Superbowl Sunday ’08

Stinker with Yellow Hat

I was just re-reading some older entries, and realized that I never finished telling the tale of ze wee one’s birth. Permit me to rectify that immediately. Well, almost immediately. First, a digression:

Sometime after Nikolay’s birth, I finally received the documentary I’d been waiting for months to see. Netflix had delivered it right to my door … about a month and a half too late. The film is called “The Business of Being Born,” and it examines the status of home births in America. I had added it to my Netflix queue long before our son was born, excited that someone out there was making a film like this, about people like us who chose to bypass the standard hospital delivery model. At the time, I expected to see a confirmation of everything I’d read about and studied, and to rejoice in the little bundle of joy birthed in my own bed, in my own home. Not so much.

But here’s where it gets interesting: I don’t mean to be a plot spoiler, but suffice it to say that there is a character – erm, woman – who is planning a home birth throughout the course of the film, whose plans are altered when she discovers that there are problems with her baby and that she must have a cesarean. This is NOT what I expected from this documentary. When we finally received it, we were a little ambivalent about watching it, primarily because we didn’t want to be reminded of everything that we’d missed out on. Would it hurt too much to see the joyous, peaceful welcome these babies were receiving when our own son was yanked from my womb? Would I be able to see mothers grab their freshly-born infants and nurse them, when I didn’t see my son until about three hours after his birth?

When all was said and done, though, I was glad to have seen the film, in part because of this unexpected turn of events so closely paralleled our own. Our birth story is still what I consider a successful home birth, because part of the strength of that model lies in having a skilled, experienced midwife who knows when to take advantage of the strengths of the hospital birth system. That being said, I can’t deny that I have ambivalent feelings about what happened on February 3, 2008. In many ways, this film helped me to process them, and to find proper words. In an epilogue, the woman who had to have an emergency cesarean talks about her birth experience a few months out. Was she glad that her son had arrived, and been healthy despite his birth trauma? Yes, of course. Did she love him? Again, yes, of course. But did she feel as though she had “given birth?” No, not at all. In fact, she compared the trauma of an emergency cesarean to a traffic accident in which she sustained a critical injury and had to go into surgery. And at the end of all that, they handed her a baby.

And so it went for us. By the morning of Sunday, February 3 we all knew what was coming. We assembled at the breakfast table – my husband, my mother, my midwife, and I, and ate. That’s right, I ate. I knew full well that a cesarean was a strong possibility, but we were going to do everything in our power to prevent it. One of the strategies I had was eating before I went into the hospital: my sister-in-law had gone in without eating and suffered from utter starvation and exhaustion as a result.

Early in the morning, while it was still dark, we packed our bags (who packs a hospital bag when they aren’t going to a hospital?) and picked out a “coming home outfit” for our son. This turned out to be waaay to big for him, as he fit into “preemie” sizes during his first few weeks. In retrospect, I wish that I had showered. After several days of avoiding bathing (because my water had broken) my hair was pretty darn icky, which makes all those lovely first photos a horror for me to look at.

Incidentally, in addition to the fact that most hospitals would have made a cesarean a foregone conclusion at this point, I had an inkling that things were going to end up on the operating table because I’d had a dream in which the doctors unzipped my stomach (there was a convenient zipper installed!) and he looked up at me, smiled, and said “Hi, Mom!” I remember that he was wearing a striped yellow hat, given to him by my father and his wife. (Seen above.)

When we arrived at the hospital, things were a bit … odd. Firstly, there were mainly women around. In a way, this made sense, as we had gone to a hospital with a midwifery program, in the hopes that they would be most open-minded to a “failed” home birth transfer. The lack of men had another reason, I suspect: Nikolay was, after all, born on a Super Bowl Sunday. No doubt anyone with the least desire to see the game had cashed in their days off. (In fact, Papa and I watched the tail end of the game from our hospital room later that night. That’s one point in favor of the hospital, I suppose, as we don’t have a television at home.)

Hospital Machinery

Shortly after we were settled in, I began to be hooked up to all manner of machinery. This is, of course, precisely what I had hoped to avoid at home. Because my water had broken (at this point almost 36 hours ago) and labor was not progressing, there was no choice but to induce labor with “Pit” or Pitocin. As low dose of pitocin was added to my IV drip, and we waited. Everything was proceeding well … in fact, things were rather dull. We were bored. Carol, our midwife, slept on the “Papa pull-out chair” because she was utterly exhausted from the two other births she had attended over the previous 48 hours.

Carol

I won’t post a photo of Carol sleeping, that would be mean – but here is a photo of her  just before she went nightie nights. She is a true gem: Competent, trustworthy, and kind … if home births after cesarean (HBAC or home VBAC) were legal in Arizona, we would SO work with her again.

Hello Baby

Have I mentioned that we were excited to meet Mr. Nikolay Grigorievich?

Mama Ham

Here I am, hamming it up for the camera because NOTHING ELSE was happening.

