Humpf. I'll just say it. I'm frustrated. Can I get my PhD and several huge research grants, like, tomorrow? Humpf. Or better yet, yesterday.
The source of my angst? I'm just very, very tired of seeing actual scientists/researchers continuing to ask the wrong questions as it relates to the care of preterm infants, newborns and mothers. Why are we doing research that asks if doing A or B is better based on the flawed paradigms within which the ENTIRE medical community works?
Can't we find ways to look at how basic paradigms are sustained despite effective research to the contrary? Shouldn't there be some lithmus test for research proposals that sounds the "uh-huh" alarm when the scientific question is based on the failed paradigm? Yes says me. Et tu?
Tuesday, June 29, 2010
Sunday, June 27, 2010
I'm not just singing to the choir OR our best ain't good enough
I met 28-week Jasmine first, observed her powerful efforts to keep her tiny, one and a half pound body tucked, arms and legs folded in close for security as if trying to recreate her experience in the womb where she’d been just hours earlier. The sounds of the bright and busy intensive care nursery, the breathing apparatus, the lines and unwieldy diaper she wore, all weighed on her attempts to find a comfortable moment for rest. Her nurse that day generously responded to my suggestion to encourage Jasmine to quiet her movements by adjusting her blankets, rearranging her equipment, and quieting the room so that Jasmine could rest while being softly supported in a tucked posture. Jasmine grasped my finger tightly as her nurse gently adjusted her blankets, and then fell into a quiet, relaxed sleep. I headed down the hall to the post-partum unit to meet her parents. Tina and Jason greeted me hesitantly; their anxiety that I might bring unwelcome news of their newly born baby girl somewhat relieved as I introduced myself and congratulated them on the arrival of their amazingly strong and engaging baby. Tina, recovering from emergency surgery due to placental abruption, pre-eclampsia, and having not yet seen her baby, smiled weakly to my account of Jasmine’s behavior. As the days turned into weeks, Jasmine and her parents spent many hours together, somehow managing a bright attitude despite the lasting effects of pre-eclampsia damage to Tina’s body, the unexpected infection that put Jasmine on a breathing machine for a short time, and the difficulty of spending hours with little privacy or comfort. Along the way, I spent time with Jasmine and her family, guiding and encouraging them in their developing roles. I experienced satisfaction that Tina and Jason felt safe to share their worries, frustrations and hope during our times together. I managed effectively to advocate for a quieter room and a number of nurses invested in this family regularly cared for them. Despite these good efforts, I am left with the challenge of “was it good enough”? far too often. As typically occurs in so many instances, the earlier appreciation of the baby’s need for a supportive environment in which her abilities emerge, gives way to the hope that pushing the baby to “take a bottle” will result in an earlier transition to home. Despite what I felt had been a particularly successful process in providing this family the foundation to navigate past the typical obstacles, the forces of habit and NICU culture prevailed. Ultimately, Tina and Jason took Jasmine home healthy yet, breast-feeding abandoned. Furthermore, I know they experienced undo pain and plenty of conflicting messages as to their competency as parents along the way. The story of one family continues on long past "discharge"; the chapter of time when I get the privilege to walk along with them carries a great deal of joy yet also, the burden of always wanting and needing to do more with the little time that is given. Families who must endure the NICU deserve better. Evidence and logic demand it. While there are many who sing the same song, there is much work to be done.
*names and details have been changed to protect privacy*
*names and details have been changed to protect privacy*
Sunday, June 20, 2010
To those little lost souls
As Father's day winds down and as I sit here cruising the Internet after an ill-conceived cup of coffee at 7pm, my mind keeps turning to the memory of two little ones who spent only a few short months in my womb. Part of me hopes that by finally writing these last two birth stories that I can finally heal the sadness that shadows me every day. Maybe by writing about them I can give them new life and free myself too.
Larry was an angel - He came and left without any stressful obstetric/maternal care interventions or choices. He gave me the gift of a natural miscarriage, one I knew was coming and for which I waited, confident after my vba2c in my body's ability to manage it. It wasn't exciting or pleasant, but in a way, I birthed him and was able to bury him. The completeness of this I found out later was really important.
About 10 months later, I was again pregnant. I felt fearful that I would lose this baby, Lucy, too. I went to see some midwives that I'd hoped would help me with a home birth for the next baby. Although I'd had a successful hospital vba2c, I really wanted to have a home birth but still, apparently this isn't a real option for women where I live.
At 10 weeks I asked for an ultrasound. I knew that something was wrong. As the technician did the ultrasound I could see a darling little fetus but I knew that she had already passed. The technician sent the doctor in to tell me, but I knew. I really wished I'd brought my husband with me...I was awash with grief.
I decided to once again wait for a natural miscarriage and told the midwives that I'd seek obstetric care if necessary. I went up to visit my family in Minnesota and cried for a week and begged my mom to keep my children another week. The night my husband and I drove back home, I began to bleed and the bleeding turned into hemorrhaging pretty quickly. I felt like I was in labor.
I ended up going to the emergency room at a local woman's hospital. I was treated very poorly for choosing to wait for a miscarriage. "You should have had a d&c, this is what happens if you don't, who LET you wait"? Yeah, I make decisions about my care - no one LETS me do anything! When I asked about taking the fetal remains so that I could bury the baby the OB acted as if I were completely insane. "No one has ever asked to take it home with them! It is a surgical by-product." Thanks for completely dehumanizing me and my baby! I tried to, calmly at first, explain that I didn't need to take it home with me in a jar, but that I wanted to make arrangements for the proper disposal of her remains that would be religiously significant TO ME. I am still very upset about how I was treated. Luckily a social worker came and confirmed that, yes, people arrange for the disposal of their miscarried babies all the time. A local funeral home even donated cremation services for just such a situation.
