the point where 50% of the time I am stuck with one I faint. Which would be one way to solve my blood pressure issue. But I know with my complications there’s no avoiding it so I don’t even ask about it. I just ask her to put it in my arm rather than my wrist and to tape it down so tightly it can’t possibly move and I can’t possibly see any tubing coming out of my skin.
Todd shows up. We sit and wait. He tries to arrange care for the dog over the phone. He thought he would go home later and take care of her. He gets yelled at by me again for thinking that he’s going to get to leave at any point in this process. He finds a friend to take the dog until we come home. He has to leave to let her in the house, and fetch my glasses and contact lens solution, which he forgot to pack.
An hour later the nurse needs to draw more blood for a manual platelet count. The stupid cells still refuse to show up under the microscope. She returns 15 minutes later and draws more blood.
Now I’ve been at the hospital 2 hours. Shift change. A new nurse comes in with the on-call obstetrician, who informs me that we will induce labor with Pitocin, a hormone that causes the body’s smooth muscle tissue (including the uterus) to contract, and I’ll also be on magnesium sulfate, an anti-seizure, which conveniently counteracts the effects of the Pitocin by relaxing all smooth muscle tissue. In other words, it will be a bumpy ride. Because magnesium sulfate relaxes muscles to the point where moving is very difficult and vomiting is almost a given, I will not be allowed to eat or to leave the bed and will have a urinary catheter. Oh and I can’t have an epidural because my platelet count is too low. It’s give birth with no pain medication in the worst possible position (tied flat on my back in bed) or have a C-section under general anesthesia. I agree to start the Pitocin.
Two nurses come in and start hooking up about 5 lines to my IV. This takes them roughly another half hour. Todd returns. The doula, Mary Beth, arrives. We sit back and wait for labor to start.
The labor floor is full tonight, and the fetal monitor shows the information for every room. I can see myself, with a flat line for contractions and a healthy rhythm showing for the baby’s heartbeat, as well as 10 other women up and down the hall. Not one is in active labor. The nurses have said that everyone is being induced. Must be the weather.
It’s now about 10 PM so we turn the lights down and settle in. Todd has brought relaxing music to listen to, but I am content just to listen to the gentle gallop of the baby’s heartbeat on the monitor. She is cruising along at 140 beats per minute, completely oblivious that there’s anything wrong with me. The staff is happy with her performance.
Several hours pass. The automatic blood-pressure cuff goes off every 15 minutes. It tightens to about the tightness of a normal cuff, then tightens some more. My hand turns purple every time.
The nurse comes in once per hour or so and asks me how my pain is. I have none. I’m showing mild contractions on the monitor. She readjusts the monitor every single time. She ups the dosage of Pitocin. Around 1 AM I fall asleep for an hour. When I wake up, my legs are wet. I tell Mary Beth I think my water has broken. She gets the nurse. I tell the nurse I think my water has broken. She looks at the fluid, looks confused, and gets a pH test strip. We sit around the bed excited that my water may have broken, because it means labor will speed up now. But it’s not my water. The nurse doesn’t know what it is.
We sit awake until 5 AM and then fall asleep. The nurse continues to ask me every hour how my pain is. I continue to say I have none. The nurse can see contractions happening in my belly, but can’t get the monitor to pick them up. We all hope I am a very lucky woman who will have a relatively painless labor.
At 9 AM Tuesday morning the obstetrician who sent me over last night comes in. She examines me and finds I’m still 3 cm dilated and 90% effaced. No progress. I am not one of those lucky women. Everyone is confounded as I have been on the maximum dose of Pitocin for many hours. According to everyone with experience, I should be in “head-bangin’” labor by now. The doctor says she will break my water and see if that starts things, but if I haven’t made substantial progress in the next 4 hours, I will be having a C-section with general anesthesia. It’s too dangerous to leave the baby in any longer.