Shortly after this photo, my husband stepped outside to use the rest room. I’m not sure why he didn’t use the one in our room, maybe he wanted to stretch his legs. The point is that he stepped out, and by the time he returned a few minutes later I was being wheeled to the OR, lights a flashin’, alarms a beepin’. What happened? Well, let’s backtrack for a moment here.

Remember that Pitocin that I mentioned previously? Well, here are some of the known risk factors for using Pitocin:

Risks for Mother

  • Mothers using Pitocin frequently report increased pain with contractions. Most mother using Pitocin also use pain medication to handle the increased pain.

  • Pitocin use requires continuous monitoring to detect complications and/or progress which interferes with mobility.

  • Pitocin use requires an IV for administration.

  • Pitocin use can cause long contractions and contractions with double peaks.

  • Pitocin use slightly increases the possibility of a uterine rupture.

  • Pitocin use increases the likelihood of a fetal malpresentation or malposition.

  • Pitocin use is associated with an increased need for cesarean surgery for distocia and fetal distress.

Risks for Baby

  • Pitocin use increases the likelihood of depressed fetal heart rate patterns.

  • Pitocin use increases the chances of Fetal Distress due to decreased oxygen availability.

  • There are increased risks to your baby if you have a cesarean surgery.  Source

Of course, I had read about all this before – but my focus had always been on the earlier part of the list: risks for the mother. I assumed that with Pit would come harder, more painful contractions, and that we would have to fight really hard to have the natural birth we’d wanted. I was so very glad that my midwife was with us, and that she would at least be able to act as a doula in the hospital, though she wouldn’t be the one in charge of the birth. We had even gone to a hospital with a midwifery program, so I was in the hands of a very friendly and kind woman (she’d have to be to allow me to labor at this stage).

I confess I didn’t think too hard about the secondary part of the list: risks for the baby. And for us, that’s what it came down to. Shortly after they administered my first dose of Pitocin via the hep loc, a nurse became very concerned. She couldn’t hear the baby’s heart beat anymore, just mine. So they had me turn, first to one side and then the other. They hoped that it would shift the baby so they could more easily discern his heart beat. When that failed, they decided what they really needed to do was attach a heart rate monitor to him. As in, to the baby. To his head, more precisely – which of course required quite a bit of maneuvering. During the attachment procedure, the baby (who had been engaged in my pelvis) somehow UNlodged himself, and was once again not “engaged,” the position taken by a baby just prior to birth. Joy. That was a pretty major setback – but it got worse. Bear in mind, we’re still only about a minute and a half into Greg’s potty break here. Things were happening VERY fast. When they finally did get his heart beat, it was almost indistinguishable from mine – hovering in the 80s or 70s or something else that is obscenely LOW for a baby in utero. Bad news. “Depressed fetal heart rate pattern?” Check. “Fetal distress?” Check.

It was decided that perhaps the slow trickle of amniotic fluid was causing him to be smooshed in the womb, and that they should give him a bit more water/fluid to cushion him … so they inserted yet another cable and proceeded to pump me full of water, which of course immediately began to spill right back out. They were also concerned that he wasn’t getting enough oxygen, so they put an oxygen mask on me… which was pretty cold. So there I lay, six or seven women hovering around me, poking me, prodding me, a cold oxygen mask on my face (which was also pretty darn loud) and water trickling out of me, and everyone looked very, very worried. I can tell you now (though I could barely hear the beeping at the time) that this was because Nikolay’s heart rate continued to plummet. By now we’re about three or four minutes into the whole procedure, and the midwife in charge talks to our midwife Carol and my mother. My husband still is nowhere to be found. They confer and, as the hospital midwife walks over to me, I already know what she will say. I see my mother looking very anxious, and Carol looks back to me and nods “yes.”

“I think we need to go in now, Sweetie. (Or Dearie, or Sweetheart … who can really remember the precise term of endearment used at such a time?) You’ve given it a good shot, but your baby is in trouble and we need to get you to the operating room. You should have a C-section.”

I started to cry, which is not only uncomfortable but also embarrassing behind an oxygen mask, but nodded … and as I was being wheeled out I remember seeing Greg walk into the room, utterly dumbfounded at the noise and commotion. I squeezed his hand, and as they wheeled me a little ways down the hall, I remember praying something to the effect of “Into thy hands I commend both of our spirits, Lord.” Which is of course something medieval saints were said to say when they die – but let’s face it, when you’re about to go under general anesthesia, you might as well go all out.

Prince Charming

The next thing I remember is Greg kissing me awake, like Prince Charming. I was annoyingly and uncomfortably cold and disoriented, as I always am when waking up from a general anesthetic. (This was my third time, the previous two times being the removal of my tonsils and that pesky appendix.) I looked down, and noticed that I still had a scrunchie on my wrist – they had been so fast to hook me up to things that they didn’t bother to take it off. (Oh, another joy of hospital cleanliness: Just before I went under, I remember seeing them take the pillow I had brought from home – seen in photos above – and tossing it on to the floor of the OR. Later, after everything was over, someone tried to hand me the same pillow to sit up on. Are you kidding me? It was on the FLOOR of an OPERATING ROOM.)