So here I am, 2 years after losing Lucy, and I am still feeling very sad. This isn't how I wanted my reproductive years to end - with the bad taste of insensitive maternal care in my mouth and psyche. Not to mention that these two losses brought out the worst in my marriage....and we are still trying to work through that. No inspirational message there. Just life - it can be raw sometimes.
Larry was an angel - He came and left without any stressful obstetric/maternal care interventions or choices. He gave me the gift of a natural miscarriage, one I knew was coming and for which I waited, confident after my vba2c in my body's ability to manage it. It wasn't exciting or pleasant, but in a way, I birthed him and was able to bury him. The completeness of this I found out later was really important.
About 10 months later, I was again pregnant. I felt fearful that I would lose this baby, Lucy, too. I went to see some midwives that I'd hoped would help me with a home birth for the next baby. Although I'd had a successful hospital vba2c, I really wanted to have a home birth but still, apparently this isn't a real option for women where I live.
At 10 weeks I asked for an ultrasound. I knew that something was wrong. As the technician did the ultrasound I could see a darling little fetus but I knew that she had already passed. The technician sent the doctor in to tell me, but I knew. I really wished I'd brought my husband with me...I was awash with grief.
I decided to once again wait for a natural miscarriage and told the midwives that I'd seek obstetric care if necessary. I went up to visit my family in Minnesota and cried for a week and begged my mom to keep my children another week. The night my husband and I drove back home, I began to bleed and the bleeding turned into hemorrhaging pretty quickly. I felt like I was in labor.
I ended up going to the emergency room at a local woman's hospital. I was treated very poorly for choosing to wait for a miscarriage. "You should have had a d&c, this is what happens if you don't, who LET you wait"? Yeah, I make decisions about my care - no one LETS me do anything! When I asked about taking the fetal remains so that I could bury the baby the OB acted as if I were completely insane. "No one has ever asked to take it home with them! It is a surgical by-product." Thanks for completely dehumanizing me and my baby! I tried to, calmly at first, explain that I didn't need to take it home with me in a jar, but that I wanted to make arrangements for the proper disposal of her remains that would be religiously significant TO ME. I am still very upset about how I was treated. Luckily a social worker came and confirmed that, yes, people arrange for the disposal of their miscarried babies all the time. A local funeral home even donated cremation services for just such a situation.
So here I am, 2 years after losing Lucy, and I am still feeling very sad. This isn't how I wanted my reproductive years to end - with the bad taste of insensitive maternal care in my mouth and psyche. Not to mention that these two losses brought out the worst in my marriage....and we are still trying to work through that. No inspirational message there. Just life - it can be raw sometimes.
Monday, June 7, 2010
My VBA2C and yes, I claim it!
For some reason, it has taken me 4 years and 4 months to write this and my previous birth stories. I understand why I am doing it now. I am on the cusp of a new chapter and old chapters need closure before new ones can begin with full attention.....
Even after the debacle that was the cbac birth of my daughter and despite our previous experiences with infertility, I was hopeful that I would somehow find a way to birth another baby. One day I was walking through Costco and saw one of those mega packs of pregnancy tests. I looked at the package and thought "I'm pregnant". I went from there to see my hair "guy" but peed on the stick in the salon's bathroom. Yep, I was pregnant and I wasn't even late yet. Yeah! Even though I was of "advanced maternal age" at 39 at that time, I was quite certain of the outcome. I would carry the baby to term and deliver him/her vaginally and naturally. I knew this with every fiber of my being.
I began prenatal care with my OB/RE and didn't mention anything about wanting a vba2c. I knew he wouldn't go for it and it wasn't worth stressing either of us out over it. In the meantime I began to call OB offices in Chicago, found the national ICAN yahoo group (my lifesaver), and attended homebirth meetups to learn more about natural birth. None of the OBs I contacted would even consider a vba2c, neither would any of the home birth midwives or the one home birth OB in town. So many times I posted pathetic messages on the ICAN group like "All hope is gone" and "why am I being so stubborn". Thankfully my ICAN friends always brought me back to reality and reminded me that there are ALWAYs options, even when we don't think so. They helped me see that my hard labors might have been due to malposition. #1 had a compound presentation and I think #2 was anterior. I started to see a chiropractor to give myself an edge on positioning (plus I was still in pain from the dislocated sacrum from #2 labor). I exercised and was the healthiest I really had ever been. I spent hours reading birth stories, studying the research and understanding my fear of birth/pain. I ordered a hypnobirthing home study CD set and listened to it every night. I found a wonderful doula who was a vbac and hbac mom herself. I was increasingly strong, determined and unwilling to compromise. Family and friends "worried" about me but I was very clear that I was following my instinct and honoring my inner wisdom. Plus, I knew that I was growing within myself a stronger woman, a woman who "finishes what she starts". No more did I say things to myself like "I want a natural birth, but I won't be a martyr if I need an epidural or c/s". Now I told myself "no one knows YOUR body better than YOU, interventions are NOT an option. Period."
Finally, when literally all my options were exhausted, I decided to ask one of the midwives at the hospital where I work if they ever had cared for women who wanted vba2c. You can not believe how much courage this took! I work in the NICU as a developmental specialist and I'm always trying to balance what babies and families need for support against the realities of the medical team's emotional availability to be open to new concepts and paradigms so that I can gradually mold that availabilty for the benefit of babies/families. One of the most enlightening aspects of this journey for me was how relevant my road to vba2c was to my professional passions. Anyway, the midwife told me, as if this was not even a big deal, "yes, we support vba2c, in fact our chief is actively working to keep our primary and repeat c/s rates low." Wow. I was so surprised! Could I imagine giving birth just a few steps away from my office? I felt horribly vulnerable but that wasn't going to stop me. I'd found a supportive caregiver!!!
A few miscommunications later and a few VERY satisfying episodes of telling-off stupid residents by citing actual evidence, I officially switched providers at 32 weeks.
