friday morning: this is my last day of work. in the gym shower on the way to work, there's a noticeable rush of fluid. home to get the nitrazene strips, which show nothing. i head on to the office, thinking it's a false alarm...after all, primigravidae are all late, right? and labor doesn't feel around the corner. i need one last weekend, i need time to exhale and open up some mental space...
at work, more fluid rushes, and one tests dark blue around lunchtime. by now i am feeling crampy in spurts, and am rushing to tie things together, write last minute emails, etc. i don't think i'll make it to the end of the day. my colleague dave seems a little wide-eyed and scared i might give birth right there when i mention the mild contractions. if only so fast! christian and i leave OPA around two, and stop at real foods, although already i am a little distracted and don't remember being there well. my brain is entering labor space, which is a few degrees removed from the rest of the world. i catch a cab home, stopping at a notary on the way to try to deal with the easement paperwork i promised VDOT, and by the time i'm home i'm thinking that making chicken soup, baking cookies, cleaning, and all the nest'y early labor projects we had lined up are just not going to happen.
by the time georgia swings by after work, i'm already concentrating on the surges. maybe it's too soon but they feel intense. i'm on the bed with a yoga ball. i can handle them but it's beyond distracting. georgia's brought gu. little do i know how critical this non-food source of food will be over the next 3 1/2 days. i'm glad i don't know, or i would have been scared. kim arrives while georgia is still here but before maria arrives, i think. the psoas massage i'd scheduled for me, and then given to kim, is not going to get used. in retrospect, maybe if i'd used it it would have helped, or changed things a bit. but how can one know?
georgia leaves when maria arrives, around 7 or 8. i know it's early to call maria but the surges already feel like they are 3-4 minutes apart, and i feel a little worried that things are ramping up too fast. maria likewise assumes this may be a fast birth -- perhaps that's why she's getting involved even though she has plans to leave at 4am saturday for a weekend in reno at her daughter, viola's, volleyball tourney. i am glad she is there; she brings a steady presence. she listens to babe, and all sounds fine. we head into late night, maria on the couch, christian on the bed, kim curled on the floor beside my head. i'm lying on my side and the surges, when they come between stolen rest, are intense. i'm vocalizing to 'open' and stretching my arm in the air to try and increase the surface area through which the sensation can dissipate. i'm holding kim's hand, and ordering christian to press HARD on my hips/butt with each surge. this is where i feel everything; my uterus almost seems dead. but there's a band of hot iron around my pelvis, in my gluteal medius and minimi, and some in my back. maria thinks babe might be OP upon palpation; i think this is just where the work needs to happen, and still believe i have a narrow and/or imbalanced pelvic area. is this a personal myth i've built that's feeding into my inability to open and let go, or is there validity to it? possibly some of both. but whatever it is, it's painful.
the night is long, for me.
saturday morning, i shower. the tub has been out and full since last night but is no longer warm, and since my bag is open it's not a great idea to linger in there. the shower only has an hour of hot water, and the water pressure isn't great, but it's still relief. i wonder if morris can hear me, and/or how loud i am to the people upstairs. why do i care? i'm still self conscious, even though i can't help but vocalize in what feels like a loud voice to my own ears.
Saturday...the pace of UC's seems to have slowed. i know this isn't great for labor but it brings some relief. at some point today maria checks me, and doesn't say anything, which i take to mean we have a way to go. she says we need to focus on ramping the labor up. this scares me a little, as i'm already tired and struggling to cope. i feel myself shying away from increased sensation, but also know she's right. we try some homeopathics and herbs, and i walk around the kitchen table, slowly, through surges, with acupuncture needles in my gateway points. we also try to assemble the breast pump, which is tricky/not working, so g brings her hand pump over for doing nipple stim. the nipple stim seems to work a bit, as long as i keep it up. maria leaves for the afternoon and i hang out on the yoga ball in front of the birth altar, nipple stimming and moaning through surges. christian and kim are vigilant about getting me to eat whatever i can: gu, nuun, bites of oatmeal, sips of chicken broth. every once in awhile it all comes up in a big vomit during a surge. this double whammy makes me whimper miserably -- isn't coping with a surge enough? the nausea and hurling on top seem unjust. but who said labor was just...these hurls tend to happen especially during the intense spinning babies' positions maria has me try: side lying release through 3 surges, off-the-bed inversion through 3 surges. the latter is particularly insane. i can't hold myself up on my arms, and the pain is twice as intense as rightside up. but we're trying to make room so babe can turn. and if babe can turn, maybe this pain will change into something else, or at least be PRODUCTIVE. i know from maria's face during our checks that dilation is still minimal and/or stuck. i'm starting to feel deflated. I think at some point today or tomorrow I cry like a baby to Kim and Christian, expressing frustration. and fatigue. this isn’t going as “planned”...