I was later informed that my cesarean was the fastest such section they have ever performed. From the time I hit the OR to Nikolay’s extraction it was something like five and a half minutes – and not a minute too fast, considering his continually plummeting heart rate. Of course, it took quite a while longer to stitch me back up. By the time I met my son, he was three and a half hours old.

Stinker in Hospital

And even this meeting, I am told, took a bit of maneuvering on Greg’s behalf. He was with Nikolay and saw that a nurse was about to feed him some formula. When informed that he was to be breastfed only, she said “well I guess we’d better go wake the mother, because he’s hungry.” (Gee, ya think?!)

Meeting Mama

This was not the meeting I had hoped for. I had envisioned wrapping my freshly-born babe, and holding him as soon as he was born. I had wanted to establish nursing right away, and to leave his cord uncut for a bit so that all the blood remaining in it would reach its rightful owner. I had wanted so many things – and instead we had trauma followed by surgery followed by being handed a baby. Greg and I sometimes joke that we’re not even sure if he really is our son, as neither one of us was “there” when he was taken out of me. If it weren’t for the fact that all the other babies in the NICU were … shall we say, of a darker complexion? … then we might have been more worried. As it was, he was pretty obviously ours, but the next few days and nights were some of the most difficult we’ve had to endure. The story of our hospital stay is another tale entirely, filled with some joy and a great deal of annoyance and grief. Suffice it to say that if I have my way, I’m walking out of the hospital an hour after our next baby is born.

Stinker with Auntie Tonya in Hospital

For now, though, we were glad to have our little stinker safely in our arms. Well, sometimes. You know, when he wasn’t chained to the machines in the NICU… but that’s a whole other story. In the end, we praised God (and still do) that nothing worse happened, and that he preserved all of us during that time. We were able to go home four days later. Four looong days later.

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The Longest Day Ever

Dear Kolya,

When I describe the events of February 2, 2008 it might be polite to bypass what happened from the late evening  of the day before to early morning that day, or perhaps to merely mention two words: Castor Oil. ‘Nough Said. I think your grandmother has a photo of Mama taking said concoction, along with Papa taking a medicinal Scotch in preparation for the day ahead. We assumed that everything we’d been practicing for months in our Bradley natural childbirth classes would soon come to pass. Mama took out her notebooks and reviewed the stages of labor. We re-read the passages on how to time labor contractions, because we figured that would come in really handy.

Then, when the contractions started to kick in early in the morning, just after midnight, Mama tried to lie down and go to sleep. We had been warned that though it might seem impossible, we should try to sleep while we still could: a first labor can be really tiring. It took me an hour or so, but I managed … for a wee bit. And when I awoke, all the lovely contractions were gone.

NOOOOOOO!

This was bad news. Really bad news, because of course your amniotic fluid had started to leak. We were on a deadline. The standard timeline is 24 hours – though in a hospital they would have rushed us even more. So we started to do all manner of fun things. Mama did exercises, and contractions started up again. Every time, I would time them and write them down, keeping a detailed log. I don’t have it anymore, but if you saw it, it would look something like 6-7-6-5-6-5-5-5-6-7-8-9-7-6-5-6-8-and so on. Everytime we thought we were getting to a period of “every five minutes, it would fizzle out again.

So we went hiking. In the Phoenix Mountain Preserves. You know, to get things started up.

Hiking 1

Not entirely certain what I was thinking with that outfit … but there you have it.

Hiking 2

I think this is the closest we’ll get to a full-on side view of you the day before you were born.

hiking 3

Hooray! A contraction!

Hiking 4

Ah, well … better luck next time.

So we headed home, and many hours of excitement mixed with boredom ensued. Labor started, then it stopped. Then it started, then it got regular and stronger, then it fizzled.

It was determined that the stress of being “on the clock” and my water having broken was hindering contractions. Papa gave me foot rubs (the kind that had been prohibited during pregnancy! Bliss!), back rubs, neck rubs. We laid down on my right side and snuggled. We laid down on my left side and snuggled. I was very relaxed. A few more contractions, a longer fizzle. During all this, we monitored your heart rate, and the level of fluid coming out. We ate spicy Thai food from the fabulous restaurant down the street.

In the evening, at the 24-hour mark, we huddled. Carol, our midwife, your Oma, your Papa, and Mama sat around and debated options. The infuriating bit was that our midwife informed us that all of this starting and stopping business was totally par for the course for a first labor. In fact, had my water not broken, she wouldn’t even be there. We’d still be a few days out. But noooo… you had to go and stretch or something to burst that little bubble. Kidding. I know it wasn’t you.

In the end, we opted to stay at home until the following morning. We hoped that labor might really kick in overnight … and most importantly, having reached the 24 hour mark, we knew there really weren’t any hospitals that would continue to let Mama labor naturally. Because of concerns for your safety, we were sure they’d plop Mama on a table and extract you immediately. What made this really interesting for our poor Midwife was that several other patients had gone into labor that weekend – while we were starting and stopping, she delivered two babies.

So we prayed, and did everything we could, and went to sleep. Or tried to. After all, one way or another, we were meeting you the next day. And that was pretty darn exciting.

To be continued …