The night before my due date, I went to bed around 10pm with some early contractions. I slept for a little while but then woke up around 2 am and practiced breathing and using the relaxation techniques from the hypnobirthing CD. That worked for about an hour then I went downstairs and got out my birth ball and just rocked on it for awhile. Around 6 am I woke up my husband and told him that things were progressing. I fully expected this time that I might have the same quick, intense labor as I did before so I didn't panic when the contractions became difficult to manage. I had also arranged to have a TENS unit as an option for pain control so I stuck that on and continued to rock over the ball while my husband called our doula, Tama, and got the kids ready for school. Tama got to the house around 7:30 am and my husband took the kids to school. Tama encouraged me to squat but that made the contractions really intense. I remember thinking "you are resisting the process! just let go and let it happen!" When hubby got back we decided to try some time in the bathtub. Oh heavenly bathtub!!!! The contractions were still intense but I felt like I could stay "on top" of them while in the water. It was a sunny but bitterly cold January day and the hot water ran out early on. Hubby literally was boiling water and pouring it in the tub. I was so angry that he couldn't get the water warm enough! lol.
Tama was perfect. She simply sat next to the tub and calming interjected a few times to breathe. She somehow knew that what I really needed was her physical presence, without any undo distraction. I loved the tub and didn't ever want to get out. Oh why didn't I plan a UBA2C! I really wanted to stay at home at that point but I thought that probably wasn't fair to Tama to ask it of her. She finally coaxed me out of the tub. I remember being so afraid that my water would break if I walked across the living room to go out to the car. They finally got me in the car around 11am wearing only a sports bra and a towel wrapped around my waist. :-) Incredibly the contractions slowed and mellowed on the way to the hospital. I actually felt good, sensual and so in-control! I was totally into it, moaning and breathing, it was great. I got to the hospital and of course the ER wanted to ask me a whole bunch of stupid questions to which I gave them NOTHING. I didn't owe them anything. This birth was on my terms. In the elevator I was "vocalizing" and I heard someone say, "is that Jennifer"? Ugh, yes, giving birth at work is a bit, well, public. And there I was basically naked on an elevator full of colleagues.
One of my big fears from before was Triage. I had my husband call the unit to tell them we were coming and to make sure an actual room was available. My midwife friend (who wasn't allowed to deliver with me due to me being high-risk, puke) had everything smoothed over for me and we went right into a room. Of course right away an IV went in and they slapped a monitor on me. I was squirming around so much that it was hard to get a read on the monitor. They suggested an internal monitor to which I replied "NO"!!! Geez, the baby was going to be there any minute anyway. I did agree to let them rupture my membranes and that was a huge relief. I went from 8 cm to complete instantly. My only regret is the purple pushing position thing. But it wasn't horrible and I couldn't believe I was actually pushing! It was wonderful. I felt no pain at that time. I was doing this thing that I always knew I could do and had let so many things get in the way of. As soon as my baby was born I said, "I want to do that again"! I was on such a high. My son was placed on my chest and we started nursing. This is how a nursing relationship is supposed to start! What a difference.
I had a few stitches placed, I teared a little, at the time I thought the pinching sensation was the damn residents hands in the way. Maybe it was, I was really annoyed that she was doing anything down there.
Then I got up, went to the bathroom and walked around, holding my baby. When there was a mix up with the cord bili labs, I walked down to the nicu and greeted my coworkers so that I could support my baby during a blood draw. "you don't even look like you just gave birth" and "why are you walking around"? were typical comments. But I felt great!!! I begged the doctors to let me go home early. I was out of there 20 hours after walking through the door.
My little boy was born on his due date at 12:12 pm and so was I after a very, very long gestation.
Written with love on the 9th and 7th anniversaries of 2 c/s.
Even after the debacle that was the cbac birth of my daughter and despite our previous experiences with infertility, I was hopeful that I would somehow find a way to birth another baby. One day I was walking through Costco and saw one of those mega packs of pregnancy tests. I looked at the package and thought "I'm pregnant". I went from there to see my hair "guy" but peed on the stick in the salon's bathroom. Yep, I was pregnant and I wasn't even late yet. Yeah! Even though I was of "advanced maternal age" at 39 at that time, I was quite certain of the outcome. I would carry the baby to term and deliver him/her vaginally and naturally. I knew this with every fiber of my being.
I began prenatal care with my OB/RE and didn't mention anything about wanting a vba2c. I knew he wouldn't go for it and it wasn't worth stressing either of us out over it. In the meantime I began to call OB offices in Chicago, found the national ICAN yahoo group (my lifesaver), and attended homebirth meetups to learn more about natural birth. None of the OBs I contacted would even consider a vba2c, neither would any of the home birth midwives or the one home birth OB in town. So many times I posted pathetic messages on the ICAN group like "All hope is gone" and "why am I being so stubborn". Thankfully my ICAN friends always brought me back to reality and reminded me that there are ALWAYs options, even when we don't think so. They helped me see that my hard labors might have been due to malposition. #1 had a compound presentation and I think #2 was anterior. I started to see a chiropractor to give myself an edge on positioning (plus I was still in pain from the dislocated sacrum from #2 labor). I exercised and was the healthiest I really had ever been. I spent hours reading birth stories, studying the research and understanding my fear of birth/pain. I ordered a hypnobirthing home study CD set and listened to it every night. I found a wonderful doula who was a vbac and hbac mom herself. I was increasingly strong, determined and unwilling to compromise. Family and friends "worried" about me but I was very clear that I was following my instinct and honoring my inner wisdom. Plus, I knew that I was growing within myself a stronger woman, a woman who "finishes what she starts". No more did I say things to myself like "I want a natural birth, but I won't be a martyr if I need an epidural or c/s". Now I told myself "no one knows YOUR body better than YOU, interventions are NOT an option. Period."
