Tuesday, March 20, 2007

Birth Story: Part One (Mayan) and Part Two (Isadore)

Part One: Mayan Grace

I knew little about childbirth when I became pregnant--but like most, I followed the example set for me. In this case, my parents always spoke fondly of Katie Goodman, the nurse midwife that delivered me at Ketchikan General on the small island in Alaska. So when I searched out the one nurse midwife in our town, I was crushed to hear that she was full for my due month. I now know that the joke is to call Mickey Brennen the night you are going to conceive to get in with her. That left me with the other OB’s at the office, a group of 6 or so, and after a good cry I called back and the receptionist set me up with a Dr. Howell. “I really think you’ll like her,” said the receptionist who’d never met me.


I am not even sure how the idea got in my head but at my first appointment I mentioned that I would like the have a natural childbirth. Dr.Howell’s eyes rolled and she clammed up. When I learned that the doctors at the practice rotate being on call, I asked her what my chances were of her actually being at my birth. It was about 20%. Why would I put all of this effort into building a relationship with my OB to then not have them be at my birth? It sounded utterly ridiculous. She told me that they encouraged patients to schedule prenatal appointments with all of the other OB’s so that you will likely have an OB that you’ve met at least once. Woo-hoo! What about the episiotomy and cesarean rates of the other Dr’s? They all differ. Sounded like a huge crap shoot to me.

Frustrated I called a local childbirth educator and midwife for suggestions--at this point a home birth sounded too “out there” for a first baby, maybe a second but not for my first. I reserved a spot for my husband and I in her Bradley classes and she gave me the number of the one OB in town that supports natural childbirth and that she’s worked with many times--Dr. Stevenson. She also recommended the books “Husband-Coached Childbirth” and “Natural Childbirth the Bradley Way”. I booked the prenatal with Dr. S and gobbled up those book in the meantime.

So many concepts in there made sense to me and Blake. The observations of how animals give birth unassisted in the wild, their need for privacy and quiet--and the opposite environments that hospitals and typical hands-on OB’s present. We quickly got “Bradley-fever” and charged forward with confidence and fervor that we would need no drugs, cesareans, monitoring, episiotomies and the like. Dr. Stevenson had no problem with our vision at all. I began to learn that he was considered the “rebel” of St. Charles Family Birthing Center, pissing off the other OB’s at every turn with his “whatever-the-mother-wants” philosophy. We loved him but as time went on and we kept attending our childbirth classes we started to fall more in love with home birth and also with our teacher, Nicole Tucker. She was so informed, had a sweet gentle manner but also knew how to set mainstreamers straight without being pushy. She had a well-researched answer to every question and if she didn’t, she would go and find it for me. Blake and I discussed and decided to approach her to be our midwife. She happily agreed but let us know that she been attending birth for 8 years but was still working on her certification and preferred to work with a “supervising” midwife. Fine with us; we just wanted to met her. I only knew about one midwife in town, Brenda, who a friend had a bad experience with. Apparently, when at the pushing stage their home birth started to get stressful, Brenda took the husband aside and told him to anger his wife-”what gets her mad, like white hot mad?” “be an asshole--piss her off the best you can” and he obeyed, desperate and thinking this would help his wife. It destroyed the energy of the birth and they quickly transferred where she ended up with a c-section of her enormous baby boy. Meanwhile the family could not believe why the husband turned into such a jerk at what should have been a beautiful time for them. We decided this “get mad” technique was something we would avoid at all costs. Which would not have been a problem, but as Nicole explained her normal partner, Lisa ,was taking her once a year break around the time of our due date so Brenda was our other option. I flat out told Brenda that we knew abut the “ get mad” technique and it was not okay with us, we put it in writing and she said “fine”. Onward we went!

