Friday, October 18, 2013

BIRTH STORY PART 3 THE BIRTH OF RUBY



I've wanted to share this story for a long time as a sort of catharsis for this next birth. Thank you for following along and listening if you've read part I and part II.  I think my experience will help explain why I am so passionate about this issue. 

Shortly after solidifying our plans to move to Austin in 2010, we found out we were pregnant. While the timing wasn't ideal, we were thrilled. We arrived in Austin, when I was about 16 weeks and by all discernible means, healthy. I had chosen a midwife in Austin and she took over my prenatal care immediately. 

Moving to a new city/home/life where you know absolutely no one is tough--even if you aren't pregnant. It is also financially stressful to relocate and I had to find work immediately. I had to keep my pregnancy under wraps to get hired--thats the reality people--and I wasn't always able to say "hey I can't lift that." When I finally did come clean about my pregnancy, I was treated more or less like a burden despite being utterly qualified and dependable. My requests to sit for a few minutes were met with begrudging eye-rolls. I won't say where I worked but let's just say that they don't have pottery and its not a barn. As I said I was on my feet constantly and expected to carry, lift, and move things incessantly. I was a manager and in an often stressful position with erratic hours.

At my visits to my midwife, she urged me to slow down and even quit. Quit my job? But I work. I've always worked. You can't just not work because you're pregnant right? (I laugh now, because I haven't worked outside the home for 3 years now and yes, you can just not work. But, I digress). 

As I neared my third trimester, each prenatal visit my blood pressure continued to climb and based on my midwife's recommendation, I was admitted for observation and tests and assigned to the on-call OB. A nice enough, experienced, old fellow (and excellent surgeon) with no uterus. I guess that's pretty normal for men.  He ordered bed-rest for the rest of my pregnancy and was put on medication and forced to say goodbye to my home birth. My midwife stayed on in a supporting role, which was a relief as we had no other support or family.  

Each week after this was a series of medications, tests, interventions that brought me further and further from my birth plan. My doc played along with my idea that I was still going to give birth naturally, and as the first 30 weeks of my pregnancy had been such a breeze it was all very hard for me to accept that I was now suddenly "high risk." Even up until the day I delivered there were no other signs of pre-eclampsia other than high bp. I honestly don't know if the situation itself was the cause of my blood pressure. I still shudder when I drive down the street where his office is. Such a scary time for me. More on that later. 

About 2 weeks before I delivered I started having really bad heartburn. This is obviously very common but it was so bad that I would be up all night with severe cramping and pain in my back. Everything we researched seem to bring us to the conclusion that it was normal in late pregnancy. I noticed immediately it would worsen right after I would take the second dose of my bp medication (by this point I was taking 2 kinds, for a total of 6 pills a day plus a prescription for heartburn!) In short, it became difficult for me to eat or sleep--which are really the last 2 things you can do when you are on bedrest. 

The day before Thanksgiving I had a really high bp reading, and discovered that I had a bladder infection, probably because I literally could not stomach a glass of water at this point. I started yet another medication for the bladder and a stronger medication for the blood pressure. That night I had my worst "heartburn" yet which I am convinced was the baby's reaction to the medication, which no one still believes me but I KNOW.  My doc was out for a few days for the holiday and I quit taking EVERYTHING and felt better immediately .bp readings were reasonable without medication.  

When I saw him the next time we switched medications AGAIN.  I didn't have the nasty reaction but it didn't help my bp either.  When I came in for my next appt. My it was off the charts, seizure level, and my liver enzymes/protein etc.. had tripled. I also had a cold. He told me that we needed to deliver the baby that day. I was allowed about 15 minutes of weeping in the office and told I had to go straight to the hospital without getting anything (I often wonder if this was so he could be home by dinnertime?My c-section was about 6pm) and have Scott meet me there. I was 36 and a half weeks. 

When I got there I was hooked up to ALL KINDS OF SHIT and told I could no longer have food or water. Considering I hadn't eaten more than soda crackers for a week and had almost no liquid that day either this was bad news. I had to have a catheter (inserted with a bladder infection=awesome) and a blood pressure cuff squeezing the crap out of my arm every 2 minutes. Needless to say I was in a pretty foul mood when Scott arrived. Luckily he put on his game face and cheered me up about how happy he was we were about to meet our baby. (He told me later he had a heart attack in private before he got there). I stopped whimpering momentarily and started to get excited that our little one was really coming THAT DAY. 
Scott looking like a serial killer and doing a great job of faking happiness for me
Surgery happened pretty quickly after that.. I was conscious. Conscious of lying naked, cut open, spread eagle on a table in a freezing cold room full of surgeons, talking about what they were going to have for dinner, while I had tears running down my face, mourning the loss of everything I had been preparing for. Once my spinal kicked in..things got better. All the gadgets I was hooked up to stopped hurting and Scott was allowed into the room and I got a heating blanket. 