Finally, when literally all my options were exhausted, I decided to ask one of the midwives at the hospital where I work if they ever had cared for women who wanted vba2c. You can not believe how much courage this took! I work in the NICU as a developmental specialist and I'm always trying to balance what babies and families need for support against the realities of the medical team's emotional availability to be open to new concepts and paradigms so that I can gradually mold that availabilty for the benefit of babies/families. One of the most enlightening aspects of this journey for me was how relevant my road to vba2c was to my professional passions. Anyway, the midwife told me, as if this was not even a big deal, "yes, we support vba2c, in fact our chief is actively working to keep our primary and repeat c/s rates low." Wow. I was so surprised! Could I imagine giving birth just a few steps away from my office? I felt horribly vulnerable but that wasn't going to stop me. I'd found a supportive caregiver!!!
A few miscommunications later and a few VERY satisfying episodes of telling-off stupid residents by citing actual evidence, I officially switched providers at 32 weeks.
The night before my due date, I went to bed around 10pm with some early contractions. I slept for a little while but then woke up around 2 am and practiced breathing and using the relaxation techniques from the hypnobirthing CD. That worked for about an hour then I went downstairs and got out my birth ball and just rocked on it for awhile. Around 6 am I woke up my husband and told him that things were progressing. I fully expected this time that I might have the same quick, intense labor as I did before so I didn't panic when the contractions became difficult to manage. I had also arranged to have a TENS unit as an option for pain control so I stuck that on and continued to rock over the ball while my husband called our doula, Tama, and got the kids ready for school. Tama got to the house around 7:30 am and my husband took the kids to school. Tama encouraged me to squat but that made the contractions really intense. I remember thinking "you are resisting the process! just let go and let it happen!" When hubby got back we decided to try some time in the bathtub. Oh heavenly bathtub!!!! The contractions were still intense but I felt like I could stay "on top" of them while in the water. It was a sunny but bitterly cold January day and the hot water ran out early on. Hubby literally was boiling water and pouring it in the tub. I was so angry that he couldn't get the water warm enough! lol.
Tama was perfect. She simply sat next to the tub and calming interjected a few times to breathe. She somehow knew that what I really needed was her physical presence, without any undo distraction. I loved the tub and didn't ever want to get out. Oh why didn't I plan a UBA2C! I really wanted to stay at home at that point but I thought that probably wasn't fair to Tama to ask it of her. She finally coaxed me out of the tub. I remember being so afraid that my water would break if I walked across the living room to go out to the car. They finally got me in the car around 11am wearing only a sports bra and a towel wrapped around my waist. :-) Incredibly the contractions slowed and mellowed on the way to the hospital. I actually felt good, sensual and so in-control! I was totally into it, moaning and breathing, it was great. I got to the hospital and of course the ER wanted to ask me a whole bunch of stupid questions to which I gave them NOTHING. I didn't owe them anything. This birth was on my terms. In the elevator I was "vocalizing" and I heard someone say, "is that Jennifer"? Ugh, yes, giving birth at work is a bit, well, public. And there I was basically naked on an elevator full of colleagues.
One of my big fears from before was Triage. I had my husband call the unit to tell them we were coming and to make sure an actual room was available. My midwife friend (who wasn't allowed to deliver with me due to me being high-risk, puke) had everything smoothed over for me and we went right into a room. Of course right away an IV went in and they slapped a monitor on me. I was squirming around so much that it was hard to get a read on the monitor. They suggested an internal monitor to which I replied "NO"!!! Geez, the baby was going to be there any minute anyway. I did agree to let them rupture my membranes and that was a huge relief. I went from 8 cm to complete instantly. My only regret is the purple pushing position thing. But it wasn't horrible and I couldn't believe I was actually pushing! It was wonderful. I felt no pain at that time. I was doing this thing that I always knew I could do and had let so many things get in the way of. As soon as my baby was born I said, "I want to do that again"! I was on such a high. My son was placed on my chest and we started nursing. This is how a nursing relationship is supposed to start! What a difference.
I had a few stitches placed, I teared a little, at the time I thought the pinching sensation was the damn residents hands in the way. Maybe it was, I was really annoyed that she was doing anything down there.
Then I got up, went to the bathroom and walked around, holding my baby. When there was a mix up with the cord bili labs, I walked down to the nicu and greeted my coworkers so that I could support my baby during a blood draw. "you don't even look like you just gave birth" and "why are you walking around"? were typical comments. But I felt great!!! I begged the doctors to let me go home early. I was out of there 20 hours after walking through the door.
My little boy was born on his due date at 12:12 pm and so was I after a very, very long gestation.
Written with love on the 9th and 7th anniversaries of 2 c/s.
Tuesday, May 18, 2010
A mother of a birth story - love and pain
As I begin to write, I am honestly not sure if I can remember all of the details. Sad as it is to say, the memory of my daughter's birth brings a rush of emotion: grief, shame, regret...yet also love for her and gratitude that from this life-changing event, many good things have flowered from the bad.
After our son's first birthday, I cautiously considered the hope of having another child. Back during the time of our infertility, I had often stated that I really thought that if I could only get pregnant once, my body would figure out how to do it again. Was it okay to greedily wish for another child? I pondered this and whether I had the guts to get back on the fertility roller coaster. I remember making a very conscious decision one day that, yes! my desire for another child was too great to be denied. I made an appointment to get a referral for the reproductive endocrinologist immediately. I believe I was actually one day pregnant the day of that visit. Lesson #1: My intuitions should be respected and that positive decisive thought is powerful .
