I've Moved!

My new blog is called Reflections from a Global Nomad, in order to acknowledge that we no longer live in Maadi and that we are, in fact, global nomads, not staying in one place longer than two or three years. Please join me at http://DeborahReflections.blogspot.com

Thursday, July 29, 2010

Alexa's Birth Story

It was Wednesday, 7 July 2010, 8:40 am. I was just waking up. I'd been up every one or two hours during the night, as was my routine at that point, but I was feeling pretty good overall. I didn't have any plans for the day. The day before, I'd had lunch with some friends and brought home the infant car seat that their daughter had outgrown. The next day, I had my first appointment with the midwife who is part of my OB group--I'd met with one of the doctors once, and we'd agreed that I was more of a "midwife type of person" than an "OB type of person." But I had no real plans for the day. Maybe do some laundry, try to figure out what still needed to be purchased for the baby, read the last chapter of my Hypnobabies home study course ... nothing major.

I got up and went to the bathroom--again; all those middle of the night wakenings were for bathroom breaks too. While sitting on the toilet, I felt something unexpected: mild cramps that felt a lot like menstrual cramps. I immediately became concerned. I knew that many women's contractions start out like that, and I was not ready. Alexa wasn't expected to arrive for another month; Jeff was still in Egypt; we didn't have half the supplies we would need for a new baby. But I wasn't too worried. After all, I was expecting Braxton Hicks contractions to start any day. I did say a quick prayer, though: "God please don't let that be real contractions. Just let me be constipated or something, please."

And God laughed.

Around 8:50 am, I was reaching for the doorknob to leave the bathroom and go find some breakfast. Suddenly I felt warm liquid running down my legs. I stared in disbelief at the full-length mirror on the bathroom door. My pajama pants were soaked. A small, rational part of my brain informed me that my water had broken and that I needed to call the doctor's office.  A large, irrational part of my brain informed me that I had urinated on myself and that I needed to change clothes. I went to the closet to get my other pair of pajama pants. Right after I put them on, I felt another gush of warm liquid running down my legs. The small, rational part of my brain informed me that I definitely needed to call the doctor now. The large, irrational part of my brain informed me that I had just dirtied my last pair of pajama pants, so I needed to do laundry, especially if there was any chance that I was going to the hospital that day.

I didn't listen to either part of my brain. I called my husband at work in Egypt, where it was around 4 pm. No one answered the phone. I called his mobile. No answer. I called the house. No answer. I called work again--still no answer. I lost count of how many times I called various numbers at which I thought Jeff may be reached. Finally, I called my doula, Carey, here in the States. No answer. This was getting old, and I was getting stressed. The small, rational part of my brain kept insisting that I call the doctor. The large, irrational part of my brain still believed that if I didn't believe it was happening, it wasn't really happening. I'm convinced that the small, rational part of my brain was quietly processing information and making plans while simultaneously encouraging the large, irrational part of my brain to remain in a state of disbelief--if I actually started to believe what was happening before I had a fully developed course of action in place, it would not have been pretty.

Finally, I called the doctor. It was around 9:30 am. The nurse told me to have someone drive me to their office. I told her that I'd come, but it would be a while--I hadn't had a shower, and I had to have my mom go to the store to get some pads. She said that they didn't mind that I hadn't had a shower, and I needed to come as soon as possible. I said I'd come but made no promises about when--I didn't want to end up at the hospital with ruptured membranes, no contractions, and hours in which I could be offered interventions that I didn't want. After that call, I called my mom at work. My opening statement went something like this: "Mom, just listen and don't freak out. I know you've got a lot of work to do today [she'd mentioned that the night before when she told me that she'd be going in early and maybe staying late], but I need you to leave work, go to Wal-Mart, buy me some pads, and come home." She sounded much calmer than I had anticipated when she said she was on her way. But before she got the phone hung up, I heard her calling her boss's name to tell him she was leaving, and there was a definite note of urgency that bordered on panic. Oh well.

