Friday, September 18, 2009

Airlifted...

Things always seem a little more manageable when you can sleep in your own bed. Sure, it doesn’t have the convenience of a call button or the ability to prop you up to just the right angle, but it’s your bed, and its curves and dents fit your form just right.

The birth of my first child did not go as planned. Yes, I know that when having children, all your plans get thrown out the window, and things are never as you expect them to be. It’s like starting a project on your house. You think that repairing a hole in the wall in the kitchen will just require a bit of spackling, some primer, and a few coats of paint. But then you remember that the spackle takes twenty four hours to dry, and your paint brushes never got cleaned out from the last time you used them, and you can’t find your putty knife, you forgot to prime the walls before you painted, and the paint you got doesn’t seem to match, even though you know you picked out the right color. So, after three trips to the hardware store, you repaint the entire kitchen, get paint on the cabinets, go back to the hardware store for some paint remover, then spill the paint remover on the tile, requiring you to re-grout, and before you know it, an afternoon’s worth of work has turned into weeks, and a ten dollar repair job has just jumped into the hundreds.

I completely intended on a natural, low-intervention birth. But instead, I got an eight day stay at the hospital, complete with surgery, NICU visits, and a home heart monitor.

I was ready to scale a fourteener. I was ready for the switchbacks, the bushwhacking, the blisters and the weight of the heavy pack. I was ready for a mountaintop experience, ready to see for miles and miles from a snow-capped peak. Instead, I was airlifted just a hundred feet from the summit.

On Sunday, August 30th, I went to church like normal, but started feeling contractions during the service. Some of the women in the congregation noticed. But the contractions weren’t coming regularly, and I knew that some women feel these for days before anything happens. So we went home, and I went to lie down for awhile. And Dan was gearing up to mow the lawn. But after timing the contractions, and noting that they were picking up a bit – every seven to ten minutes or so – I called down to Dan to tell him that we’d better start packing.

Dan became a packing and cleaning machine. He vacuumed, de-cluttered, packed, and made peanut butter and jelly sandwiches while I started timing the contractions. All I wanted him to do was sit next to me and help me time them, but he couldn’t sit still. Finally, we were packed, and I decided to go for a walk. Of course it’s ridiculous to go for a walk without the dogs, so Dan harnessed them up, and we began our slow waddle around the block. The dogs had no idea why we were going so slowly, nor why I had to stop every five minutes or so to lean on Dan’s shoulder. But they knew something was up when we got back and Dan started packing the car. They know our bags, the frantic “we’re about to go on a trip” look on our faces, and they wait at the door for the moment when we call to them, “load up!” and open the hatch to our Jeep. Except this time, the dogs can’t come with us. Our wild dog, Meg, began to sense that something had gone awry with her plans to join us. And so, in perfect Meg fashion, she decided to sneak out the door as soon as Dan opened it to carry out another load. So my early labor was speckled with shouts of “Meg, Come!” throughout the neighborhood, as she decided that since she wasn’t coming with us, she’d might as well make her own adventure. We tried everything. We called her in high voices, enticed her with treats, even brought her food bowl out and shook the kibble inside, but it wasn’t until we tricked her to jump in the car that we finally got a hold of her and took her back inside.

The contractions were picking up. So I finally decided to call the doctor’s office and see what they thought. I hate telephones. I hate the awkwardness of the first greeting, the fear that you’ve interrupted someone in the middle of some important life discovery or an argument with his or her spouse, the feeling that maybe what you need from him or her isn’t so important, and the horrible pause that comes before finally concluding the phone call and saying goodbye. But I was having contractions and thought maybe someone else ought to know about it. So I called the doctor’s office, got scooted around from one answering service to another, and finally talked to a doctor on call, who told me to hang tight, and to continue laboring at home.

So we turned on “Arrested Development” episodes. We called our parents and gave them updates. We wandered around, hiding clutter in closets and drawers, vacuuming, wondering what we were forgetting, swaying together during each contraction. I drank Gatorade and ate Jello from tiny cups.