I continued my prenatal care with my previous OB and once again enjoyed a delightful pregnancy. Co-workers lovingly informed me that I was "soo beautiful last time, this time, no". Apparently this was their kind way of suggesting this baby would be a girl. ???? It didn't matter, I felt beautiful. I also assumed that I would try again for a natural vaginal birth. Of course. At one of my later prenatal visits my doc asked me when I wanted to schedule the c-section. Literally my jaw dropped. That was completely out of left field in my reality. I had NO IDEA that vaginal birth after cesarean (VBAC) was even an official "thing" or that some hospitals or doctors were unsupportive. How the f did that escape my radar? After all, I do work in the maternal-child healthcare industry. I had already forced my husband to go to a refresher Bradley class and now I decided to look into a doula. I interviewed a newly practicing doula who was affordable. She was nice enough. I didn't know what I should be looking for but I knew I'd gone to the hospital much too soon last time and I wanted to avoid doing that again. I knew that I was a "wimp" about pain and that for sure the hard and fast labor from before wouldn't happen again. All labors are different. This time would go according to plan. Ugh. I didn't do ANY emotional work. Also late in our relationship my doula "disclosed" that she'd had a traumatic medical experience at the hospital I was going to deliver in (the same place as #1). This turned out to be a rather important factor. Lesson #2: Pay attention to that voice inside no matter how muffled she may sound and DO the emotional work, be ready for everything.
Two years to the day of my son's birth, I went into labor, 4 days before my due date. The labor came fast and hard. I called the doula. She arrived. I didn't know what to do, neither did she. We went to the hospital right away. The sun was blinding me as sharply as the labor pains on the way there. I arrived to the same Triage space, the nurse yelled at me to stop moaning, to get out of the bathroom, to wait on that damn cot and put the monitor on. I couldn't take it. It was the same day, it was the same. The same! I begged for the epidural. The doula looked frightened. I went to a labor room. Everyone left. A young doctor stabbed my back 20 times. A nurse yelled at me to "be still". I was in transition. "Stop trying to put the needle in my back, I want to push". "Be still!!!". Epidural finally in. Doctor on call checks me. 10 cm. Yeah. I'm numb. "PUSH". I can't feel anything. The doula is silent. We have to put in an internal monitor. Baby's heart rate is dropping a bit with contractions. "You can't do it". Consent to c-section. No rush to OR. Baby is born, apgars 9 and 9. Swaddled baby flashed in my face. "she's pretty". It's a girl? tsk, tsk, so much scar tissue.
The next few hours after that are lost to me. I just remember being in the maternity ward with my baby and trying to nurse her. She couldn't latch quite right, just like her brother. At one point a nurse came to give her a bath and despite my request to do so in the room with me, she took her out for the bath. An hour later I called to find out where my baby was. "Oh she was a bit cold so we put her under the warmer". ???? Please bring me my baby, I pleaded. Another hour later I threw a temper tantrum to get my daughter back. She still couldn't nurse, who knows, but I'm sure she got a bottle while she was gone. Suddenly, I was in excruciating pain. I called for the nurse who gave me serious pain meds. The on-call doctor who did the section came by and whispered to my husband, "I hope you don't plan on having any more children...lots of scar tissue". The pain continued to worsen so around midnight I was taken to radiology and a probe was placed in my back into my right kidney and snaked through to where my ureter was supposed to be. The ureter connects the kidney to the bladder. I was watching the probe on the x-ray monitor and could see the probe and barium progress through my kidney, through the upper part of my ureter to....nothing. Empty space. The doctors had told me that they suspected there was a "stitch" in my ureter. I could clearly see there was no stitch - it had been severed. But I played along with their "stitch" game. Went down for a horrible procedure to try and "unplug" the ureter by going through my urethra and bladder. No luck. duh. So a drain was placed in my back to keep my kidney from shutting down by allowing my urine to drain and collect into a plastic bag strapped to my thigh. I was also unable to nurse my daughter for 10 hours because of the barium.
I went home with the kidney drain, a constantly leaking urine bag on my leg, the c-section wound, a dislocated tailbone (somehow I popped my tailbone out during one of the really strong contractions), a small, barely nursing baby, a two-year old and the promise of another major abdominal surgery in 6 weeks to repair my ureter.
I was determined to nurse my baby and we worked diligently at it for 4 weeks before she was able to do it very well. At six weeks, I went to a different hospital for the repair. I insisted on taking and keeping my baby with me. I had to check and double check many times to make sure that all medications given would be compatible with breast feeding. Nurses admonished me for bringing "that" baby into a dirty hospital, pain and discomfort was the norm but I was determined in a way I had never been before. For the first time in my life I didn't' give a DAMN what anyone else thought or wanted. After that surgery I had to have a catheter in my bladder (much worse than a drain in my back) for another 4 weeks. I was enormously depressed and in constant pain from my tailbone long after the other wounds healed. Through it all my daughter was the most lovely and quiet baby. It makes me cry in fear that she was like that because she couldn't afford to be all fussy and demanding. A sacrificial offering to her mommy. I told her one day a few months after I felt better, "honey you can cry and wail now if you want. Mommy feels better now". She just smiled and cooed gently. Unbelievably, I went back to work after 12 weeks of leave. I was nowhere near ready to do so physically or emotionally. Lesson #3: Be selfish, be determined, be good and kind to yourself - it's not selfish after all. You and your baby deserve a whole and healthy mommy.
After our son's first birthday, I cautiously considered the hope of having another child. Back during the time of our infertility, I had often stated that I really thought that if I could only get pregnant once, my body would figure out how to do it again. Was it okay to greedily wish for another child? I pondered this and whether I had the guts to get back on the fertility roller coaster. I remember making a very conscious decision one day that, yes! my desire for another child was too great to be denied. I made an appointment to get a referral for the reproductive endocrinologist immediately. I believe I was actually one day pregnant the day of that visit. Lesson #1: My intuitions should be respected and that positive decisive thought is powerful .