I started going around the room, methodically grabbing things and throwing them on the bed to pack. I hadn't packed my hospital bags yet--there was no need to pack them for another week or so at least, right? Mom arrived about 2 minutes later. (It should be about a 5-minute drive home from her office.) When she asked what she could do, I had her pull up my hospital bag list on my laptop (I'd planned what to bring, although I had not yet purchased about half the items on the list) and start packing. I got in the shower. I felt relatively calm and determined not to rush. After all, I wasn't even feeling real contractions yet, so I still had several hours to go at least, maybe even a day. I took my time in the shower. Then I helped Mom finish packing my bags--one labor bag and one postpartum bag, which included the things I wanted for Alexa.

At some point in that process, Mom handed me her phone so I could talk to my sister. Lisa urged me to go straight to the hospital, reminding me about her experience with her firstborn. Her water had broken, she had called the doctor, and she left for the hospital. Halfway there, her contractions had started with a vengeance. By the time they got to the hospital and found that my niece had rotated from head-down to breech, they had to hurry to get the C-section prepped (no breech vaginal births for those docs). My stubborn streak showed itself, and I continued to move quickly but unhurriedly. I did start moving a little faster around 10:30, when I noticed that the contractions were getting stronger and coming more frequently, but I tried not to let Mom see what was happening. Every few minutes, I tried to reach Jeff--still no answer.

Finally, around 11 am, we left for the doctor's office. On the way, the contractions got stronger, closer, and more regular--at the start of the drive, they were coming every 10 minutes or so; by the end, it was every 5 minutes, but they still weren't too incredibly strong. The doctor's office is 45 minutes from Mom's house, with the hospital about halfway in between. Unbeknownst to me, Mom seriously considered going there instead of to the doctor, despite my clear wishes.

Meanwhile, I continued trying to call Jeff. Finally, his boss answered the work phone and put Jeff on the line. My first words to my husband: "I've been trying to call you but no one would answer the [expletive]* phone. My water broke two hours ago." I don't remember his words, but I could hear his voice shift from concerned husband mode to I-have-a-task-to-accomplish mode as he immediately accepted that our baby was coming, he wouldn't be there for the birth, and he needed to get there as soon as possible.

I also was able to get in touch with my doula, Carey. I apprised her of the situation and told her I'd call from the doctor's office. I still had some hope that my labor was progressing slowly enough that I'd be sent home instead of to the hospital.

We arrived at my doctor's office shortly before noon. I gave the receptionist my name, and she said "Oh, you're the one they've been waiting for. Go on back." From there, things get a bit blurry, as the contractions were powerful enough and frequent enough that I wasn't much aware of anything else. I know I was taken back to see the midwife, Suzan. I don't recall if I was weighed or if my blood pressure was checked. At some point, one of the nurses started to say something to me while I was having a contraction, and another nurse shushed her. I wanted nothing more than to lie down on my left side--the very position I had loathed for the last several months, since I preferred to sleep on my back but no longer could. The midwife walked in the room and confirmed immediately that I was indeed in labor. By that point I think I was already lying on the exam table, on my side, curled up and just trying, with limited success, to relax. Suzan had me roll onto my back so she could check me. I was 6.5 cm dilated and 90% effaced. I asked if the baby was breech; last I'd known, she was transverse. But she had rotated to a head-down position, so one worry was relieved. I called Jeff and then my doula with the news.

I have vague memories of Suzan saying something about calling transport for me. Apparently she wanted me to go to the hospital by ambulance. Then I heard her telling my mom that it would take them too long to get there; I needed to leave immediately. If I started feeling the need to push on the way, Mom was to pull over and call the paramedics. I don't think I was supposed to hear that last part. I was told that I had plenty of time and that I wouldn't even be 9 cm by the time I got to the hospital.

I'm very glad not to remember much of the drive to the hospital. I know Mom drove like a madwoman, with her hazard lights on, horn blaring, weaving in and out of traffic. Her phone kept ringing. She went to answer it once. I snapped at her, telling her not to touch the phone while driving that fast and under that much stress. I think she told me to answer it. I'm not sure, but I think I talked to my sister at some point before telling her that I was having a contraction and hanging up on her. Mom started to say something during a contraction at one point. I have no idea what she wanted to say--I interrupted her with a sharp "Stop talking!" Apparently childbirth makes me rude. Sorry, Mom. Sorry, Lisa.