We broke the news to Dr. S at our last prenatal, and we were in our 7th month at this point. He was sad but understood and offered his support for us at anytime (but declined our offer to attend our birth at home for cash under the table). He also said that the latest measurement was a little off, smaller than normal and to have Nicole watch out for that. The fact was she already had noticed this and Blake and i were not concerned--we are both small people and we felt that maybe the baby’s positioning was affecting the measurement. As the weeks progressed, the measurements continued to fall short. Brenda and Nicole both explained to us of the possibility of IUGR--intrauterine growth restriction. They offered us the option of getting an ultrasound, and in our adamant no-intervention mentality, we declined. Why would our baby have IUGR? None of the cause applied to us--I was well-nourished on an organic diet which included 80 grams of protein, was on no medications, I had taken no drugs during the pregnancy, didn’t smoke, never done white drugs...of course this is where we began to sour on Brenda. She kept asking us, while she reclined in our living room chair, legs crossed, casually twiddling her hair, over and over if I did white drugs. Oh my God, NO! I could hear the annoyance growing in Blake's voice.

I did love having home visits though. While the OB at the clinic barely would spend 10 minutes with me, the midwives would spend an hour. They would want to talk about my concerns, how Blake and I were doing, what books we were reading, the meals we were making...I even shared dreams I had with them. One dream in particular really caught their attention: I was on the beach and Dr. Stevenson was there, and I was giving birth but the ocean was not sea water it was mud...so the mud flowed in up to my thighs and he caught the baby in this mud. Both midwives looked at each other and I laughed and brushed it off as hormonal anxiety dream.

From the period of 33 weeks to past 40 weeks there was very little growth. Of course I know i was informed of this and the midwives respected our decision to not get an ultrasound (what is it really going to tell us? I thought--it wouldn’t change our treatment, there is nothing you can DO for IUGR anyway...plus I doubted our baby had it.) but I don’t really remember hearing it. All I heard in my head was “nothing will make me have this baby in a hospital so we will just continue on course”. My due date passed--the 4th of July--and still no action. I being to get very irritated going to the grocery store (”no baby yet??”) and sent Blake instead. I assured my family that the baby will come when it’s ready...but as 42 weeks approached, so did Nicole who let me know that we only had a week left before she can legally deliver me at home. Not that she was against recalculating my date, but at this point I was pretty tired of being pregnant and wanted to see a healthy baby in my arms and put the whole IUGR concern to rest. Even though I knew it was not optimal and I respected that babies should come on their own time, something told me that I needed to be proactive at his point. I had heard stories about castor oil and how it made you sick, so that was a no. Striping of membrane was way too aggressive, so instead we chose black and blue cohosh and nipple stimulation.

I spend Friday alternating the two tinctures and using a breast pump. I began to have some weak sporadic contractions, but by Saturday something that could be called a labor began. My mom and sister came over with movies and Nicole came as well. By evening it felt like we were making progress. I walked, I rocked, and everybody quietly waited. The baby had perfect heart tones every time. By the wee hours of night, I progressed to 10 but felt no urge to push. I debated resting but also thought that maybe if I did a little pushing, it would stimulate the urge to push, so the midwives said okay. I squatted and pushed, I sat in the stool and pushed, I propped on the bed and pushed. Nothing. Baby was still very high--and now my back was hurting terribly. We’d nap between contractions (which we’re still like normal contractions but not as powerful as I’d like and definitely not pushy feeling) Nicole napped at the end of our bed and took tones which were still fine. Brenda and my family slept.

After a few hours and nothing, Brenda took over. She had her “head midwife” hat on and seemed fully in charge, which we were lukewarm about. I tried pushing again after she very painfully did a sweep of my membranes. The baby didn’t budge from it’s high up position. I was getting frustrated and discouraged. Then she did it, exactly what we asked her NOT to do--she said” Get her mad, Blake” “Get so mad you see white”. We could not believe it!!! We all awkwardly looked at each other and I secretly made my pushing noises sound more deep and angrier but in fact I was trying to shut up Brenda! I was so appalled that she thought I was not pushing with all of my might. After some time we retreated to the bathroom, just Blake and I. He looked at me with concern and I cried on his shoulder. Nicole came in, sat with us and explained that if things didn’t begin to happen that we should think about transferring. She sounded so sweet and gentle and made it clear that it was our decision but also I could hear that she would only suggest this if she thought it was appropriate. I cried more and did get angry--I would NOT have my baby in a hospital, I was sure that they would cut me open and it just wasn’t an option for me. So I warriored back out to the bed and screamed while I pushed “I am not going to the FUCKING HOSPITAL.”

