Monday, January 9, 2017
Reporting back from the front...
It's taken me nine months to write this.
So, there I was, face up on a hospital gurney, staring at the hospital ceiling when I got knocked for a second time into a door frame on our way to the operating room. "Oh man, we got the screwed up gurney again!" the resident yelled over me to her colleagues. "It's got that bum wheel like a bad grocery cart." And they all laughed. I was headed into my first major surgery and about to meet my first child, and they were all making casual jokes about dysfunctional equipment.
We had our little girl. We didn't know who she was and now we do and we discover more about her every day.
I'd like to tell you that I have gotten to the place where I feel super grateful about my birth experience because she and I left the hospital in one piece, or two pieces, really. That's not exactly the case yet, but I'm getting there. One friend's very sound wisdom was that the more I tell my story, the more it will lose the trauma and simply become the tale of how she was born. Or in this case, I'll quote the late, great Carrie Fisher and say; "Take your broken heart and turn it into art."
Our favorite night nurse on the postpartum ward at the hospital stopped what she was doing once, looked me right in the eye and said; "You are going to get through this." And later, truly in the middle of the night; "After all this, after everything you've been through, she's still at the breast. You should be so proud." And I was proud. And not just of myself, of the two of us, the three of us in fact. The husband was there every night on that stupid hospital cot, changing her every diaper that I was too slow on my feet to get to, holding my hand, calling people to come visit to raise my spirits, and reminding me that there would be bacon the next morning at breakfast.
I did not have a textbook labor like my mother and I certainly didn't drop a baby and bounce back immediately like my Ukrainian ancestors. To start, I went home from work early on the Monday before my due date because I had a cold. I slept for about an hour and a half that afternoon. That was probably my last uninterrupted stretch of sleep for a week.
What can I say about my expectations about childbirth versus my reality? And I say "my" reality here, because childbirth certainly seems to be one of those deeply personal, intense physical and emotional experiences that varies so much from person to person. The anticipatory moments, the during moments, and the after moments of having a newborn all present different levels of challenges for everyone. Even the reality of the husband's experience was so different from my reality.
Well, I'll put it this way: when we finally left the hospital, several nurses who had been faithfully cheering us on saw us off saying; "See you in a year or two!" To which I smilingly replied; "Fat f#$king chance!" So this is your opportunity, dear Reader, to abandon ship if you like. I do not recommend reading the following if you are say, eight months pregnant...
Several hours following my afternoon snooze on that Monday evening before my due date, I was home alone, (the husband was teaching), and standing in the kitchen, looking out the back window when my water broke. I kept being told how unlikely this would be. "It only happens to 10% of women that way", they said. "It happens in the movies that way but not often in real life." But let me tell you. The feeling was unmistakable and the sense of; "shit is getting real" excitement quite palpable. Since I'd already started having a few mild contractions, I was encouraged by my doctor to stay at home where I'd progress better. So this thing they also tell you about waiting for your contractions to be five to seven minutes apart? Yeah, that never happened for me. My contractions went from 20 minutes apart to much closer together within a few short hours and never became regular. When there were some that were two minutes apart, my doctor told me to come in and we went to the hospital in the middle of the night. We then were sent home because tests to find out whether my water had broken or not were "inconclusive". When we then returned four hours later, I had dilated five centimeters, 45 minutes of which we were stuck in rush hour traffic, (super fun!). The staff admitted that my water had to have broken when I said it had, (no kidding). Later the next night, I pushed for far too long and ended up having a last minute C section. We found out after the surgery that it was because our baby was posterior, i.e., facing "sunny side up", which can be problematic for first time moms, as well as some others. I was also posterior at birth, I was the second, and as we have discussed, my mom is a horse. So that was labor for me.
I want to be clear that I had an epidural and I have no regrets on that. Not that anyone said this to me during labor, but experienced midwives will tell you that posterior babies often cause irregular and close contractions, and instead of getting closer together, the contractions just get longer. I've heard stories about women carrying on full conversations between contractions. That sounds cute. You'd better believe that as an opera singer with solid vocal projection, the husband confirmed that the whole triage area knew exactly when I was having another contraction. And I wasn't carrying on conversation in between. I am so certain that my epidural did not cause my Caesarian that had I labored without one, I think I would have been even worse off knowing those last hours of pain were futile. Along with the stories about how labor is "not that bad", my mother had always told me; "As long as everything is normal, you should do fine." (But seriously, regardless of any of that, if you want it, get the epidural and don't let the hippies shame you.) With regard to keeping flexible as surgery became necessary, in the back of my mind, I remembered that on the German side of her family, an aunt had labored too long and lost her first baby. Labor wasn't "normal" for me, but what ultimately matters is that we were both fine in the end.