As we got closer to the hospital, the contractions intensified. I wanted to lie down so badly I could hardly stand it. I pressed my feet against the floor, braced my hand against the roof, and stretched out. I considered reclining the seat, but that small, rational part of my brain took control and reminded me that lowering it as far as I wanted to made the seat belt ineffective, and with the way Mom was driving, the seat belt needed to be effective.

At the hospital, neither Mom nor I knew which entrance to use--I was scheduled for my hospital tour the following week. I ended up going in the wrong entrance, although it was in the right part of the hospital. As I stepped through the door, I didn't know where to go next. But it didn't matter; I couldn't walk anymore. I hit my knees, then went to all fours. Suddenly I saw feet--lots of feet. At least four pairs. People kept asking me questions. I answered the first one, which was "Did you fall?" I said "No, I'm having a baby!" The next person who asked a question while within reach of my hand received some papers shoved toward her instead of an answer--the midwife had given me papers to give to the admissions person at the hospital. Once the woman (no idea who she was; I don't think I ever saw anything but her feet) had the papers, the questions stopped and a wheelchair arrived. With the assistance of about three extra sets of hands, I got in the wheelchair. Then there was a blur of faces, walls, and elevator doors. According to the time on my admission bracelet, it was 12:48 pm.

I ended up in a room with a bed. I was out of the wheelchair and in the bed--again, lying on my left side--in what felt like milliseconds. After that I just let them do what they wanted. I ended up in a hospital gown. I saw my doula and my midwife come in; I'm not sure who came in first. Then my life became a blur of "Oh God!", "God, help me!", and "it hurts!" There were brief moments of what felt like sanity in between, but I'm not sure how sane I really was. I remember saying that I should have had a C-section--forget mere drugs, I wanted to skip straight to not pushing**--and telling my doula that I hadn't gone by the ATM to get the rest of the money I owed her. She laughed and said that was alright. But most of my "conversation," if you can call it that, consisted of curt demands: "Cold!" (translation: I want a blanket) and "Wash cloth!" (translation: I'm hot and I want that cool wash cloth on my forehead) were the main ones. Oh, and there was that great big "NO!!" when the midwife didn't hear me decline the first time and told me to give her my hand so I could feel the baby's head before she came out. I'm not sure why I was so adamant, but that simply was not happening.

Through it all, my doula was there. She placed a cool cloth on my forehead when I was hot, removed it when I tried to shake it off, put a blanket around my arms when I was cold. She reassured me that God would help me when that sincere prayer was all I could say. At one point, she asked if I could use my Hypnobabies light switch, to which I said "No, I never even read the last lesson!" She asked if I wanted to listen to one of the relaxation scripts. I informed her that they were on my iPod, which was in my labor bag, which was in the trunk of my mom's car.

It felt like I began pushing immediately. Then it felt like it took forever. Suzan kept saying that one more contraction would do it, but one more contraction came and went and the baby wasn't coming out. I found out later that Alexa's head slid partway out and then just stayed there for half an hour.

Eventually, finally, at 2:06 pm, I felt a huge, painful pressure, then a sudden release. With the release came a gush of liquid and the sensation of something solid sliding out of my body. I knew that the head had caused the pressure, and once it was out, everything else quickly followed. I did not immediately hear Alexa cry, although she cried within a few seconds. I saw her as they clamped and cut the cord--I started to protest that I wanted delayed clamping, but I subsided under the gentle pressure of my doula's hand on my arm. I knew that she was as pro-delayed clamping as you can get, so if she was silently urging me not to protest, there was something important and time-sensitive happening. Alexa was taken to the heat lamp across the room for a few minutes. Then she was in my arms for a few brief seconds before they took her away. I don't recall exactly what was said, but I knew she was being taken to the Neonatal Intensive Care Unit (NICU) for observation. Everyone was very reassuring, to the point that I didn't really get worried about her. I'd seen her, I knew she was breathing, and they said they just wanted to observe her and they may not even need to admit her. I found out later that she was having difficulty breathing, and because she'd come out face first, she had some bruising that made her look blue--it was easy to mistake the bruises for evidence of insufficient oxygen.