As we have a conversation about how things might go, the first strong contraction happens. It appears breaking the water has done the trick. In another 5 minutes or so I’ve had two more strong contractions that require concentration to breathe through. I’m starting to feel pain in my back. Mary Beth gets out a rice-filled bag to heat and place on my back, which promptly explodes everywhere. Todd uses a copy of the birth plan to scoop up the rice.
I start doing my breathing exercises to get through the contractions. Todd reads birth affirmations to me. The doula speaks in soothing tones. It’s nothing I can’t handle so far. Contractions are about 4 minutes apart and last a minute a piece, which Mary Beth says is good.
At about 11 AM the contractions start to feel very intense. They have speed up and last even longer. I start to think I can’t get through them. Mary Beth thinks I’m probably not near the hard stuff yet. I start to think I probably have several more hours of intense contractions to go. I have a few more “I can’t do this” moments and a nurse enters the room. She tells me if I want an epidural we can do bloodwork to see if my platelet count is any better. It will take an hour so it would be best to draw it now. At this point, the midwife, Patrice, enters the room. She examines me and declares it’s way too late for that. I’m already a good way into transition and says I’ll be pushing in under an hour.
This lightens my mental state considerably. I’m almost through with what everyone tells me is the hardest part of labor. From there everything seems easier. Todd and Mary Beth continue to whisper relaxing affirmations in my ears during contractions. The midwife shows Todd how to put pressure on my tailbone to ease my back pain, which works miracles.
The next hour passes in a blur. Soon Patrice is sitting on the edge of the bed, asking me if I feel the urge to push yet. I tell her I feel like I need to take a big dump. She says that’s good. She examines me and says I’ll be there soon.
Soon I start feeling like I want to relieve myself, and I think this is the urge to push, but I’m not sure. Every time I bear down I have tremendous pain where the catheter has been inserted, so thankfully that gets removed. I have an easier time after that distinguishing the sensations that I’m supposed to be feeling, but I’m still confused. Pushing isn’t really instinctual. It’s partly like going to the bathroom yet totally different. The midwife has to coach me in a few different positions to get it right.
Soon the baby is crowning. All standing at the bottom of the bed say they can see she has dark hair. The midwife asks me to watch in a mirror, which I don’t really want to do, but she says it will help me push. What I see is the baby’s head coming out with each push and getting sucked back in every time. I am upset because every birth video I saw in childbirth class showed the babies flying right out. That’s when I started cussing.
Pushing is more arduous physical work than I have ever experienced. Even if I had had pain medication, that aspect wouldn’t have been taken away. I am sweating and panting. My blood pressure is up to 160/110. I say I can’t do it. The midwife says “OK, I’ll just pack up and go home then.” I want someone to reach in and grab the baby. Use the forceps. Cut me open. I don’t care. But there’s no way out of this except to run through the burning building.
Todd and Mary Beth each have one of my legs and have been telling me to use them for leverage. The midwife decides that’s not working. I have to run this part of the race myself. They let go, stand back and chant with each push. I close my eyes and they disappear. There are roughly 30 people in the room all cheering as if I’m running down the home stretch of the Olympic marathon, but I can’t hear a single one of them. I head down a long black tunnel and feel only the overwhelming effort crushing down on me like ten tons of water.
“Take your baby.”
I hear it at the end of the tunnel like a deaf person hearing for the first time and the world explodes into light. I reach down and pull the baby up onto my stomach. She is warm and creamy. She is not crying. She is looking around taking in the explosion. A thousand hands reach in to dry her. Todd is standing over me crying.
But I’m not crying. I expected to cry with an overwhelming sense of accomplishment. I cried at the finish of my first marathon. Look what I did! But I can’t. I feel no pride or accomplishment. I haven’t run a race and crossed the finish line.
In the moment her body has become separated from mine, I lose myself. I am forever part of this tiny person, and I have ceased to exist.
Johanna Patricia was 7 pounds, 2.1 ounces, and 18 inches long. They took her up to the nursery and pronounced her in perfect health, oblivious to all my concerns. I lost a fair amount of blood due to the clotting problem, and stayed in the hospital for two days longer than normal, but my health problems resolved themselves. Jojo, Todd and I are all resting at home, looking forward to our new life together.