I continued my prenatal care with my previous OB and once again enjoyed a delightful pregnancy. Co-workers lovingly informed me that I was "soo beautiful last time, this time, no". Apparently this was their kind way of suggesting this baby would be a girl. ???? It didn't matter, I felt beautiful. I also assumed that I would try again for a natural vaginal birth. Of course. At one of my later prenatal visits my doc asked me when I wanted to schedule the c-section. Literally my jaw dropped. That was completely out of left field in my reality. I had NO IDEA that vaginal birth after cesarean (VBAC) was even an official "thing" or that some hospitals or doctors were unsupportive. How the f did that escape my radar? After all, I do work in the maternal-child healthcare industry. I had already forced my husband to go to a refresher Bradley class and now I decided to look into a doula. I interviewed a newly practicing doula who was affordable. She was nice enough. I didn't know what I should be looking for but I knew I'd gone to the hospital much too soon last time and I wanted to avoid doing that again. I knew that I was a "wimp" about pain and that for sure the hard and fast labor from before wouldn't happen again. All labors are different. This time would go according to plan. Ugh. I didn't do ANY emotional work. Also late in our relationship my doula "disclosed" that she'd had a traumatic medical experience at the hospital I was going to deliver in (the same place as #1). This turned out to be a rather important factor. Lesson #2: Pay attention to that voice inside no matter how muffled she may sound and DO the emotional work, be ready for everything.
Two years to the day of my son's birth, I went into labor, 4 days before my due date. The labor came fast and hard. I called the doula. She arrived. I didn't know what to do, neither did she. We went to the hospital right away. The sun was blinding me as sharply as the labor pains on the way there. I arrived to the same Triage space, the nurse yelled at me to stop moaning, to get out of the bathroom, to wait on that damn cot and put the monitor on. I couldn't take it. It was the same day, it was the same. The same! I begged for the epidural. The doula looked frightened. I went to a labor room. Everyone left. A young doctor stabbed my back 20 times. A nurse yelled at me to "be still". I was in transition. "Stop trying to put the needle in my back, I want to push". "Be still!!!". Epidural finally in. Doctor on call checks me. 10 cm. Yeah. I'm numb. "PUSH". I can't feel anything. The doula is silent. We have to put in an internal monitor. Baby's heart rate is dropping a bit with contractions. "You can't do it". Consent to c-section. No rush to OR. Baby is born, apgars 9 and 9. Swaddled baby flashed in my face. "she's pretty". It's a girl? tsk, tsk, so much scar tissue.
The next few hours after that are lost to me. I just remember being in the maternity ward with my baby and trying to nurse her. She couldn't latch quite right, just like her brother. At one point a nurse came to give her a bath and despite my request to do so in the room with me, she took her out for the bath. An hour later I called to find out where my baby was. "Oh she was a bit cold so we put her under the warmer". ???? Please bring me my baby, I pleaded. Another hour later I threw a temper tantrum to get my daughter back. She still couldn't nurse, who knows, but I'm sure she got a bottle while she was gone. Suddenly, I was in excruciating pain. I called for the nurse who gave me serious pain meds. The on-call doctor who did the section came by and whispered to my husband, "I hope you don't plan on having any more children...lots of scar tissue". The pain continued to worsen so around midnight I was taken to radiology and a probe was placed in my back into my right kidney and snaked through to where my ureter was supposed to be. The ureter connects the kidney to the bladder. I was watching the probe on the x-ray monitor and could see the probe and barium progress through my kidney, through the upper part of my ureter to....nothing. Empty space. The doctors had told me that they suspected there was a "stitch" in my ureter. I could clearly see there was no stitch - it had been severed. But I played along with their "stitch" game. Went down for a horrible procedure to try and "unplug" the ureter by going through my urethra and bladder. No luck. duh. So a drain was placed in my back to keep my kidney from shutting down by allowing my urine to drain and collect into a plastic bag strapped to my thigh. I was also unable to nurse my daughter for 10 hours because of the barium.
I went home with the kidney drain, a constantly leaking urine bag on my leg, the c-section wound, a dislocated tailbone (somehow I popped my tailbone out during one of the really strong contractions), a small, barely nursing baby, a two-year old and the promise of another major abdominal surgery in 6 weeks to repair my ureter.
I was determined to nurse my baby and we worked diligently at it for 4 weeks before she was able to do it very well. At six weeks, I went to a different hospital for the repair. I insisted on taking and keeping my baby with me. I had to check and double check many times to make sure that all medications given would be compatible with breast feeding. Nurses admonished me for bringing "that" baby into a dirty hospital, pain and discomfort was the norm but I was determined in a way I had never been before. For the first time in my life I didn't' give a DAMN what anyone else thought or wanted. After that surgery I had to have a catheter in my bladder (much worse than a drain in my back) for another 4 weeks. I was enormously depressed and in constant pain from my tailbone long after the other wounds healed. Through it all my daughter was the most lovely and quiet baby. It makes me cry in fear that she was like that because she couldn't afford to be all fussy and demanding. A sacrificial offering to her mommy. I told her one day a few months after I felt better, "honey you can cry and wail now if you want. Mommy feels better now". She just smiled and cooed gently. Unbelievably, I went back to work after 12 weeks of leave. I was nowhere near ready to do so physically or emotionally. Lesson #3: Be selfish, be determined, be good and kind to yourself - it's not selfish after all. You and your baby deserve a whole and healthy mommy.
Thursday, May 13, 2010
A mother of a birth story - The first cut
After the miraculous conception of my first child, which is a whole fantastic story as well, I enjoyed a fabulous pregnancy. Yes, I am that woman. No morning sickness, just the right weight gain, no problems. Besides, I LOVED being pregnant. I loved the smiles of passing strangers, the belly rubs, my changing body, everything. I could have done without the horror birth stories but I didn't pay them any mind. I was going to have a natural birth. And those nightmares of my child dying in childbirth from my fear? I was quick to suppress those thoughts whenever that came to mind.