I called my mom at around nine or so that night. I was getting more and more sure that this was it. Tonight would be the night we’d go to the hospital – the final stage towards Jonah’s birth, towards meeting him, seeing his face and his hands. In the middle of the call with my mom, I told her to hold on a sec. I was having another contraction. I set the phone down, called to Dan, and started our slow dance through the tightness of the contraction. After it was over, I picked up the phone and said, “Okay, that one’s over,” and my mom started ranting about how I needed to get to the hospital, about how quickly these things could happen, about how I didn’t want to get amniotic fluid all over the car seats because you’ll never get the smell out.

So I waited another hour.

Then I called the hospital, told them we should probably come on in, and waddled to the car. Dan drove so slowly, trying to keep our Jeep from riding like the truck it is over all the Pittsburgh potholes. We parked on the street and took a slow walk into the hospital emergency room, stopping a few times to sway and breathe. Jonah was coming. He was really coming. But I couldn’t really focus on that. I could only just focus on breathing through every contraction.

I remember thinking how calm the ER waiting room seemed. The nurse in triage took my blood pressure, offered me congratulations, and told me to wait. There were others waiting, too, for relatives and friends, maybe, and they watched football games and comedy reruns from tiny televisions mounted on the walls. I hadn’t been in a hospital for myself since I was in the fourth grade, in to get two layers of stitches in my left arm from falling into a window well while trying to escape my neighbor’s squirt gun.

After about ten minutes, the transport person came with a giant wheelchair. I asked if I really had to sit down, and she said, “Yes,” and that “all the women complain about it.” We went up to the fifth floor, and they put us in a tiny room with a bed, a monitor, and a bathroom. They took my insurance information from Dan, gave him a bunch of papers to fill out, and sent me to the bathroom to change into a hospital gown and get them a urine sample. I could handle the urine sample, the putting my clothes into the plastic hospital bag, the next contraction. But those gowns were far too complicated for me to handle alone. I called for Dan to come help, and together, with a total five masters degrees between us, we finally figured out how to align the snaps, tie the knots, and successfully put on the hospital gown.

The nurse in the maternity triage room stared at me in disbelief when I told her I didn’t want an IV, just a hep-lock. She said, “So… you aren’t going to want an epidural?” in a tone that might as well have asked if I didn’t believe in the sun coming up or the world being round. I said, “Well, I’m not sure, but I don’t think so,” and she left in the loudest silent disbelief.

They checked my dilation, and I was hoping for at least four centimeters, but was only three, and they did a final ultrasound to make sure the baby was head down. They monitored my contractions for about twenty minutes, and finally decided that yes, they were going to admit me. We landed in our birthing suite around eleven or so, and we entered with the television flashing the food network, a horrible irony in that I’d have nothing but ice chips for the next forty hours or so. But I jump ahead.

I was Strep B positive, so they started me on antibiotics, and once I was hooked up, we started walking the halls. But we didn’t get far, and I sent Dan for a pail. I was going to get sick. So much for all the eating I’d tried to do while laboring at home in order to help me through labor.

We headed back to the birthing suite, where we stayed, standing, rocking, breathing, for the next five and a half hours. Dan put Hem on the IPod, and the lead singer’s soft voice entered and left my consciousness throughout the night.

Dr. Meyer came in. He was relaxed, making jokes with me between contractions, and asking us about our lives, how we met, where we went to college, what we did for a living. Turns out, his wife went to Hope College, and was a student of Jack Ridl’s. So we shared our favorite William Stafford poems, and talked about how great Jack was as a teacher, and is now.

When Dr. Meyer checked me soon before midnight, I was at six centimeters, and in the middle of his check, my water broke with a snap. With that, I was tethered to the monitor for the rest of the night. Soon after, our doula, Lakeisha, came, and she held my hand, rubbed my back, got more ice chips, and rewet the washcloth every half hour or so. Lakeisha, the nurse, and the doctor, were calling Dan the “daddy doula” because he was doing such a good job supporting me through each contraction.