Pictures from Jojo's birth are here: http://www.kodakgallery.com/Slideshow.jsp?mode=fromshar...hktse&Uy=p4c9ys&Ux=1
I was going to have the perfect pregnancy followed by the perfect all natural birth resulting in a perfect child. I was confident I had done everything right. I read all of the books. I knew the risks of every anesthesia option. I visualized my way through “hypnobirthing” classes. I have a team of doulas ready with birthing balls, acupressure massage techniques, and 1,001 ways to talk me out of an epidural. I knew things could go wrong but they weren’t going to go wrong at my birth. I’m the picture of perfect health after all.
The universe has a way of chopping off the over-confident at the knees.
Let’s start this birth story a few weeks ago, at my 36-week routine appointment. Mildly elevated protein levels were found in the cup I peed in, a sign of pre-eclampsia. I had no idea how they got there, since my blood pressure was the picture of normalcy at 118/70. The doctor ordered a blood workup to determine if my liver and kidneys were functioning correctly. The tests came back normal.
Except they couldn’t count my platelets. That part had to be rerun. But they were sure it would be fine.
At my 37-week appointment, protein again appeared in the cup. Again my blood pressure was normal. The doctor said some elevated protein levels are normal for the end of pregnancy. Oh and they still couldn’t get a platelet count. Would I go over to the hospital and have them draw the blood there?
Thursday, April 12. At my 38-week appointment, the protein count is very high. My blood pressure remains normal. My platelets are low. The doctor suspects HELLP syndrome, a severe form of pre-eclampsia which affects the mother’s ability to clot blood. She thinks the baby may have to come out sooner than expected, as this syndrome can lead to seizures in me and prevent the flow of oxygen and nutrients to the baby. She orders me to collect all of my pee in a jug for the next 24 hours, which I faithfully do and deliver dutifully to their lab on Friday afternoon.
Fearful of an induced labor, which can lead to all kinds of complications, I spend the weekend trying every old wives labor inducer in the book. Nothing happens.
Monday, April 16, I go back to the doctor. The nurse takes my blood pressure and immediately tells me to lie down on my left side. She takes it again. She tells me to stay put. The doctor comes in. I have ten times the legal limit of protein in my urine. A normal quantity is 300-400 mg in a 24-hour period. I have 4 GRAMS. In addition my BP is now 145/100.
Go to the hospital. Do not pass go. Do not stop at home to get your things. The baby is coming out NOW and if I’m lucky I won’t get killed in the process.
I get in the car and frantically call Todd. Come to the hospital now. Why? He asks. Why? Why do you think? I yell at him to just get there and hang up on him. I call my mother. I’m crying. I’m not ready to have the baby. I don’t know what will happen. I don’t know if everything will turn out ok.
I arrive at the hospital, walk up to labor and delivery, and check in. The doctor has called ahead and they are ready for me. They bring me to a room where I am promptly told to totally undress and leave a urine sample. There is a clear plastic basin at one end of the room which I know is to hold the baby. The baby goes there. MY baby goes there.
I sit on the bed for a few minutes until a nurse comes to take all of my vitals and draws blood. The on-call midwife from my OB practice comes in, examines me, and tells me I’m a good candidate for induction, as I’m already fairly far progressed, with my cervix dilated to 2.5-3 cm and 80-90% effaced. In fact, I’m almost at the end of the first phase of labor.
The nurse comes back and hooks me up to an IV. This is thing #1 on my birth plan that I didn’t want, because I wanted to be mobile to deal with the pain, and I also hate needles to the point where 50% of the time I am stuck with one I faint. Which would be one way to solve my blood pressure issue. But I know with my complications there’s no avoiding it so I don’t even ask about it. I just ask her to put it in my arm rather than my wrist and to tape it down so tightly it can’t possibly move and I can’t possibly see any tubing coming out of my skin.