My husband and I went to Bradley classes. This should have been a red flag at some point but I was extremely anxious about his overall interest, or lack thereof I should say. He honestly couldn't figure out what I was worried about. His mother had 8 children, himself a vaginal footling breech delivery. "What's the big deal"? Umph. Wish I had shared that sentiment back then too.
I was so...stupid. I knew nothing about birth. I loved my OB who'd been my reproductive endocrinologist as well. He was and is a very compassionate and caring man. What I didn't know is that he believes that babies should be born at 36 weeks, ideally. (cringe) The hospital I was to deliver at had an alternative birthing center which was actually a room down the hall from the labor ward with a queen size bed and a dorm-room refrigerator. When I went for the tour, I asked the nurse about the space. "Oh you won't want to go THERE. You are going to want an epidural". I chuckled at her simplistic view and said jokingly, "well you won't MAKE me have one will you"? Ha! ha! ha...
Fast forward to week 38, my OB suggested I get induced by week 40 if the baby hadn't come yet. I at least knew enough at that point that I was not willing to even talk about induction. I went into labor at 41 weeks, 3 days while shopping at Costco. Contractions were about 15 minutes apart and pretty intense but I kept shopping. My mom was coming that afternoon and I just HAD to everything ready. (shrug) I went home to my husband who was busy re-building our back porch. If you've ever seen Chicago city porches, you know this is a massive project akin to removing the entire back half of your home and rebuilding. We had to have electrical service discontinued for him to do the work and he was in a panic to get it all done before "baby" came.
I took a shower and called my doctor who told me to call when the contractions were 2 minutes a part. I called back a minute later because they were 1 minute apart and painful! On the way to the hospital my husband stopped at Wendy's and asked if I wanted "anything" as I writhed in pain on the passenger side of the car. If you've ever seen that episode of "Family Guy" where something similar happens, that was us. It really makes me laugh to remember it. "I figured this could take awhile and I'm hungry", he said. Really, he had a point.
I got to the hospital and was put into Hell. They called it "Triage". Put in a tiny cubicle, strapped up to a bunch of wires and told constantly, a laboring women with nonstop contractions, to "settle down" on the stupid cot and guess what happened? I lost it. There weren't any labor rooms available and I was only 1cm. That freaked me out. Based on my Bradley class, these contractions had to mean I was in f'ing transition!!! Of course 2 hours later, in Hell, I find out that the labor rooms weren't available not because they were in use, no, there weren't any CLEAN ones available. "I'll clean the damn room myself"! I shouted. In the meantime I let them give me a HALF dose of Stadol. That was horrible. Now I felt all of the misery but was looped out so that I couldn't bother anyone with my complaints. Finally they got me into a room but now I felt dizzy and nauseous and just wanted to go sit on the toilet. Oh no! I was dizzy and therefore "un-safe" to walk 4 feet to the bathroom with my nice husband at my side. (I am completely skipping the part where my wonderful husband was texting and ignoring me as I reached out for his help while in Triage. "You were only 1cm, I figured it was going to take awhile", thanks.)
Just for the record, I want everyone to know that it is anatomically impossible to pee on a bedpan while on your back and having serious contractions. I had to sneak to the bathroom when the nurse left the room. My good friend, Ann-Marie in the meantime had gone to pick up my mom from the airport and they arrived at about that time. Their empathetic, frightened faces were a great comfort. Really! Husband, exit stage right. ??? I don't remember seeing him again until we were in the OR.
Of course I'd begged for the epidural by this point but first we had to wait for the room, then we had to wait another 4 hours for an anesthesiologist. ??? Mean nurse and doc kicked my family out of the room to torture my into an impossible position and yelled at me to sit still. I'm sorry but constant contractions make sitting still kind of difficult. Finally the epidural was in and I was SO relieved. My OB came by right after that and told me that my cervix had swelled and that I was still at 5cm and regressing. I would "need" a cesarean. At that point I would have agreed to anything. My friend left and I was prepped for surgery. My poor mother was threatened with expulsion if she did not agree to stay off the unit as it was past visiting hours and she was not "allowed" near the surgical suite.
As we prepped for the surgery, I was calm and ready to see my baby. That changed when my OB literally sat on my chest to pull my son's head out of the birth canal. He'd wedged himself in there with one hand over his head. (For almost the whole last half of the pregnancy I kept saying I could feel his hand tickling my cervix). That scared the hell out of me and I thought for sure that he was going to die. Finally I heard him cry and instantly I knew he was okay. I didn't get to see him right away but he was somewhere close by with my husband as they closed me up.
In the recovery room I held him and tried to nurse. He wasn't interested at all and suddenly a big, anciently old nurse wisked him away to "bathe" him. I asked her to at least do it near me so I could see him. Poor little guy, what a traumatic event when you are less than an hour old!! I was so powerless to ask for anything that was important to me. I had shunned the idea of a birth plan because I figured everything would be just fine.
My son was born at 11:50pm and by the time I got into a room, it was really late. My husband took my mom home for the night. I've never felt so lonely in my whole life! Swollen from the surgery, in pain and barely able to do anything for my baby. At first he was placed in a bassinet at the foot of my bed. How was I supposed to get him from down there? Hello? I just had major surgery?! Finally I got the nurse to hand him to me and I didn't let him go the rest of the time. Nursing was really hard at first, frustrating for us both as he had a hard time latching for the first 36 hours. I pumped my colostrum and fed him with a spoon when we were both crying and exhausted; eventually we got the hang of it. The one bright spot was that the maternity ward nursing staff was very supportive of breastfeeding although one nurse the first night wanted to check his blood sugar, "just to make sure" he was okay with the few drops we'd managed.
Physically I recovered well. Honestly the surgery barely slowed me down. Coming home to a heat wave and no electricity for a week was a real bummer but we got through that and I just figured if we were lucky enough to ever have another baby, that I'd have a natural birth the next time.