Brenda checked me and I was back to 8 centimeters.

We were devastated. I was completely tapped, physically and emotionally and mentally. I knew that we had to go. That is when Brenda said “Or you could just eat a big meal and nap and we’ll try again.” I finally resigned myself to transferring and now she made it sound like all I needed was a nap and some food?? Had she not seen me barfing up every bite I’d taken the entire labor? What was her problem? I later came to believe that she greatly feared the hospital, which her condescending and defensive interactions with the staff made clear.

At this point, it was Sunday afternoon so we we’re getting close to 30 hours at home. We loaded up and Nicole arranged to have a friendly face meet us there: Dr. Stevenson. He gave me a hug and told me that he was glad to see us but that he wished it was under different circumstances. He didn’t make me feel like iId failed but instead I felt protected and safe. My back hurt so bad that the contractions were almost at a stand still. We went straight for the cocktail: epidural and pitocin. I went from severe pain to happy and joking with the anesthesiologist and erupting the whole room with laughter in about 10 seconds. So that’s why women get these! I thought. The pit drip started and Blake and I together on the hospital bed got some shuteye. When I woke up a few hours later I felt great, and felt a great pressure inside of me. In fact it felt like the bay was coming and I was not doing anything! The team assembled, and I was in such great spirits that I felt only mildly annoyed that Brenda had her knee up on my bed while she sipped a coffee, and my mom and sister craned their necks to try and get a good view. Thankfully Nicole pleasantly shooed her off, by giving her a camera and telling her to take pictures. My sister and mom moved in, supporting my left side, Blake on my right , and Nicole in between the doctor and me while I pushed. Dr. S invited Blake to do a “fourhanded catch” (big hospital no-no, mind you). It took not 15 minutes to push the baby out into their hands, all 5lb 13oz of her, in the darkest, thickest meconium the nurses had ever seen--just like my dream: Dr. Stevenson delivering my baby in the mud.

He even allowed Blake to carry our little girl over to the warmer where the peds waited. Of course, they wanted to sweep her way to the NICU right away, and I asked them to bring me her to hold. I hadn’t even gotten to look into her eyes yet. The ped hesitated one leg toward the door, and I said in my calmest but don’t-you-dare-fuck-with-me voice “Bring me my baby--you will let me hold her before you take her away” and she brought her to me, although obviously miffed about it. And there she was--a little girl, with the sweetest little squished face and pouty bottom lip. They took her after a minute and I told blake to follow. I delivered the placenta and Dr. S stitched a small tear. I was cleaned up and my sister got me a wheel chair to take me to the NICU. Brenda felt the need to condescend my sister (a nursing student) about whether or not she knew “how to work one those.” My poor sister bit her tongue, but after getitng me into the chair, gave me a kiss and said she needed to go and get some rest, but I knew she needed to get space from Brenda. Dr. S gave my sister a hug in the hall as he left, and she trembled with anger and being the kind-hearted and aware doctor he is knew just why. I told everyone to go home and rest, and went and saw Mayan in the NICU. There was nothing wrong with her, they just wanted to observe, so I approached the pediatrician and told her that we could observe our child ourselves and we would like her to room in with us. By this point, think she got the picture that we were a proactive couple and no body was in charge of us, so she said okay but that we need to be here for at least 24 hour. I was terribly uncomfortable in that room (which they call a suite and I hear women gushing about all the time---”aren’t they wonderful!”) because our home and our bed were calling. So at exactly 5:18pm the next evening we were packed and out the door with MAYAN GRACE.