Todd shows up. We sit and wait. He tries to arrange care for the dog over the phone. He thought he would go home later and take care of her. He gets yelled at by me again for thinking that he’s going to get to leave at any point in this process. He finds a friend to take the dog until we come home. He has to leave to let her in the house, and fetch my glasses and contact lens solution, which he forgot to pack.
An hour later the nurse needs to draw more blood for a manual platelet count. The stupid cells still refuse to show up under the microscope. She returns 15 minutes later and draws more blood.
Now I’ve been at the hospital 2 hours. Shift change. A new nurse comes in with the on-call obstetrician, who informs me that we will induce labor with Pitocin, a hormone that causes the body’s smooth muscle tissue (including the uterus) to contract, and I’ll also be on magnesium sulfate, an anti-seizure, which conveniently counteracts the effects of the Pitocin by relaxing all smooth muscle tissue. In other words, it will be a bumpy ride. Because magnesium sulfate relaxes muscles to the point where moving is very difficult and vomiting is almost a given, I will not be allowed to eat or to leave the bed and will have a urinary catheter. Oh and I can’t have an epidural because my platelet count is too low. It’s give birth with no pain medication in the worst possible position (tied flat on my back in bed) or have a C-section under general anesthesia. I agree to start the Pitocin.
Two nurses come in and start hooking up about 5 lines to my IV. This takes them roughly another half hour. Todd returns. The doula, Mary Beth, arrives. We sit back and wait for labor to start.
The labor floor is full tonight, and the fetal monitor shows the information for every room. I can see myself, with a flat line for contractions and a healthy rhythm showing for the baby’s heartbeat, as well as 10 other women up and down the hall. Not one is in active labor. The nurses have said that everyone is being induced. Must be the weather.
It’s now about 10 PM so we turn the lights down and settle in. Todd has brought relaxing music to listen to, but I am content just to listen to the gentle gallop of the baby’s heartbeat on the monitor. She is cruising along at 140 beats per minute, completely oblivious that there’s anything wrong with me. The staff is happy with her performance.
Several hours pass. The automatic blood-pressure cuff goes off every 15 minutes. It tightens to about the tightness of a normal cuff, then tightens some more. My hand turns purple every time.
The nurse comes in once per hour or so and asks me how my pain is. I have none. I’m showing mild contractions on the monitor. She readjusts the monitor every single time. She ups the dosage of Pitocin. Around 1 AM I fall asleep for an hour. When I wake up, my legs are wet. I tell Mary Beth I think my water has broken. She gets the nurse. I tell the nurse I think my water has broken. She looks at the fluid, looks confused, and gets a pH test strip. We sit around the bed excited that my water may have broken, because it means labor will speed up now. But it’s not my water. The nurse doesn’t know what it is.
We sit awake until 5 AM and then fall asleep. The nurse continues to ask me every hour how my pain is. I continue to say I have none. The nurse can see contractions happening in my belly, but can’t get the monitor to pick them up. We all hope I am a very lucky woman who will have a relatively painless labor.
At 9 AM Tuesday morning the obstetrician who sent me over last night comes in. She examines me and finds I’m still 3 cm dilated and 90% effaced. No progress. I am not one of those lucky women. Everyone is confounded as I have been on the maximum dose of Pitocin for many hours. According to everyone with experience, I should be in “head-bangin’” labor by now. The doctor says she will break my water and see if that starts things, but if I haven’t made substantial progress in the next 4 hours, I will be having a C-section with general anesthesia. It’s too dangerous to leave the baby in any longer.
As we have a conversation about how things might go, the first strong contraction happens. It appears breaking the water has done the trick. In another 5 minutes or so I’ve had two more strong contractions that require concentration to breathe through. I’m starting to feel pain in my back. Mary Beth gets out a rice-filled bag to heat and place on my back, which promptly explodes everywhere. Todd uses a copy of the birth plan to scoop up the rice.