After that things went fast. She came out easily and I heard the doc say, in between chicken or steak, that the cord was around her neck twice although when he said it, he said "the cord's around his neck" to the other surgeon so I assumed it was a boy. After they took her out and dangled her over me for a second they said, "Don't you want to know if its a boy or girl?  Its a girl!" 
You are not my mom! 

At this point we cried because we secretly wanted a girl the whole time but I didn't want to admit it, in case a sweet little boy came out.  She was normal color and looked HUGE to me. I was shocked when I found out later she was only 4 lbs.  I got to see her for 2 seconds before she was taken away. Scott got to go with her but I didn't know where. I was alone while they finished closing me up. 

Once I was in the recovery room..a place I will always remember as the most "god-awful-cave-of-unhappiness EVER.". I was told even though she was healthy, breathing and got a score of 9 out of 10 Apgar rating, that because of her size, policy stated that she needed to be in the NICU to make sure she could maintain her body heat on her own. They told me she would be with me within an hour or two. Scott was able to go up and be with her and report back. My spirits were still high at this point and I was psyched that I had a girl. My midwife had helped deliver three other babies that day, but came by for support anyway, and we started spreading the word. 

I, on the other hand was still at risk with my bp so I was placed on a magnesium drip and leg and arm cuff for 24 HOURS!!  This is kind of like a full body cast that squeezes you. I could not get out bed, eat, drink ,anything--most importantly, see my daughter. 
Trying to be brave in the godawful cave of unhappiness
Several hours went by at which point it was getting late and the NICU nurse came down and told me that they didn't think she could stay warm enough for me to see her and I was going to have to wait until tomorrow. 

Obviously I became completely unhinged, and cried. Anyone who knows anything about birth knows that a little skin to skin contact with her mama probably would have solved the problem. I threw an absolute fit (not good for bp) and my nurse--the kindest one I had out of EIGHT--went upstairs and convinced them to bring her down to me for TEN MINUTES. I manipulated the nurse into twenty and had to be satisfied with that for the night. I'd like to note here that my blood pressure stabilized as soon as they brought her to me--as did her temp.
Together and happy
Mommy feels good
A little later the ICU doc called me and said that she really needed to eat something and that we should give her some formula. I believe my words were something like "over my dead body, you will give my 4 lb newborn hospital formula"  Maybe not the smartest thing to say when you're strapped to a hospital bed.  They gave me three options..formula in a bottle (!), an IV, or daddy could come up and do tube feeding with donor breast milk every three hours for the night as the doc (male) didn't think I was "up to pumping."  My nurse was already down the hall getting me a pump and 30 minutes later I had almost 2 inches of colostrum for her to add to her supplement. They were amazed I could get so much to her and I was amazed what I can accomplish when I'm REALLY PISSED OFF.  Dad continued feedings all night (God I love my husband) and I remained strapped in bed.  I woke up several times in the night balling because I still didn't have my baby.  

Eventually the next evening rolled around and I was finally moved to the postpartum wing, where amazingly no one has a concept of "quiet voices," and all my machinery taken off. They finally brought her to me, and again my blood pressure stabilized as soon as I had her and her temperature stabilized as soon as she was with me....duh. 

At this point I had not eaten or drank anything for 48 hours which was really about 2 weeks because of my "heartburn" and was getting really pissy that no one would allow me to get some food. I yelled at my first nurse because she would not allow us to order food from the cafeteria before it closed, because she had not gotten the "okay" from my doc (who was gone for the weekend). We proceeded to have a big conflict with this nurse who refused to allow me food until I "farted." 

I was delirious at this point and just needed to eat something. Scott finally ran down to the cafeteria and brought us up some dinner anyway (I hadn't farted by the way but was ready to fall over from fatigue), and I immediately felt better. My midwife came to help me get Ruby latched on and I was able to breast feed her with a supplement tube of donor milk as mine had not come in yet. She took to it like a champ and we were finally in business. 

For 2 days she was still under the care of an NICU nurse which came into our room every 2 hours and checked her. They threatened that if she did not maintain her temp they would take her away so Scott and I became psychotic thermometer parents. The idea of them taking her again was unacceptable. 