My husband and I went to Bradley classes. This should have been a red flag at some point but I was extremely anxious about his overall interest, or lack thereof I should say. He honestly couldn't figure out what I was worried about. His mother had 8 children, himself a vaginal footling breech delivery. "What's the big deal"? Umph. Wish I had shared that sentiment back then too.
I was so...stupid. I knew nothing about birth. I loved my OB who'd been my reproductive endocrinologist as well. He was and is a very compassionate and caring man. What I didn't know is that he believes that babies should be born at 36 weeks, ideally. (cringe) The hospital I was to deliver at had an alternative birthing center which was actually a room down the hall from the labor ward with a queen size bed and a dorm-room refrigerator. When I went for the tour, I asked the nurse about the space. "Oh you won't want to go THERE. You are going to want an epidural". I chuckled at her simplistic view and said jokingly, "well you won't MAKE me have one will you"? Ha! ha! ha...
Fast forward to week 38, my OB suggested I get induced by week 40 if the baby hadn't come yet. I at least knew enough at that point that I was not willing to even talk about induction. I went into labor at 41 weeks, 3 days while shopping at Costco. Contractions were about 15 minutes apart and pretty intense but I kept shopping. My mom was coming that afternoon and I just HAD to everything ready. (shrug) I went home to my husband who was busy re-building our back porch. If you've ever seen Chicago city porches, you know this is a massive project akin to removing the entire back half of your home and rebuilding. We had to have electrical service discontinued for him to do the work and he was in a panic to get it all done before "baby" came.
I took a shower and called my doctor who told me to call when the contractions were 2 minutes a part. I called back a minute later because they were 1 minute apart and painful! On the way to the hospital my husband stopped at Wendy's and asked if I wanted "anything" as I writhed in pain on the passenger side of the car. If you've ever seen that episode of "Family Guy" where something similar happens, that was us. It really makes me laugh to remember it. "I figured this could take awhile and I'm hungry", he said. Really, he had a point.
I got to the hospital and was put into Hell. They called it "Triage". Put in a tiny cubicle, strapped up to a bunch of wires and told constantly, a laboring women with nonstop contractions, to "settle down" on the stupid cot and guess what happened? I lost it. There weren't any labor rooms available and I was only 1cm. That freaked me out. Based on my Bradley class, these contractions had to mean I was in f'ing transition!!! Of course 2 hours later, in Hell, I find out that the labor rooms weren't available not because they were in use, no, there weren't any CLEAN ones available. "I'll clean the damn room myself"! I shouted. In the meantime I let them give me a HALF dose of Stadol. That was horrible. Now I felt all of the misery but was looped out so that I couldn't bother anyone with my complaints. Finally they got me into a room but now I felt dizzy and nauseous and just wanted to go sit on the toilet. Oh no! I was dizzy and therefore "un-safe" to walk 4 feet to the bathroom with my nice husband at my side. (I am completely skipping the part where my wonderful husband was texting and ignoring me as I reached out for his help while in Triage. "You were only 1cm, I figured it was going to take awhile", thanks.)
Just for the record, I want everyone to know that it is anatomically impossible to pee on a bedpan while on your back and having serious contractions. I had to sneak to the bathroom when the nurse left the room. My good friend, Ann-Marie in the meantime had gone to pick up my mom from the airport and they arrived at about that time. Their empathetic, frightened faces were a great comfort. Really! Husband, exit stage right. ??? I don't remember seeing him again until we were in the OR.
Of course I'd begged for the epidural by this point but first we had to wait for the room, then we had to wait another 4 hours for an anesthesiologist. ??? Mean nurse and doc kicked my family out of the room to torture my into an impossible position and yelled at me to sit still. I'm sorry but constant contractions make sitting still kind of difficult. Finally the epidural was in and I was SO relieved. My OB came by right after that and told me that my cervix had swelled and that I was still at 5cm and regressing. I would "need" a cesarean. At that point I would have agreed to anything. My friend left and I was prepped for surgery. My poor mother was threatened with expulsion if she did not agree to stay off the unit as it was past visiting hours and she was not "allowed" near the surgical suite.
As we prepped for the surgery, I was calm and ready to see my baby. That changed when my OB literally sat on my chest to pull my son's head out of the birth canal. He'd wedged himself in there with one hand over his head. (For almost the whole last half of the pregnancy I kept saying I could feel his hand tickling my cervix). That scared the hell out of me and I thought for sure that he was going to die. Finally I heard him cry and instantly I knew he was okay. I didn't get to see him right away but he was somewhere close by with my husband as they closed me up.
In the recovery room I held him and tried to nurse. He wasn't interested at all and suddenly a big, anciently old nurse wisked him away to "bathe" him. I asked her to at least do it near me so I could see him. Poor little guy, what a traumatic event when you are less than an hour old!! I was so powerless to ask for anything that was important to me. I had shunned the idea of a birth plan because I figured everything would be just fine.
My son was born at 11:50pm and by the time I got into a room, it was really late. My husband took my mom home for the night. I've never felt so lonely in my whole life! Swollen from the surgery, in pain and barely able to do anything for my baby. At first he was placed in a bassinet at the foot of my bed. How was I supposed to get him from down there? Hello? I just had major surgery?! Finally I got the nurse to hand him to me and I didn't let him go the rest of the time. Nursing was really hard at first, frustrating for us both as he had a hard time latching for the first 36 hours. I pumped my colostrum and fed him with a spoon when we were both crying and exhausted; eventually we got the hang of it. The one bright spot was that the maternity ward nursing staff was very supportive of breastfeeding although one nurse the first night wanted to check his blood sugar, "just to make sure" he was okay with the few drops we'd managed.
Physically I recovered well. Honestly the surgery barely slowed me down. Coming home to a heat wave and no electricity for a week was a real bummer but we got through that and I just figured if we were lucky enough to ever have another baby, that I'd have a natural birth the next time.
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