I start doing my breathing exercises to get through the contractions. Todd reads birth affirmations to me. The doula speaks in soothing tones. It’s nothing I can’t handle so far. Contractions are about 4 minutes apart and last a minute a piece, which Mary Beth says is good.
At about 11 AM the contractions start to feel very intense. They have speed up and last even longer. I start to think I can’t get through them. Mary Beth thinks I’m probably not near the hard stuff yet. I start to think I probably have several more hours of intense contractions to go. I have a few more “I can’t do this” moments and a nurse enters the room. She tells me if I want an epidural we can do bloodwork to see if my platelet count is any better. It will take an hour so it would be best to draw it now. At this point, the midwife, Patrice, enters the room. She examines me and declares it’s way too late for that. I’m already a good way into transition and says I’ll be pushing in under an hour.
This lightens my mental state considerably. I’m almost through with what everyone tells me is the hardest part of labor. From there everything seems easier. Todd and Mary Beth continue to whisper relaxing affirmations in my ears during contractions. The midwife shows Todd how to put pressure on my tailbone to ease my back pain, which works miracles.
The next hour passes in a blur. Soon Patrice is sitting on the edge of the bed, asking me if I feel the urge to push yet. I tell her I feel like I need to take a big dump. She says that’s good. She examines me and says I’ll be there soon.
Soon I start feeling like I want to relieve myself, and I think this is the urge to push, but I’m not sure. Every time I bear down I have tremendous pain where the catheter has been inserted, so thankfully that gets removed. I have an easier time after that distinguishing the sensations that I’m supposed to be feeling, but I’m still confused. Pushing isn’t really instinctual. It’s partly like going to the bathroom yet totally different. The midwife has to coach me in a few different positions to get it right.
Soon the baby is crowning. All standing at the bottom of the bed say they can see she has dark hair. The midwife asks me to watch in a mirror, which I don’t really want to do, but she says it will help me push. What I see is the baby’s head coming out with each push and getting sucked back in every time. I am upset because every birth video I saw in childbirth class showed the babies flying right out. That’s when I started cussing.
Pushing is more arduous physical work than I have ever experienced. Even if I had had pain medication, that aspect wouldn’t have been taken away. I am sweating and panting. My blood pressure is up to 160/110. I say I can’t do it. The midwife says “OK, I’ll just pack up and go home then.” I want someone to reach in and grab the baby. Use the forceps. Cut me open. I don’t care. But there’s no way out of this except to run through the burning building.
Todd and Mary Beth each have one of my legs and have been telling me to use them for leverage. The midwife decides that’s not working. I have to run this part of the race myself. They let go, stand back and chant with each push. I close my eyes and they disappear. There are roughly 30 people in the room all cheering as if I’m running down the home stretch of the Olympic marathon, but I can’t hear a single one of them. I head down a long black tunnel and feel only the overwhelming effort crushing down on me like ten tons of water.
“Take your baby.”
I hear it at the end of the tunnel like a deaf person hearing for the first time and the world explodes into light. I reach down and pull the baby up onto my stomach. She is warm and creamy. She is not crying. She is looking around taking in the explosion. A thousand hands reach in to dry her. Todd is standing over me crying.
But I’m not crying. I expected to cry with an overwhelming sense of accomplishment. I cried at the finish of my first marathon. Look what I did! But I can’t. I feel no pride or accomplishment. I haven’t run a race and crossed the finish line.
In the moment her body has become separated from mine, I lose myself. I am forever part of this tiny person, and I have ceased to exist.
Johanna Patricia was 7 pounds, 2.1 ounces, and 18 inches long. They took her up to the nursery and pronounced her in perfect health, oblivious to all my concerns. I lost a fair amount of blood due to the clotting problem, and stayed in the hospital for two days longer than normal, but my health problems resolved themselves. Jojo, Todd and I are all resting at home, looking forward to our new life together.
Pictures from Jojo's birth are here: http://www.kodakgallery.com/Slideshow.jsp?mode=fromshar...hktse&Uy=p4c9ys&Ux=1
posted by Bon @ 2:14 PM
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