Over the last few years I have developed this sense, this overarching fear, of waiting for the other shoe to drop. When things are going relatively well I start wondering when it will all crash down. Even though the news was pretty grim I still saw a tiny shard of hope. "Miracles can happen." This, from my doctor who is a Christian and has seen medical miracles. Both he and I knew it would require a miracle.
Seconds ticked into minutes. Minutes blurred into hours. Hours drug on to days. Tuesday arrived without any further bleeding. I went to my ultrasound thinking that either I am carrying a dead baby or a miracle has happened. Medically, physiologically, there isn't much middle ground. Knowing the tech is not qualified to tell me all I want to know, I simply ask to see the heartbeat. I've seen another woman's child's heartbeat four weeks after a grim prognosis. Would it be the same for me? I could tell right away the tech was experienced. She was efficient in getting set up and as soon as possible aimed the wand toward the heart.
There it was.
"There it is!"
There it was. Flickering rhythmically. Somewhere around 200 beats a minute. My little one was still alive! If only I were an ultrasound tech and could get a clue what the rest of it meant. I waited a couple of hours for the radiologist to view the reports, come to his conclusion, and report to my doctor. "The radiologist tells me he has never seen this amount of improvement in this amount of time." About 80% of the blood between the placenta and uterus had been absorbed. There was no new bleeding and there was significantly more tissue attached to the uterine wall than there was four days earlier, evidence of the placenta shunting it's structures to maintain adequate blood flow despite having a smaller percentage of attached surface area.
It was good news, but not 100% comforting. If the threatened miscarriage was due to a physical abnormality or a developmental issue it could still reoccur at a later time.
Now that we know she is happy, healthy, and developmentally on track we can call this a miracle. But at the time there was still uncertainty.
Fast forward to one week before my due date. I was SO READY for her to come out. When pregnant my joint issues are amplified ten-fold climaxing to constant pain in the last three or four weeks. Both times I have torn the cartilage in my pelvis further crippling me for months. Since my joints are unusually weak I depend heavily on my muscles to provide joint stability. As things get looser with the pregnancy my muscles are taxed more and more, sapping my energy, requiring me to take time off from work for several weeks before the baby is born. With Abigail's pregnancy, the torn pelvis didn't improve after tearing, it only got worse leaving me in intense pain for the last four weeks of the pregnancy. There were times that all I could do was lay on the couch and cry. Hence, when labor started one week before my due date I was relieved.
That morning began with a general backache, something I didn't take note of until much later; I was in too much general pain to notice my back joining the symphony. Contractions maintained the same rhythm as the week before: sometimes an hour would pass between contractions, sometimes only 10 minutes, but nothing consistent and not particularly interruptive. Once Tim returned from work in the evening contractions had begun to get closer together and were much more noticeable so I cloistered myself in the bedroom hoping to maintain that trajectory using concentration with peace and quiet and Sudoku on my phone. After about two hours of this things began changing. I knew I crossed the threshold from latent labor to active labor and would likely give birth soon! Things really intensified over about four contractions so I said it was time to begin the process of traveling to the hospital 40 minutes away.
We left for the hospital (the choice since after my intense labor with Shoshana I wanted the option of pain medicine if I needed it) between 10 and 11 pm, I think. Once there I changed positions frequently, was in and out of the birth tub, saying with a sigh "that contraction was tough but NOTHING like the induced contractions of labor with Shoshana. I could do this for days!" We chatted between contractions, listened to music, progressed consistently. Once transition got close and the sun was coming up we could tell that once again I had a cervical lip. An incredibly painful piece of cervix being pinched with every contraction rather than pushed and stretched. I asked for my pain management options since this is what I feared. The suggestion was made by both Amanda, acting as doula, and the labor RN that we should try breaking my water before trying pain medication which would give more consistent pressure on the cervix. I agreed.
We expected to wait 30 minutes for the midwife on call. She was in another room with a woman pushing. Around this time the shift changed and things got... interesting. 30 minutes turned into an hour and I was screaming with every contraction. Now this is what I remembered from Shoshana's labor! Fire and agony. Tim and Amanda asked again about the status of getting my waters broken since they still hadn't broken on their own. At this point I asked again about my drug options and I was assured that once my water broke things would progress so quickly that drugs wouldn't help. My support team was also assured that the midwife would come VERY SOON to break my water.