Later, I would be telling people that I only pushed for an hour or so, and the husband would have to step in and say; "It was closer to four hours, dear". I had what's called a "lite epidural", so I had some control as to how much I could feel the contractions while I was pushing and was even able to stand up with support and try different positions, but I was completely delusional about the progress I was not actually making. There is this weird time suck of adrenaline that happens. I really thought we were going to meet our baby any minute. The hard thing about being told that it's time for surgery, is that you know it's not the end of pain with a C section. It is just the beginning of a different type. And for a singer with my type of training, the recovery from having a large abdominal incision is not always an easy one. The OB on call said there was no time limit for how long she could let me continue, but it was getting dangerous with the baby's heart rate and my fever. At this point, our fantastic labor and delivery nurse rushed over and said; "Remember how you were so excited to meet your baby?! That is still going to happen tonight." I was given a few minutes to adjust to the idea before they upped my epidural and brought me in for surgery. From somewhere, after bawling my eyes out, I reminded the OB on call that I had a large but benign ovarian cyst that would need removing during the surgery. It had been there for years and this fact was supposed to be on my chart and didn't make it on there for some reason. I consider myself kind of a badass for my clarity and presence of mind in that moment. I also reminded the husband what my cousin had once warned me was a common mistake for C section husbands: "When they give you the gown for the operating room, keep your pants on!"
When the baby was finally unleased, so to speak, we heard a cry and the doctor called out; "Dad, yell out the gender!" And then there was a pause. The husband explained later it was just his catching his breath at the sight, the reality, of our baby. "We have a girl," he said. We felt enormous relief when she was declared a 9 out of 10 on the Apgar infant health evaluation scale and they followed that proclamation with; "And we don't give 10's!" She was 6 lbs, 11 oz of ruddy perfection with a full head of brown hair like her father's and nothing like the bald babies of my family. And because we didn't know the gender ahead of time, I was a basket case of happiness that I got a little girl and the close connection I feel with my mom and felt with my grandmother could continue on in a daughter. Then the doctors loudly nerded out for a while at the second part of the surgery, removing my cyst, which as the owner of my body, was weird, and I don't need to get into. I wanted to keep looking in the direction of the husband holding our baby, but (fun fact!), there is an intense amount of shaking that happens during the end of labor and this doesn't go away with a C section. It just travels up the body. The anesthesiologist told me this was hormonal and to try not to fight it.
The first moment they put her on my chest in the recovery room, we both breathed more easily. Literally. My temperature went down and hers went up. That parent/child chemical connection is pretty amazing. But in looking back, I didn't feel as much a sense of wonder as much relief, like; She's back with me now, after only about 20 minutes apart.
If, right now, you were to offer me the option of 24 more hours of unmedicated labor or another week-long hospital stay, I'd take the labor. And yes, we were unexpectedly there for a full week.
First off, after surgery, when, after a day or so, I could barely get back to the room from a hallway walk, I consented to taking a small dose of the narcotics the hospital seemed to be relentlessly pushing. That night, I had horrible, fast-paced, manic nightmares, so I requested there be no more of those, please. In between, we, like most new parents, had some rough midnight hours trying to get a baby with a full head of steam to eat something. I was struggling to get out of bed with a fresh incision and the husband is just an extremely sound sleeper in the wee hours of the morning. Things went something like this:
Me: Attempting to get out of bed... in vain
Me: "Brendan... Brendan? BRENDAN!!!
Husband: Jumping out of bed: WHAT?!
But this was really only the beginning for us.
To put this into context, our girl was born early on a Wednesday morning and that Friday morning, I woke up feeling very short of breath and told the hospital staff. My vitals were apparently normal. I called attention to the same issue the following morning and they were not normal. I was placed on oxygen and moved to another floor to be monitored because of fluid in my lungs. Again, that new mom delusion is pretty amazing. People might be telling you that you are pretty sick, but all you can think about is whether your baby is hungry or not and whether you can be discharged the next day and finally get some sleep without having to tell someone your name and birth date or have someone ask; "Has anyone offered you narcotics yet?" for the billionth time. That Saturday, in having to rule out a pulmonary embolism, a rare postpartum cardiac condition, and the flu, all while treating me for the potential of a virulent hospital pneumonia, by Saturday afternoon, I had been given antibiotics through two hand needles, three blood tests, (two of which failed due to my veins), a strong diuretic that interrupted a nursing session, a flu test which feels like a stick is being shoved into one's brain through the nose, and a CT scan during which I had to try to control my already erratic breathing and wheezing. And get this; before the scan, they asked me if I were sure I weren't pregnant. I did not miss a beat on that one: "If I am pregnant, then that Caesarian section I had a few days ago went horribly wrong..." The technicians apologetically fumbled to help me onto the machine, no easy feat given my incision. The OB who had performed my surgery said my pelvic floor muscles were incredibly strong and hard to cut through. Gross. Everyone had told me ahead of time that my being in touch with this region of musculature would be a boon to me...
Anyway, that Saturday afternoon, I had undergone as many varying uncomfortable physical sensations as I could tolerate, and keep in mind, I had just been through two nights of labor, so that is saying a lot. It was then that I started telling the husband; "I think these people are torturing me". He assured me he could understand why one might think that, but that they were not. Later that day my father-in-law, having just two years ago spent his first week in a hospital, said; "You are being tortured," which was strangely validating. I don't think I slept for more than an hour at a time in the entire week's hospital stay between the fluid in my lungs, the constant interruptions for vitals, meds, and you know, feeding my child. The most peaceful sleep I got altogether was actually during an EKG. The husband, of course, was terrified that whole test that I had the post-partum heart condition they were testing me for, whereas I was just grateful for the minutes waiting for transport when no one would wake me up to ask me an inane question or tell some bit of information I already knew. Ahem... resident who woke me up at 5am after a 4:30 feeding to blather in my face about nothing. Oh, and to ask if anyone had offered me narcotics yet. In my world, and I thought in most, 5am is for sleeping. I digress. Thankfully, my EKG was normal.