Then the real torture began. I shook uncontrollably from the adrenaline. I felt like I was freezing, and my whole body shook like you'd see in a cartoon, not like anything I'd ever experienced. My belly was massaged to make the placenta detach. The cord was yanked on to pull the placenta out. I was given a shot of pitocin to prevent hemorrhage--quickly enough that I didn't have time to decline it if I'd wanted to (I still was disoriented enough that I probably would have consented, especially since I wasn't able to breastfeed immediately to cause the uterus to contract). My second-degree tear was stitched up--and the anesthetic cream hadn't been applied to a large enough area; one stitch went in without anesthesia. I was so exhausted and out of it that my protests consisted solely of the occasional "Ow!" I was distracted by a nurse having me sign the consent forms giving them permission to do everything they'd already done--there hadn't been time before. I also learned then that I'd done the impossible--given birth in the hospital without so much as a hep-lock. Suzan had told the nurses not to bother with it; there wasn't time.

My doula informed me that I had family in the waiting room; should she make an announcement or let them come in? I asked her to wait until I'd talked to Jeff. I called him and gave him the news, then allowed my visitors in. My mother and my father-in-law were the first; then my father-in-law left and my brother came in. I don't remember the conversation or anything. At some point I became lucid enough to ask my doula about what exactly had happened with Alexa. At the time I understood what she said. Now I don't remember most of it.

I was in the delivery room for about an hour. Then the nurses brought a wheelchair for me. I was taken to the NICU, where I was able to see Alexa, although I couldn't hold her. One of the doctors came over and explained what was going on with her. She had been brought in for observation because of difficulty breathing. She was on oxygen and a few monitors. He wanted to start her on antibiotics because it was possible that she had an infection, but the blood work wouldn't show it for 48 hours. I gave permission for the antibiotics but declined the routine Vitamin K shot he wanted to give her. I was impressed that he respected my wishes without pressuring me.

After a too-brief visit with Alexa, I was taken to my recovery room. It was a strange, disconnected feeling: I no longer had the baby belly, I was in the hospital, I had just given birth. But I had no baby, at least not one for whom I had any routine care responsibilities or who was even within my sight. I was in the maternity ward with no baby. I actually got jealous when I heard the baby next door crying.

The rest of that day and most of the next brought a flurry of activity. I was seeing visitors, submitting to exams and checks, pumping breast milk, going down to the NICU to see Alexa whenever I could. I was also trying to figure out the State Department paperwork that needed to be done to get the ball rolling on Alexa's passport and medical clearance. Jeff called from various airports to report his progress. He arrived the following day around 7:30 pm, during the shift change at the NICU when even parents aren't allowed to visit. When the NICU re-opened at 8, we went down so he could meet his daughter. I'm glad I thought to have a camera available; I have a picture of when he first saw her. After some time with her, we went back to my room to get some sleep. That's when my body fell apart--it realized that with him there, I could relax some, and the pain began. It wasn't my stitches or perineum that hurt, though; it was my back, shoulders, and neck. The nurses gave me medicine that relieved the pain and let me sleep.

I was discharged from the hospital the next day. Jeff and I checked into a nearby hotel to stay near Alexa. We spent every moment we could with her. Finally, the following Tuesday, she was released. That's when I felt like I really became a mother, when we took full responsibility for her. That's when the birth was complete.


*I usually don't curse, but in this situation, it just seemed appropriate.

**My next birth also will be all-natural, despite my mid-birth desire for a C-section. The NICU nurses told me that had I had drugs, which would have been necessary for a C-section, Alexa's breathing problems could have been much more severe. Many babies whose mothers have epidurals are born sleepy; if they're already at risk, this exhaustion can interfere with their ability to transition to breathing air.

4 comments:

  1. Debbie, wow that's an amazing story! Thank you for sharing, I'm very glad everything turned out ok, and congratulations!! - Melissa Rekas

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  2. Congratulations. I'm glad everything turned out ok too.

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  3. What a birth story! I'm glad everything went relatively well. Amazingly, our oldest son was born on July 7th (I know she was on the 8th, but still), and he was in the NICU at first too. Those are some long hard days feeling so disconnected and tired and sore without the sweetness of holding a new baby! But I'm glad she was OK!

    Hope you all are enjoying your early weeks together!

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