late that night maria says i need rest, and we can either try to get a dose of morphine at the hospital and come home again, or drink some wine and benadryl. i take the latter, believing it might knock me out. it doesn't, but i do rest enough to dream between surges. i'm torn between better rest and worse surges while side lying vs. worse rest but less intense surges on hands and knees. i take the former. maria stays over again, on the couch. kim's resting at home, which is good. i wonder if/when maria is leaving us, and whether sue is going to take over. a team transition right now worries me -- i don't know how i'll handle it, as i feel very reliant on maria as a guide by this point. i worry the switch will shut down labor even more and make me hesitant, but the worry can't go far since the surges demand so much. i'll let her sort it out, i think to myself, and for now am just grateful she is here with us, regardless for how long.
sunday: new day. start with shower. we're going to cycle through the tricks again, and add a new one (castor oil), as a last resort. by now there is talk of augmentation if this cycle doesn't work again. we agree to see how the day goes, and if labor is still lagging, to consider kaiser in the evening. i'm getting tired enough that this sounds ok, even good, if it comes to that. and i know maria's concerned about the 72 hour window for the open bag. physically, babe and i are still ok, so there's no immediate concern, but the more i am checked, and the longer the window, the greater the risk. i understand and respect this concern. around 6pm we start packing up for kaiser, shortly after i puke the castor oil shake i forced down a few hours earlier.
at the kaiser ED, the nurse who takes us up to L&D says she had her first child with maria, at home, in a 12-hour labor. i feel so heartened by this kindred spirit as my first point of interaction at the hospital, and realize that maria probably has good cred here. of course, there's always the curiosity of why hospital workers choose to deliver at home; i've met or heard of quite a few, midwives and ob nurses. is it because they know firsthand what happens in the hospital, and want to avoid it? or because birth is less a mystery to them, more a norm, so there is more comfort doing it in a normal environment? i'm curious...
as soon as we walk into delivery room 4 i turn into the wc and spend 30 mins while the castor oil does the rest of its thing. my bowels are flushed, utterly and completely: i don't poo for the remaining 30 +/- hours of labor, which seems unusual. when i emerge maria is explaining to the nurse that we are only there for low dose pitocin. period. the nurse, whom i instinctively don't take to, says, 'no epidural? how will she handle the pitocin?' i'm standing right there being talked about, and i don't like it. i'm relieved to learn her shift is ending shortly. i ask for the clock to be covered, and also the case full of drawers that say 'epidural prep' on the front. kim puts a pic of the fop girls on the tv. this is as home as home could get, given my mental capacity right now. my team is here, so my heart is here, thus for now, this has to be home.
then comes kate huber, rn. oh, kate, who though a blur through the night, was a good and supportive soul from new zealand. she had worked at a birth center and her demeanor was calm, patient, maternal without being saccharine. she was a breath of fresh air, and came in unobtrusively now and again to check pitocin levels (2-6ml through the night) and see if we were okay. i spent awhile laboring in the room, leaning over the bed and listening to the mother next door during her pushing stage. very vocal, very expressive, then silence, then a baby's cry. we were dueling spirits, and i envied the point in labor where she was: born. i later spend 3 hours alone in the dark shower, wondering if my cries of O-PEN were coming into the new mama's room, and whether they would be an intrusion on her newfound peace and silence. in the shower, the endless hot water and the grab bar were a welcome improvement from home. hanging from the grab bar in a deep squat felt particularly good, and relieved the uncomfortable sensation of wanting to poop (but not being able to poop) that i was feeling through surges. the shower was a solitary, lightless space, and perhaps what i needed to stop holding back.
upon getting out the surges seemed to be well established. i don't recall much except being around the bed, leaning on it, sitting on the ball, with soothing hands on my hips and back. i think we tried lunging on the bed, inverting on the bed, too. at some point, we all needed rest, and maria took me to an amazing meditative and calm place where i could lie on my back and breath through the surges without getting frantic. i was able to stay here for awhile, relaxed, letting my body fall into the bed, be supported by it, and observe the sensations without getting overwhelmed. eventually, however, they became too intense, so i went back to the shower, but in a different quieter state of mind. i took the surges in silence, and felt more at peace. when i came out, perhaps it was daybreak? i felt badly for my by-now exhausted team.
at some point dr. martin (resident) came in and strongly recommended doing another check and inserting an IUPC to measure contraction strength in order to 'make best use of the medicine (pitocin).' i instinctively did not want another tube in my body, nor to have my uterine performance measured in such an exact and invasive manner. kim and maria declined dr. martin's suggestions on my behalf, agreeing that she could come back in a couple hours and revisit the issue. in her stead (i think), dr. regenstein (the night attending) came in on her way off shift.