Another 30 minutes or so passed and I was sure Abigail was stuck. Every contraction sent me into writhing agony but she wasn't moving. All pain and no progress. Somehow, Amanda got the point across that we wanted someone, anyone, to come and break my water NOW. For the first time, the nurse paged the OB. Apparently they got the idea that I would refuse any and all treatment by an OB without express permission. I'm still not sure how they got that. There was also information lost over shift change including that I had already asked about pain management so they thought I was simply trying to tough it out, determined to have another natural birth.
The OB, who I had never met, showed up in great spirits. He was joking around with the staff and trying to be funny with my support team. Can you guess how raw everyone's emotions were after 2 hours of hearing me scream? He didn't go over well. I have one memory of him talking: "If only she would push past the lip the baby would come right out." OH REALLY? YA THINK? HOW ABOUT YOU COME OVER HERE AND TRY IT! I wanted to scream at him that I'd done that once before but this time something was different! IT WASN'T WORKING! He broke the water which was so tough I might have otherwise birthed her in the caul, with intact membranes. Talk about making up for last time when my water broke on its own at 5am, 18 days early! Then, my favorite memory of the birth happened: someone suggested putting counter-pressure on the cervical lip while I pushed. For those who don't know counter pressure on a bruised cervix during a contraction sends your pain from unimaginable, to inconceivable. I did not agree to this. However, the next contraction came so soon that I didn't get a chance to protest. He barely touched my bruised, hypersensitive cervix and I aimed a kick square in the chest. Too bad he saw it coming and it only glanced off his shoulder. That was mostly for his rude comment earlier and the simple fact that I got to retaliate for his insensitivity with the excuse of being in labor made me unusually happy.
I didn't see or hear from him again. Phew!
Going on 2 and a half hours of transition it occurred to me that this is how women die in childbirth. I had failed to communicate to my team how Abigail was stuck and my weeping between contractions that "this isn't working" didn't get the message across either. Finally, I resorted to the one thing I knew was guaranteed to get everyone's attention: talking about dying. A rule of thumb for clinicians is to always take it seriously when someone starts talking about a "sense of impending doom." Abigail was going to die and I was going to die. That was the only thing I could think to say that might get the sort of response from the clinicians that I wanted. Something had to change or things were going to go badly very quickly. I remember telling Tim to make sure that Shoshana knew how much I loved her. At that point I remember things finally starting to pick up the pace around me. Apparently the anesthesiologist was waiting on the floor, expecting my call. They were prepped for an epidural. Did I want an epidural? ARE YOU KIDDING?? I asked about pain meds two hours ago and you guys are the ones who suggested something else!
Within minutes the anesthesiologist was in the room asking basic questions and the nurse started an IV. They immediately gave me a nice big dose of Fentanyl, a powerful opioid. It didn't touch the pain. Ok, now for the 30 minute process of setting the epidural. Typically you are required to have a liter of fluid infused before starting the epidural to protect against hypotension but in my case they knew I needed the relief ASAP. Too bad the anesthesiologist didn't try sooner! I was in such agony that I couldn't sit still enough for him to do his job. In the meantime they gave me another dose of Fentanyl. Again, no difference in pain. The first poke missed. The second one sent electricity down my left leg. As he was attempting the third one I promised myself that this was his last try. If this didn't work we were having a cesarean. Come to find out later, Tim was thinking the same thing. That, and he had set a time limit: if I didn't have relief or had birthed the baby by a certain time he would demand a c-section. And I would have agreed whole-heartedly! Suddenly, gratefully, "my toes are tingling!" Within a minute I was numb from the ribs down. Don't get me wrong, an epidural doesn't make you completely numb. But a spinal does! I heard him talking to a nurse later that he felt so bad for me that he wanted to make sure that I would get immediate pain relief. I was so glad he did.
And so VERRRY sleepy.