*******

Part Two: Isadore Naomi

About 18 months later, Blake and I were pleasantly surprised to discover that we were pregnant again. We had never come to any conclusions on the cause of Mayan’s poor growth and I chalked it up to a fluke. Surely we had paid our dues the last time and I really could not imagine the next birth going any worse. For one, I knew I could have a vaginal birth and I was confident that the growth for this child would be on track. Nicole, who was now practicing on her own (and had severed all ties with Brenda after our birth), would be our midwife, but she suggested that we again have a back-up OB so we would be prepared in a similar event. Sadly, Dr. Stevenson was no longer practicing due to a lawsuit brought against him. He was accused of sexual assaulting patients and was acquitted on all charges--but what the supporters of Dr. Stevenson really believe the case to be was the hospital misconstruing his actions and frowning on his practices, and the lawsuit being an attempt to get him thrown out of their hospital. Well, it worked and the midwives and satisfied patients very much miss him. The only doctor in Central Oregon that offered any support to Nicole and the other midwives was a Dr. Rose Kenny who offered water birth at the Redmond Hospital 20 minutes away. We agreed that we would meet and toward the last trimester to get comparative ultrasounds if the growth started to waiver.

Well, it did. We had an ultrasound at 32 weeks and baby was measuring at 31 weeks. Big deal, I said. I was still staying positive and honestly was only preparing for a home birth. Most important to me was Mayan being able to have the option of attending the birth of her sibling and I was not okay with her seeing the hospital as the norm. But I was secretly fearful that I would again not have my peaceful intervention-free home birth. About this same time, there was an article in the local paper slamming lay-midwifery and home birth. A letter-writer by nature, I entered into a letter writing battle in two local publications between myself and the head of Obstetrics at St. Charles, Dr. Murphy, who in one letter called home birthers “reckless.”

As that drama died down, I had the most beautiful blessing way thrown for me. It was a Wednesday and my small support group, of sister-in-law, mother, friends and midwife gathered at the Nomad studio after hours. They let me pour out my fears to them and I cried as I told them about the stone I had brought to put on my birthing necklace, a matching chunk of turquoise from a necklace I made for Mayan so if we were apart I could rub my stone and feel close to her. They showered me with strength, rubbed my feet and made me feel so empowered. I left that evening feeling loved and part of a tribe of strong birthing goddesses.

The next morning, the day of my home birth visit, I had a my 2nd ultrasound, three weeks after the first. This was a very strange experience for me as I personally believe that the womb is a sacred place and a child should not be seen until they are born. So I not only was I the rare patient that didn’t want to know the sex but I also made the tech turn the machine around and asked her not speak to me about what she was seeing. At the end of the procedure, the tech did say that things looked fine to her, low amniotic fluid but not off the index--but Dr. Kenny would look over the data. I left feeling great and ready to go over my birth plan with Nicole and her assistant. We had just moved into our newly remodeled master suite and I had the space for the birth tub all picked out. Finally I was going to have the birth of my dreams!

Then, as they say in cliché story lines, the phone rang. It was Nicole; she said that she had bad news and that I was to call Dr. Kenny right away for the ultrasound results. I did and what I remember is this:

“...baby has grown four days worth in three weeks...”

“....can’t deliver this early (35 weeks) at Redmond hospital.”

“They are waiting at St. Charles for you to give you a c-section”

“Dr. Murphy will be in charge of your care”


I crumbled to the couch, as Blake ran in from work, and I sobbingly tried to tell him the news. I called Nicole back. She was dropping off her kids and would meet us there. But she reassured us that that we would go in to TALK about the results, check to see the how the baby was and that whatever happened it was still our decision. She was very disappointed about Dr. Kenny's alarmist approach. We called my parents, gave them a few details and asked them to watch Mayan while we went to the hospital, very unsure about what the next few hours would hold. Nicole met us in the parking lot and gave me some homeopathics before we all entered in together. They directed us to the examining room of the birthing center, and seemed ready to admit me. We explained that we were hear to speak with Dr. Murphy, and I declined the gown that the woman asked me to put on. At that point I felt that it was one of the last powers I had--simply to be in my own clothing. The thought of putting a gown on and becoming part of the “system” made me sick.