I also had a rotating line of nurses every few hours, dosing me on painkillers (straight into my breastmilk..great), checking my wound and bleeding, not to mention the endless string of lab people, birth certificate people, doctors, lactation, etc.. We literally had someone knocking on the door every 5 minutes. It was exhausting and not very conducive to nursing a brand new baby or recovering from abdominal surgery. For the next few days we continued to be the biggest pains in the asses the hospital had probably ever seen. Everyone wanted to tell us that this or that was "policy" but the rules changed with each new person. We were basically against them taking her out of the room. 

Because of her size, it seemed everyone wanted to find something that was going wrong with her when in reality Scott and I were working our butts off to give her the best possible care and she was doing great. Her weight went down to 3lb 9oz which is normal, but she was eating and cleared all meconium out of her system.  She was a little spunk-meister even then. 

She was finally transferred out of NICU to regular newborn care but it was not their "policy to give donor milk" in newborn care and told us she could not have anymore milk. Um...REALLY??..you won't give my 3lb baby anymore milk??? Aren't we in a fucking hospital? My milk had not come in yet--probably because my body didn't even know it had had a baby and they were STARVING me and keeping her from me for nearly two days.  We immediately called our lactation person and Ruby's doc and they agreed to keep her in NICU "on paper" so she could still get the donor milk. It was RIDICULOUS. 

Unfortunately, this also meant the NICU temperature Nazis were still coming by (as policy) every 2 hours even though she had technically been released into newborn care--Each one with their own story of the horrors of what might happen if we unwrap her... Good Lord. (I don't get into the financials of hospital birth too much, but for the record NICU "even on paper" is not cheap)

One person would come in and want to draw her blood, unwrap her and coo over her tiny cuteness, and then 5 minutes later someone else would take her vitals and unwrap her and then complain because she had gone down a degree, when in reality if they would have just left us alone where she was all warm and snuggled with us, her temp wouldn't drop!  Every nurse had their own agenda or weird thing they were hung up on and we were just desperate to go home, get some peace and take care of her.  

On day 3 my milk came in and we were able to shake some of the staff and we eased into a good pattern of 3 hour feedings and sleep. Day 4 finally rolled around and despite lots of attempts to find otherwise the pediatrician on call gave her a clean bill of health and told us that she was going to do something she had never done--release a four pound preemie to go home with its parents. Scott and I had our suitcases packed and the baby dressed. We closed the door and cried.  My wheelchair could not come soon enough... 
Get me the hell out of this hospital! 
The experience was about as "un-homebirthey" as I could have imagined but Scott and I--with the help of our midwife--did our best to demand the things we could and we feel that BECAUSE of all those demands we were able to take her home with us and  somewhat reestablish the connection with her that we missed the day of her birth. He and I became united in a way we had never before and I will always think of that time in the hospital as the ultimate bonding for us as a couple. We had to fight tooth and nail for EVERY thing we needed. 

I can't express how utterly devastating it was for me to carry her in my body for eight months and have her so unexpectedly taken out...no labor, no looking down at my newborn as she came into the world, no rush of super-mama, rock star, conquer-the-world, love-cocktail streaming through my veins. I felt utterly robbed, and cheated out of the most empowering and life-affirming thing I can do as a woman. 

I have cried. I have grieved. I cry while I write this remembering how it all felt.  I still look at my precious daughter's big blue eyes and feel heartbreak when I think of the way she was separated from me for the first day and a half of her life. I remember the feelings of complete pain waking up in the recovery room with my tiny baby somewhere else in that big scary hospital without me. I will never get that precious moment back. 
Ruby, nearly 3, photo courtesy of Sarah Greenman
So many people have said to me, "just be glad you have a healthy baby." Of course I am. And of course it could be so much worse, but that doesn't make it any less painful than it was. My expectations for having my children are a little higher than just being grateful that we didn't die.  I am a woman and I missed the birth of my own child. It's reasonable to feel loss over that without being called "ungrateful." 

I'm hoping I have another chance. I hope that like so many other women choosing Vbac after they were churned through a severely flawed  hospital system the first time around and said, "Wait a sec--this is NOT RIGHT" that I can have the profound experience of becoming a mother the way it was meant to be. There is a always a chance that I could end up there again and it does scare me--a lot. I hope this time I can own it a little more and conquer my fear. I know what I can and cannot say "NO to and what was most important for us to demand. That is all I want for any pregnant woman. 

Stay tuned. Thank you for reading.
R


1 comment:

Sarah Greenman said...

Thank you so much for sharing these past three posts with us. It's so good to be clear about your desires and your plan. I am putting a big warm light around you and your pending arrival. Here's to a smooth, ease-filled birth at home in the arms of your husband. xoxo