Just in case you missed it, the total was 3 hours of transition and screaming with every push/contraction. Worn out from labor, hoarse from screaming, and, apparently, nearly overdosed on opioids. Oops. Now that I could rest they wanted to wait an hour before pushing so the Fentanyl could work it's way out of our systems. What a great idea! I'll just lay here and sleep. And stop breathing a couple of times. "beep beep beep." "Elizabeth, you need to take a deep breath for me." Clinician speak for "this needs to change now." I forced myself a deep breath and the beeping stopped. As I drifted off again I thought to myself "No Narcan. No Narcan." The reversal drug is brutal. It sends you into complete withdrawal allowing you to feel all the pain again within a matter of seconds. I've had to use it a couple of times on patients. It is never pretty. A tap on the shoulder and reminder to breathe happened three times during that hour. But mostly I slept. My support team got a nap too. The only one not happy at this point was Abigail. She began to show signs of stress.
"Alright! Let's have a baby!" I felt so good! I was grateful and happy to be detached from my lower body. To this day when I hear the word "spinal" I can't help but smile. Feelings of relief, peace, gratefulness, and happiness flood my brain. That happened just this morning! Several intense pushes later she popped out and immediately started making noise. Rather than her big sister's pointed screams Abigail cooed. "ooo ooo." "There she is!" I said I picked her up and placed her on my tummy. She immediately wanted to nurse. It was actually rather comical. Her umbilical cord was still returning the blood that belonged to her back from the placenta yet she couldn't wait to eat! She must be my daughter. The poor thing had to wait anyway because the umbilical cord wasn't long enough to allow her to reach.
My smiling reverie was suddenly broken as the pediatric nurse made a rough swipe on Abigail's right cheek, removing most of the sticky skin protectant/moisturizer called vernix, something I SPECIFICALLY requested on my birth plan to be avoided. "Please don't" I asked the nurse. She said something about getting the baby dry. "We can pat her dry." When she continued to be rougher than I wanted I just happened to dry Abigail just in the places she was aiming for. She got the hint pretty quickly and left us alone.
This is getting pretty long so I'll wrap it up. Abigail was an excellent eater from the start, something I had prayed for since feeding was such a challenge with Shoshana. She was latched the whole first two hours of life. The downside is she is not nearly as good a sleeper as Shoshana. But at this point I am okay with that. As far as the emotional upheaval of the first few months, I haven't come to many conclusions about that yet. Just that I'm glad it is over. I am still puzzled by these sorts of situations and what they are supposed to teach us. I don't have any great insights. I'm still healing. And Abigail is playing a beautiful part of that healing both from the traumatic experiences of Shoshana's early days as well as her own.
Maybe you can help me out. What sorts of things has God taught you through difficult situations?
3 comments:
What God has taught me through difficult situations:
--that I need help sometimes
--that it's OK to ask for help
--that the people helping me are blessed through that
--that my way really isn't the better way
--that I need other women and can learn a lot from them
--that I can't fix myself or other people, only God can.
--that God's timing always benefits the big picture, not my tiny, self-absorbed world.
--that, prior to the last few years, I was a very much without compassion.
That's just what pops to mind:). I'm thinking I should write out a few things the way you've done here--writing helps processing. Thanks for sharing:).
Hmmm, first of all - I would not recommend this read before one's first birth. Whew! Every birth is different and every mom is different so don't think this is how birthing always goes. But then, you have a lot of ability to remember detail and write it so engrossingly. Maybe it was that crazy when I tried to birth you.....no it wasn't.
You did leave out that I was the one home watching Shosho while you went to the doctor to find out why the bleeding. I saw you pull up, park the car, come out of the driver's door and up the stairs. "Oh mamma, I'm going to loose the baby", you cried. We both cried, you in my arms, as you told me about the placenta.
It was terribly meaningful to me that I was able to be there for you.
Wisdom: I think wisdom learned in these situations is knowing that God is the maker of life and our future and our days. As humans it just seems to take BIG things to cause us to keep our perspective that it is God and God alone who is in control. It is also moving us to learn deeply that God is good all the time and in every way. His perspective is just so far above ours and His desire is fellowship with us in conforming to Christ's image. Since I've learned I'm a long way from His image, I can now trust that the things allowed in my life are for that purpose above all - like my comfort or my understanding.
God's lessons (as taught by life) are not always new factual revelations.
The personal growth demonstrated in the difference between how you reacted during and after the pain of Shoshana's birth and Abigail's birth for me was a specific answer to prayer.
The suffering was more intense and longer, but you did not hold it against God in resentment.
It was also fruit of the healing that the Lord had been quietly doing in your life in the intervening time, a healing process of which I see continuing evidence.
Post a Comment