They did a nonstress test and Dr. Murphy came in to consult with us. He was perfectly calm and collected--the exact opposite of Dr. Kenny’s call--and not one word was passed about our letter exchange and difference of philosophy. We were completely and cooly respectful. In fact, he directed his speech to me the whole time, barely acknowledging Blake or Nicole unless they asked a direct question--even so he gave the answer to me. The gist was growth was too slow, fluid was very low, and although it was our decision he had seen many (his words) dead babies. He probably said ‘dead baby’ to me at least four times. It all seemed very subliminal they way he was so composed and didn’t directly suggest what i should do but his verbiage spoke volumes to me--it put fear in me. Fear that I didn’t feel from the inside, but was entering me through his speech. To be honest, my gut said it was too soon, the baby needed more time to grow--YES, this IUGR is real but let’s drink a ton of fluids and try for 37 weeks. But the fear being put into me said that here I was being treated by a man who knows my beliefs and believes me to be RECKLESS, so if I decline care, what then? I felt more unsafe if I didn’t do what they were suggesting. In a word I felt defeated. He was telling me that he could “guarantee” a live birth if we induced now, that the baby would be premature and that likely the lungs would be underdeveloped but they had a wonderful NICU run by one of the top neonatologist in the country. Many questions plagued me--like why did the ultrasound tech tell me that everything looked fine? He replied that maybe she was calling my bluff, telling me what I needed to hear. I was too overwhelmed to be angry. We agreed to come back the next morning, so we could go have one last night with our daughter before the induction.

It was perhaps the most emotionally difficult night of my life. Mayan slept peacefully in our new bedroom as I sat cross-legged on a bearskin rug looking out our giant windows that faced the rooftops of our neighbors and the hills beyond it. I sat there and grieved my lost home birth, my peaceful birth, my empowered birth.

From my journal written soon after the birth:

“That night was terrible. I woke up and sat on our rug toward the new big bedroom windows and tried to meditate but I could only cry and Blake came to join me. I wanted to be strong at the hospital and show Dr. Murphy that I was not grieving my loss of a natural, home birth but being responsible, sensible, and strong."

Here I was again about to walk into a hospital, this time to be forced into labor to birth a baby that was currently alive and healthy, in an ugly room with stupid monitors and god-awful wallpaper border. To be fair they put me in a corner suite looking out over the “cancer garden”, which I found out later a very cool activist friend of mine gave birth in just a week earlier (she had a hospital birth with her first child due to her lupus.) I got “hooked up” and lay in bed and waited. The first few hours were a test to see how the baby responded to the contractions. At this point, naturally, my cervix was not at all dilated or effaced. Everything looked fine so we continued. My nurse was pleasant enough, but I felt no connection with her. Every time she came into the room she headed straight for the paper coming out of the machine that was attached to me by wires...if felt like the Borg, a data spewing science experiment. By lunch time, I was getting very hungry and I was told that I was not allowed to eat. I flipped out on the nurse and asked her how in the hell I was supposed to have the energy to make it through the labor if I couldn’t eat anything? No wonder so many women end up with cesareans, it’s like they are setting you up to fail--here’s possibly the most physically taxing event of your life and they are withholding food and drink!! I demanded she ask Dr. Murphy but as she walked toward the phone she shook her head saying “I can ask but he’s going to say no...” After a short hushed conversation with him, she came back and said, “He said you can have a half of a sandwich and some soup....” Ha! I (and the nurse) could tell that Dr. Murphy was treating me somewhat differently than his average patient.

All day the nurse increased my pitocin while my contractions grew in strength, but were still short and mild. By the afternoon I was one centimeter and 30% effaced. My mom brought Mayan in to visit us; she was excited and stimulated by the new environment so it was hard to really connect but also I wanted her to see that I was smiling and strong and brave. Also my friend Helene came by with organic baby essentials and I had her order some preemie outfits from Under the Nile. Nicole was in and out, giving me the real caregiver connection I needed and answering my questions from a non-medical model perspective.

Evening came and a new nurse came on--her name was Nancy and she was a “traveler” originally form Alaska (my birth state) and was not anti-home birth. She ended up being the perfect nurse for us. As things got darker, I felt I was entering the “Twilight Zone” and her presence was a soothing one. Dr. Murphy came in to check on me--i was now 2 1/2 centimenter and 50% effaced but still I was not having powerful getting-the-job-done contractions. He tried to entice me with Cytotec--and having just read about it in Ina May’s Guide to Childbirth, I was terrified of it. He told me that it just “melts the cervix away” (ew--I don’t want my cervix to melt, just open gradually), and that it would give me the freedom to get up and walk around. Also he mentioned that he hardly ever uses pitocin anymore, maybe only twice a month, and that it’s all about Cytotec. No, thank you, I said. So we compromised on breaking my waters. Compared to everything else, breaking my bag of waters seemed so old school and natural!