she was, in blunt terms, horrible with us. if i feel traumatized by anything during our birth saga, it is by the interaction we had with her. she came in reiterating dr. martin's recommendation (which was likely just dr. regenstein's recommendation, parrotted by dr. martin, in whom i also didn't feel strong trust). again, she said, we needed to have a check and then have an IUPC to most effectively use the pitocin; after all, i'd now 'been on pitocin for more than six hours! and women in africa die when their uteruses explode from this kind of overstimulation!!' she accused us of coming in to kaiser but 'refusing their help,' and of not respecting her lofty credentials. she called kim's citing of practices at sf general 'annoying,' and stormed out of the room in a huff. i was stunned, could hardly believe between surges that this woman was here in this room talking to us the way she was, that she was in a position of responsibility of 'caring' for laboring women. i almost told her to her face that she was horrible and needed to leave, but recognized maria's attempts to not be confrontational, possibly in the interest of preserving short-term and long-term goodwill with the kaiser staff. i completely understand this position and would feel the same, but as a patient and kaiser member, i am going to give my feedback about my low point at kaiser and hope it makes it to someone who can prevent her from terrorizing other women. in the end, after maria made some amends in the hallway, dr r came back in and checked me (the thought of her hand in my vagina is also pretty awful, in retrospect) and seemed satisfied with 'progress' at 6.5-7cm now.
a new team arrives, headed by dr. sarah mandel, whom i later learn is head of delivery. thank the universe. she is patient, laid back, open minded, and she and maria seem to be on the same page. her energy is positive, but after dr. r i feel myself still guarded with this new team. i'll only understand dr. m's awesomeness as the day progresses. another hour later, another check by brittany (resident) and i'm still at 7 cm. pitocin is maybe at 10 now? unsure. after the second 7cm check, i deflate, and soon thereafter maria suggests a strategic epidural to relax my body and allow me to rest in sims position, which will perhaps rotate babe out of her OP and possible asynclitic posture. as soon as i hear the recommendation i am, honestly, relieved. i know there is still a ways to go and i'm not sure how i'm going to get through the rest. as i grow more tired and hopeless my mental ability to cope with the surges also wanes, and i remember being a little frantic at this point. there is a delay in the epidural while platelet levels are discussed, but after a short while it's delivered and takes effect. i ask christian if he is disappointed in me, and whether i am making the right decision. he starts bawling, and tells me he doesn't want to see me in any more pain. i feel badly realizing how much he has bottled inside through this experience, and hope it does not leave him traumatized. i recall kim being close to us then, witnessing this moment, and feeling glad to have her in the space with us. i sleep through the day in sims position, and am also catheterized, which is a relief since peeing has been hard through the night and has come out in forced spurts during surges, all around the room. the epidural also reduces my odd sensation of wanting to push -- not because i am dilated but because i am wanting a release valve on the pressure in my pelvic/hip area. the premature pushing has swollen my cervix, which i can feel like a pointy hard smooth egg inside me, and barely beyond that, the smallest circle of baby's head. she is close, distance wise, but my cervix continues to create a stubborn wall between her and the outside world.
at some point i wake up; georgia has brought the team food from project juice. she is wearing blue and looks beautiful. she is teary, and tells me it's been hard not to be with me through this. i feel teary in turn, missing her and also feeling for her, putting myself back in the space when she was the one on the bed, 2 years ago. i want to reassure her that i will be okay, that things are okay. i don't know if she buys it, but i do believe it at that point. my team is so strong. i wish i could have been as strong, and as knowledgeable, for georgia, when i was at her birth. i feel to this day a lingering regret that i could not do more for her and i feel, in part, responsible for the suffering she went through.
the next couple hours i listen vaguely as maria and christian talk, and eat the healthy food georgia brought. i hear them crunching on vegetables. i am envious of this simple act of chewing raw food. the gu's are saving me but are a far cry from nutrition. and bring heartburn. but they're also essential.
when i wake, kim is back and there is a cervical check soon. i know we're getting close. perhaps there are two checks. but eventually i am at 9, 9.5, and dr. martin believes she can push the last bit of cervix aside, which she does. by 9 or 930 i'm ready to push, with others' direction, since my legs are numb. i lie angled back and during contractions grab my ankles, pulling knees back up towards my face and pushing out and down with all i have. i am getting lots of encouragement and feeling strong; wanting an unmediated birth experience back, I over-confidently ask for the epidural to be turned off, forgetting how high the pitocin is now (30ml), and also how unprepared, chemically, my body is to cope with pain. within half an hour i'm a writhing mess. my hips are being cracked open, with no relief, and i can't push anymore. all my energy is dumped into coping (and coping not that well). i'm getting drained and progress is waning. we discuss turning the epi back on, and/or using a vacuum extractor to take this thing home. maria also seems concerned about some tachycardia in babe, so there's a rising sense of urgency to finish this ordeal and get baby out soon. dr. mclean (attending) discusses the risks and repercussions of the extractor, and as soon as i hear, 'if three tries doesn't work we would next resort to a c-section,' i fully retreat on any willingness i had, opting instead to wait for the epi to kick back in and to restart pushing efforts.