By 2 am, I’d been standing and swaying through my contractions for hours. And things were certainly picking up. The contractions felt like all there was in the world, and yet, when I looked up at the clock, I was surprised at how much time had passed. My legs grew tired, and they put me on the bed, on my knees, leaning against the propped up head of the bed. The contractions were getting stronger and stronger, and at one point, I asked for the epidural. Part of me didn’t think I could last much longer, but part of me just wanted to be convinced that I was almost done, that I could do this, and that I really didn’t need it. When Dr. Meyer came to check me again, I lay down in the bed, and did not want to move from that position. I held on to Dan’s hand in my right hand, and Lakeisha’s in my left, and swayed my knees and rocked my whole body, and pulled on Dan’s hand with mine, trying to breathe out every contraction, imagining my breath pushing away the pain, out of my uterus, down my legs, past my knees, through my feet. I’d found some kind of rhythm. Looking back, I’m amazed at how my body just seemed to know how to cope, had found a way to move through each contraction, with rocking, with breath, with sweat.

At 3:30, I was beginning to get overwhelmed. But I was also noticing some quiet looks from Dr. Meyer and from our nurse, as they stared at the baby’s heart monitor. Each time Dr. Meyer checked me, he said the baby’s heart rate would drop, something about a sensitive vagal reflex. I couldn’t focus on that. The pain was too strong to let in any panic about the health of my baby. Everything would be okay. It hurt too much not to be. Everything had to be okay.

Dr. Meyer kept telling me to tell him when I felt a lot of pressure, and then it would be time to push. I wanted to push so badly. I wanted to move from this phase of painful waiting. The rhythm was taking me over, swallowing me up; I had to break it down somehow, and soon.

Dr. Meyer checked me, and I was almost ten centimeters; I just had a lip more to go. I could see the summit, the trees clearing, the path thinning.
Around 4 am, Dr. Meyer finally let me start pushing. I did a round of pushing. I made a mess all over the bed. They made me do three pushes in a row. The third push was the hardest. But I could feel like something was happening, like my baby was moving closer to me. And I was worried about how much more this was going to hurt.

Dr. Meyer said I wasn’t quite ready for more pushing yet, so I labored a bit longer. Finally, he let me try again, and this time he said I was a really good pusher, and that I would be able to push the baby right past that leftover lip in my cervix. But there was still a distraction. The monitor.
Dr. Meyer called in the OB on call, and suddenly the room filled with people. Two residents, more nurses, all hovering around the monitor. Dr. Meyer had me push through one more round. I was getting desperate to rest, to get this baby out, to meet my child. Mostly, to get this baby out.

But the OB doctor was skeptical. She was concerned about the numbers on the monitor each time I pushed. She strongly advised an emergency c-section. Dr. Meyer seemed to want to at least let me think that I had some choice in the matter, and asked me what I wanted to do. I asked if I could try pushing one more time. I pushed. Dan counted to ten through each push. Later, he said he was trying to count faster to help me get through each push. They had me pushing in rounds of three, and that third push through each contraction was incredibly difficult. But Jonah’s heart rate still dipped too far down, and suddenly I was surrounded by nurses and movement. I met the anesthesiologist, signed papers, and tried to keep breathing, while the nurses shaved me, put in a new round of antibiotics, had me swallow a terribly bitter antacid, and wheeled me away, without Dan.

They transferred me to the operating table, and in the middle of contractions, I was given the spinal. Dr. Meyer and the nurse held me steady, tried to calm me down, and coached me into the right position to avoid permanent paralysis. I was so grateful for them, steady for me while Dan was gone. Then I lay down; they strapped me in, put up the paper curtain, and they got to work. Around that time, Dan came in, in scrubs, and sat by my head.

It took about ten minutes – who knows – maybe more, maybe less, and Jonah was out. The doctor said, “Okay, a lot of pressure,” and out he came, all 8 pounds, ten ounces of him. She said he wasn’t coming out any other way. He’d had a tight cord around his neck. He cried for a minute, then calmed, and they put him in the warmer. I wouldn’t see him for at least another twenty minutes. It felt like I was listening to a television; the birth of my son as far away from me as the Nightly News or a “Seinfeld” episode. The thin paper curtain might as well have been a flat screen TV, or a fence with curling barbed wire.

Concerned about his heart rate, his breathing, and his temperature, they watched him for awhile. The first thing Dr. Meyer said was, “Who’s got the dimple in the chin?” “It’s my side of the family,” I said, “but we all call it ‘the butt chin.’” Dr. Meyer said, “Well, I wasn’t going to say anything, but…” and his comment helped keep my mind off of those overwhelming last fifteen minutes, helped me smile, helped form a small image in my mind of my son, a bridge across paper curtains, a crew of people in scrubs, numb legs, and a vulnerable, open uterus.