Oh, let's not forget there was also the crying. Ohhhh, the crying. Some combination of postpartum hormones and sleep deprivation made sure that when no one was visiting, I cried literally every five minutes. I'm pretty sure the husband thought I was broken. When the baby fed well, I cried. When she didn't feed well, I cried. I cried the first time I took a shower. I cried the first time I walked down the hallway. I cried the first time our transport person got lost on another floor of the hospital, (this happened twice, for a staggering rate of 100% of the time people transported me from one area of the hospital to the other). So, you get the idea. I did a lot of crying. I also pretty much had no idea what day it was or what city we were in or what month it was. The news would come on every once in a while and remind me that we were literally minutes from our home, but to me, it felt like we were on some twisted vacation in hell. Friends were texting me assuming I was glowing with new motherhood and when I read my responses now, I rather comically come across as though I am writing from prison. At one point in the middle of the night, a nurse handed me our baby and I was so delirious that while I was nursing her, I actually thought; "Whose baby is this?" It's funny now. Thankfully, I didn't say it aloud.
Please try to imagine that on the Thursday and Friday following the birth of my child, I had been a person. I'd showered, done my hair, and even put on makeup. By Saturday, I was back in the hospital gown and hooked up to oxygen. I was a patient. Our visitors from earlier in the week could hardly believe there was talk of pneumonia. The best news was what we were getting was from the pediatricians. After I'd been recently moved to the more acute floor, one pediatrician came in to report that the baby's weight was normal, she was doing well, and that her slight jaundice would go away on its own. (She only looked vaguely like a Simpsons character for about a day.) After so many depressing reports from other doctors on my mysterious health issue, my mother happened to be there for this and chased after him with a tray she had baked yelling; "DO YOU WANT A MUFFIN?" I told the nice doctor we only offered muffins to people with good news.
Our favorite nurse was quick to point out that she'd been doing this for 25 years and while many of the changes in maternity policy over those years were positive; skin-to-skin and a focus on breast feeding, etc., she felt that by requiring parents to do almost everything themselves, hospital staff are not actually preparing parents to go home. Instead, they are sending the mothers home still recovering with their energy completely sapped. For just this reason, we did take full advantage of the nursery at night between feedings, because we knew someone would have to be awake and relatively sane on our return. Fortunately, our delivery hospital is not one of the new "baby-friendly" facilities that has removed their nursery entirely.
On the following Monday night, they had ruled out everything more serious than pneumonia. When it was looking like my oxygen levels were improving and we were going to finally be discharged the following day, I had a bout of sleep apnea during the night. They whisked our baby away and when we woke up, the husband sat at the edge of his cot saying; "Where's our little munchkin?" We were despondent. Then we heard her very distinct cry coming down the hallway and shortly afterward, my own OB actually showed up for the second time in her street clothes and said that it was clear I wasn't getting any sleep there; that I was a reliable patient who would come in if I got sicker, and she was personally making sure that we'd be discharged that morning. To say we were grateful was an extreme understatement. Our family was finally on our way home.
Much of this experience was just the perspective of a relatively healthy person who had never actually stayed in a hospital before. I was, because of the time that my labor started, beginning this week at a deficit of two nights' sleep though. Of course it could have been much worse. I can only imagine what it is like for parents with babies in the NICU for an extended period of time. And for those who are discharged before their infants are, being separated with long nights full of worry can't be easy, to say the least. I haven't lost sight of how truly lucky we were in the end.
So what part did I envision about this process that actually came to pass? My fantasies of nursing my beautiful baby and receiving visitors in my kimono did all come true at least. In many ways, we have been lucky. I have wonderful paid maternity leave through my office job, a luxury I know most of this country does not share. Our baby nurses well and for us, the extreme sleep deprivation ended the second we got home, because my day's schedule was fluid and because our girl seems to like sleep as much as we do. Our families helped us settle in and our friends banded together and thanks to them, we never went hungry those days when it seemed difficult to eek out time for getting to the grocery store and chopping vegetables.
Tonight, our girl cried before bed. She doesn't usually keep crying in our arms. She was getting tired, but she really needed a bath. That added chore seemed to push us into having an over tired baby, which is always one of those things that sounds like total bullshit, but when you actually see it in any child, you know it's a thing. After a fussy night, tomorrow, she will wake up, smile at us, and make our hearts melt all over again. Sometimes I look at her and tell her aloud as I am registering it to myself that we are this fluid circle of love. She looks at both of us, and we look at her and at each other and we're all a bunch of smiling, moony-eyed idiots. I may not be over it all and my story may have to be told a few more times, but I'd say that that cliché they tell you is true. It was all worth it.