this was a good choice. with some relief from the epi, i feel a renewed commitment to birthing our baby through the canal. by now there's the receiving crowd, and a mirror, and i can see the baby's head coming farther and farther out. when the jaw and chin have cleared, suddenly there is all of her, and she's pale covered in vernix, squirming and on my chest, being suctioned and palpated. her attempts to cry aren't vigorous enough and after a minute or so they cut her cord and take her to the warming table until she cries robustly. then she is back with me, and i'm trying to let her crawl up to my breasts, wondering who this creature is and how she finally, finally, after so many hours and days, came to be separate from me. it was the sweetest, most relieved, most triumphant moment of my life, hands down, as i know it to be for so many millions of women.
peace ensues. maria and kim hang out for awhile, and kim shows us my placenta, which we keep. but eventually even they leave and we are left with a nice nurse, kim, who finishes her baby assessment after awhile, and preps us for our recovery room. my legs are tingly still and my ladyparts feel like an indistinguishable swollen mess. i am afraid to touch or look, so i just let myself be directed and cared for. in our recovery room 3102, there is still so much adrenaline we don't sleep until 7am, and then only until 9am, when babe awakes.
we spend the next two days there, at babe's beck and call. georgia, kimblo, and alisa visit. it is good to see them all. there is a superhighway of nurses and consultants who come in to take vitals, deal with paperwork, administer medicine, deliver meals. i am grateful for everyone's work and care but also just want peace and quiet and solitude with my new family. it gets to be TMI, and at some point i am stressed out by all we are supposed to do, all we are supposed to remember about my care, her care, in the weeks and months ahead. a photographer comes and is very sweet but ultimately leaves me feeling like some business is taking advantage of my moment of weakness to sell me sentimental photos that don't really encapsulate anything genuine of our daughter or our state of mind. not her fault, it's just the packaged nature of these things.
i cry a few times, in the middle of the night, and alone in the shower, reliving the past few days, letting myself really feel the physical trauma of it, which i'd been trying to survive through just to get to the other side. i feel little to no emotional or psychological trauma, but the sense of utter...struggle to survive that my body went through is imprinted. i feel vulnerable and temporarily broken. i know i will heal, and as I type this, i am already so far along in my recovery, but those first couple days i felt a little broken in my body. though soaring in my spirit.
i still have a hard time believing i did it. WE did it -- sora and i, and our incredible birth team. never in a thousand years would i have thought i could last that long, or keep my head together as much as i did. there were tears, there were meltdowns, but i know through most of it i was determined to stay as close as possible to our ideal. and this ideal certainly adjusted as the condition evolved. the candlelit homebirth gave way to the hospital room and me wired up and on drugs, but honestly, i am simply grateful to have pushed sora out into the world with my muscles. to have gotten to the point, even if assisted, of being able to push her out. many times i wondered if we would even get to that point, given how long it was taking, how little my body seemed to be cooperating. perhaps that feels like a compromise, but looking back, i feel like at any moment we -- i, sora, the team -- did the very best we could, the most true to intention that we could, to protect the ability to deliver vaginally. because at some point in the game, you just know that, because of duration and slow progress, a c-section is not that far away given today's hospital obstetric climate.
i have no doubt in my mind that had it just been christian and myself, and had we not had guardian angels on our team, and also in the cosmos, things would have ended differently. and, it wouldn't necessarily have been tragic, but for me, it would not have been the triumph i so badly sought and needed, going into this motherhood. from nurse kate's presence to the timing of dr. mandel's shift, to sora's complete steadiness and health, the labor was blessed in so many ways. i feel completely humbled by the experience of handing my self over to the universe, and of somehow being protected.
and being a new parent...I now understand that there's nothing like it on the planet. i understand why everyone who has kids is so damn excited for you, genuinely, when you tell them you are going to have a kid. i now understand why your closest friends cocoon you in love and help and protection during these early days. i now understand what sarah meant when she said her heart was 'outside her body' after elsie was born. i now understand how such a small being can rule your adult universe in a way that feels as necessary and natural as breathing. it's all a cliche, and though i feel sheepish embracing the cliche there is something so relieving about it too: i'm simply just another human. (what a relief!) who helped make another. who will, hopefully, someday question and search and find her own answer to what it means to be human, in her own way, as well. may it be a different struggle from what mine has been (to hold this path at arm's length, for fear of being struck dumb or otherwise consumed), maybe. or maybe not. the future holds a lot of changes, and i wonder what kind of world her adult self will live in. but for now, dealing with tomorrow feels like enough of a challenge, enough of a gift.