My water never broke with Mayan so the breaking waters was weird sensation--warm, gushy, and no meconium. Before Dr. Murphy left the room he told me he thought I’d have my baby by 3 am--I was shocked when I calculated that was only 5 hours away. I sent Nicole home to get a few z’s before things got hectic. As I sunk into my zone, awaiting the “real contractions” to take over, we flipped on the tv for distraction. Blake and Nancy discovered that they were both Trekkies when we happened to flip to an episode of Next Gen on the the Sci-Fi channel. It was helpful to hear them chatter about conventions and actors as my rushes deepened--strong enough to make me focus but no enough that I needed support. The night crept on, and pretty soon the pitocin was off and the contractions were all my own. Nicole came back and they became insanely powerful. I had never had them so powerful with Mayan and I used low register growling noise to cope, each time locking eyes with Blake so he learned to “read” my growl language to know where I was starting and peaking. I rubbed my strand of labor beads especially the stone I added for Mayan. I began shaking, vomiting, and complaining that there was no way I could do this for another hour. Nicole and Nancy looked at each other and agreed that these were sure signs of transition. When I finally let them check, I knew that I had to be 9 or 10, and otherwise I was done--the contractions were too great, unnaturally strong.

Nancy had to break the news: I was 3 1/2 centimeters.

It was as if my body and the hormonal process of birth had taken place including transition, the strength of contractions were all appropriate, but my cervix would not comply. Of course not--the baby wasn’t term and I thought it sweet in a way that my cervix was protecting my baby from coming out too soon.

Had I known that I had only made one centimeter of proggress, I would have ordered the epidural earlier. The second I heard “3 1/2” I gave the okay to order, but had to wait for 20 minutes. Things got even more intense and painful in those 20 minutes--freaky, unnatural contractions trying desperately to force open my unripe cervix. The minute he appeared at the door I felt I was saved. I felt somewhat confident about getting the epi because I’d had one with Mayan. The worst part was having a contraction while curled up just before insertion of the needle. The effect was immediate but not complete--one-third of my uterus still had sensation so he adjusted the dose then all my pain was gone. My blood pressure dropped so more drugs for that. I felt heavily medicated so even though it was time to take a nap, I was afraid that I might never wake up. That was terrifying--but I knew Blake would be there. The nurses were sure it would now take at least 6 hours to get to 10 and I insisted that Nicole go home and nurse her baby and I would call her when we were closer. I drifted into a strange drug-laced sleep just as the sun was coming up.

What seemed to me to be 20 minutes later, I woke up to a completely empty room. I could have swore I was somehow placed into a Twilight Zone episode. I heard talking outside of my door. I was sure they were scheduling my c-section. Nancy came into the room; I asked her what was going on.
“The baby’s heart rate had some drops...”
“So, you’re going to do a c-section.” I finished for her in a defeated tone.
Part of me was ready to see my baby no matter what means were necessary.
“Oh gosh, no! Nothing that bad,” she exclaimed.
I was shocked! And uncomfortable. My hip was aching, and she helped me turn--it didn’t help and the aching got worse and began to spread across my whole pelvis. Nancy did a quick check and said “You’re fully complete and the baby is coming NOW.” Suddenly the sensation began very clear and I felt like the baby was coming and I had no control over it--I did everything I could not to push yet.

The whirlwind began. It was 7:15 and the nurses were changing shifts. “Where is my husband?!” I yelled. “Hand me the phone!” I barked to the new nurse.
I quickly dialed Nicole's number and her voicemail picked up: BABY. COMING. NOW. was all I could muster. Dr. Murphy sauntered into the room, in full scrubs top to bottom, as a nurse helped him pull his gloves up high. I said later that it was like invisible fanfare went off in the room, the “Deliverer” had arrived. I couldn’t have cared less.
“Where is Blake??” I was panicking at this point that he would miss the birth, I could feel the baby in my birth canal.
In that classic composed tone, Dr. Murphy said “He’s on his way...I just saw him in the hallway....” like it was totally not worth the worry. A second later Blake came to my side and I looked at Dr. Murphy, ready to push--but I froze. What was I supposed to do again?
“Just hold your breath and bear down!” Nancy called over her shoulder.