They let Dan come over and see him, but he didn’t get to cut the cord, that final act of birth that separates mother from child, and invites the baby to need what the rest of the world has to offer.

I didn’t get to feel his warm body against my chest, didn’t get to feed him right away, or smell his first life flesh, still wet with the both of us. I wasn’t the one who calmed him as he entered this world; mine wasn’t the first voice he heard. Our lungs didn’t breathe the same air; my finger wasn’t the first thing his tiny hand would grasp. Our eyes wouldn’t meet for at least another thirty minutes.

As they stitched me up, and watched my baby, I was puking in a tiny bin, held by a very kind anesthesiologist.

I should be grateful. I am grateful. They saved my child’s life. It was the right decision.

But I hear of so many instances when a C-Section wasn’t necessary, that instances of C-Sections have become increasingly more common, as many as one in three pregnancies, that I wonder if I should trust the doctor’s decision, if it was really necessary in my case.

A few days after coming home from the hospital, we saw a morning news report about a woman who was in labor at home for four days. The woman kept asking her midwife if this was okay, if this was normal, and the midwife encouraged her to just keep going. After her incredibly long labor, she gave birth to her dead child, the umbilical cord tied too tightly around the baby’s neck. The mother later said, “C-Sections are not the worst thing; I’d rather have a thousand C-Sections and still have my daughter.” When I watched that, I knew we’d made the right decision.
But there is still lingering pain and doubt.

Many parents have told me how strange it feels, to leave the hospital with this new child, like they’ve robbed a bank, or conned someone out of a winning lottery ticket. They tell me that, strangely, even after the sweat and fear and all that work, their child still doesn’t feel like theirs. And maybe if things had gone as I’d hoped, I’d still feel like this child is alien to me, still feel like I had nothing to do with the creation of this tiny being. But I can’t help but think that he’d feel a little bit more like mine, like I’d done something to earn him, to earn the chance to be his mom, if I’d just been able to get him out of me safely, and on my own.

Maybe that’s the big lesson. None of us can get in or out of this world safely on our own. Maybe I needed to fully experience the helplessness of a c-section in order to understand that it really does take a village to raise a child. But ever since I’ve been home with this new being, I haven’t wanted anyone’s help. I don’t even wake my husband up for midnight diaper changes anymore. When people hold him, I want him right back; no one else burps him right, no one else can feed him, no one else knows what he wants with each new cry. So much for a lesson out of this eight inch incision.

I’m still mourning the experience I wanted. I’m still angry that I didn’t get to experience all that I’d hoped. I get angry and sad when I read other women’s natural birth stories, about how amazing it was for them to experience the fullness of birth, the strength of their own bodies, and the huge emotional rush. It’s like they’ve been invited up to Mount Sinai, or to the Mount of Transfiguration, and I was left at home, in the valley, to sweep the dust off the front porch and wait for them to come home and tell me all about their sore feet from the climb, their dry mouths from the heat, their wide eyes from all they’d seen.

Jonah would stay in the hospital a total of eight days. First, they were concerned about an infection, then his low heart rate. He was fine; he is fine. A gorgeous, wonderful miracle. But I’m still weighed down by the experience we didn’t get to have, by the fact that Dan had to work the night they finally discharged Jonah and my mother-in-law was the one to drive us home from the hospital, that over and over those first days of his life, someone else kept stepping in to tend to him, to maintain his life, to save his life, and I was left behind.

Ultimately, the job got done. But how I wish it could have been more than a job, something more than checking a chore off a list. We got a beautiful result. But I’m still struggling to find the beauty in the journey on the way there.

Getting back into my own bed helps. Giving myself the grace to see that my body did a lot of work for nine months and fourteen hours, that my body still nourishes and enables this child to grow, is hard, but when I can, it helps. But how do I get to the resurrection of this story? How do I see the hope in what has already passed? In what part of this story can I be proud? Where in all this is my story? I’m so grateful for the birth of my healthy son, but I still mourn the loss of the experience I truly wanted.

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