One push. Two pushes. And she was there. Tiny but not frail--like a miniature baby. Dr. murphy told me if I wanted to hold her I should take off my shirt and I was pleased that he remebemed our conversation about me getting to hold her skin to skin right away. She was so sweet and warm and I kissed the top of her head--it was the kiss that lingered on my lips for days afterward and I could feel it when I could not hold her. Somehow, Blake managed to grab a camera and shoot some photos. I handed her over and took a photo myself of the placenta coming out. I noticed a strange man come into the room, he looked like he was wondering aimlessly. He was terribly goofy looking and wore a 70’s style sweat suit. Just as I was about to say something about getting “that simpleton out of the room”, I saw how Dr. Murphy regarded him and realized that this was the highly respected neonatologist, Dr. Merritt. I was more relaxed about them taking her away because I was prepared for it and I knew that they were going to do whatever needed to be done--our newborn baby girl needed help.

Nicole rushed in just a few minutes after the birth, a mere 15 minutes after I called her. I filled her in on our new bundle, just 4lbs and 6oz. Mayan and my mom also came and it felt so good to reconnect. As much as we had originally wanted to not reveal the name until a post-babymoon naming-ceremony, the new circumstance led us put the name out to the universe so that family and friends could send their energy our way and have something identify with. Although, we had many boys names picked out, we had struggled with girl names. The middle name was already cemented as Blake's grandmother, a very influential women in their family, and also my sister, my closest friend, shared the same name. The first name that we were leaning toward suddenly seemed incredibly fitting--meaning gift of fertility. Life outside of the womb had begun for: ISADORE NAOMI.


The rest of the saga I prefer to keep short. It was an incredibly trying time for us, but in the end I was very proud of the way Blake and I handled it. One of the sweetest and romantic things I can recall from our six years together was the morning after Isadore’s birth. I had stayed in the hospital to be close to the NICU, but I thought it best for Blake and Mayan to go home and sleep in our bed, to try and put some normalcy back into Mayan’s life as soon as possible and she’d had a tear-filled night with Grandma. The next morning when they came back to my room, Blake had buzzed off all of his hair with Mayan’s help. It’s a cut I absolutely adore and he knows it. This was a new chapter so us and it seemed very fitting--I was deeply touched.

Going home 24 hours after the birth without Isadore was torture but I knew Mayan was having a hard time grappling with this situation: I was not pregnant anymore but also there was no baby at home. I had mixed feeling about having her see her new sister surrounded by beeping machines and covered in wires. I decided to sleep at home for 2 reasons, to be close to my toddler and husband and also because they do not provide beds for parents of NICU babies. One thing brightened up that day for me. Nicole and her assistant Dana came to give me my home visit checkup, and that morning Dana had gotten the new Mothering Magazine in the mail. She told me to open up to the letters section and there was a photo of Mayan nursing her giraffe and the letter I’d written in about my hopes and thoughts regarding tandem nursing. It was so cute and I put it in her baby book right away. (Continuing to nurse through the pregnancy turned out to be a great decision as Mayan became my “portable breast pump” while Isadore was still in the hospital.)

Isadore had developed an infection within 24 hours. She was on antibiotics and also morphine since she had a ventilator which is very uncomfortable. After a few days she was off the ventilator and on a nasal cpap, but because they were taking so many blood gases, they informed us that they wanted to do a blood transfusion. This was a very challenging decision for us as we would have very much preferred that the blood came from us but there were limitations of why that was not possible. After consenting to the transfusion, things looked steady and there were no scares. It became a long waiting game while weaning her off of the oxygen. I spent my days at the hospital and my nights at home with Mayan and Blake. I pumped every three hours, even though at this point I was not able to put her to the breast and she was barely consuming a third of what I was producing via tube feeding. The NICU fridge overflowed with bottles of my pumped milk until they kindly asked me to keep the rest at home. I spend my time rocking her, singing lullabies, and writing in my journal.

One thing I learned about challenges like these are that a person’s experience is so relative. Although there were some babies that had been in the NICU for months, and others who’s parents lived hours away and drove in on the weekends to visit their babies, I felt that this was especially hard for an attachment family who was a planning home birth. The gap between our expectations and the NICU experience was so much wider than the average family. At one point a baby came in and soon the dad followed with a car seat in hand. The doctor explained to him right there in front of me that they would like to watch the baby for 24 hours. The father was so disappointed, ready to go, car seat in hand. I wanted to stand up and scream in his face “I WOULD KILL FOR 24 HOURS!!!” But his experience was his and mine was mine and he nonetheless had different expectations.

Day 10 was an amazing day. After my usual sign-in and vigorous hand-scrubbing, I walked into the NICU and saw that they had moved Isadore out of her isolette (plastic baby incubator) to an open plastic crib. Many of the wires were gone and merely a small nose tube remained. She was swaddled and could be easily picked up and snuggled. I was in tears of utter joy, and then the nurse gave me the go ahead to breast-feed and explained that as soon as she began to get 50% of her milk though nursing I could bring her home. They were concerned because preemies usually get very tired sucking and fall asleep at the breast and then need to be supplemented via tube for the rest of the feeding. The general rule is one cc for every one minute of sucking. Hee, hee, hee...they didn’t know who they were dealing with! It did appear that on the first day or two, she hardly sucked at all--too sleepy. But she also kept throwing up after the final tube feeding or the “top-off.” So we decided to weigh first, nurse, then weigh again. After 10 minutes of weak barely-there sucking, what should have been about 10cc’s, Isadore had really taken in 36 cc’s!!! Apparently, it only took one of two sucks for my milk to come down then the powerful flow just tricked down her throat as she dozed. We were giving the go ahead to take Isadore home the next day. In an unprecedented event, because of the hospital policy that babies MUST be carried out in car seats and all we had was a Brtiax already installed, Isadore became the very first child to be “slung” out of St. Charles’ Family Birthing Center doors.

Believe me that WAS the short version.

Once Isadore was home, everything was fine--our family of four was complete. My magical milk was putting a whole pound on her sweet little body every 2 weeks. The sling became a part of her--at no point was it ever not touching her, only peeled back for diaper and clothes changes. I began to think of the carrier as an outer womb, where she could complete her growth near everything she really needed--my breasts and my heart beat. Today, I very rarely even think of her as a preemie.

I do, though, wonder about the path we chose--Mayan and Isadore’s situations were similar but we chose completely different paths in each case. I will never know if things would have been different (for better or worse) if we had refused the induction. But these two births leave me asking so many questions about my ability to grow a baby to full term or to ever have the home birth I dream of. My decision to have another child is very much wrapped up in these concerns. After blood testing and placental examination, still there is no clear answer to why the IUGR happened. After 2 years of my own investigation, I do think I know the culprit--but I have no proof, little scientific data to support my claim (research concerning the link is very limited), just many clues that all point to one thing. And although this culprit has been removed from my life, it does not mean that permanent damage hasn't been done. If I did choose to have another child, I would need to seek out care-providers that are willing to go over my situation, try new approaches, and at the same time be prepared for all outcomes. I envision a range of possible endings--from perfect growth and a birth on my living room floor to the exact fear that Dr. Murphy was concerned about, a stillborn in a hospital setting. I personally believe that I have the strength and resiliency to handle any and all of these situations, but do I want it for my family? It’s truly a chapter that is yet to be written.

2 comments:

The Noble Fat N Happy One said...

beautifully written. thank you for sharing your experience. *love* you are so amazing, and so is your family.

Sage Femme said...

these two stories just break my heart. and it's hard to be critical of a woman's birth experiences - after all, they brought two stunningly beautiful souls into this world.

but I'm so angry for how you were treated, what was taken from you and your babies and how the process was not trusted. how your instincts were so right on and no amount of tape measures or ultrasounds can change that.

much love to you, mama.