How Did I Get Here - Part 3

You can see the rest of the series here

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When you look back at certain events, especially as time passes, different things stand out to you.

I wonder if part of it is your brain trying to make sense of what happened, to find some meaning or depth. But sometimes it just feels like a scratched record skipping and playing the same three notes over and over until you want to scream in frustration and pain.

I hear the beeping of the monitors and feel my legs squeezing. The room is much smaller than the one earlier, and the window is on the opposite side. My arm hurts where the IV is. And my abdomen burns.

And then the guilt follows.

Last night I thought it would be so neat if my baby was born today. The consequences didn't matter, what a neat birthday it would be. My partner comes in and tells me what he knows - our baby is in the nursery on oxygen. He doesn't know anything else. 

A nurse brings a polaroid of my baby, because I can't get out of bed to go see her. Why? I still don't know. It's probably nearing 4pm, but time means nothing to me because nothing makes sense. My parents are there, they saw her through the window of the nursery. They bring some gifts for me, for the baby. That I still haven't seen.

Everyone keeps calling to say congratulations. How do you handle that when you aren't even sure that you had a baby? Maybe it was just a bad dream and I'm going to wake up soon to go to the hospital.

Finally, at 9pm, almost 8 hours after she was born, the nurse comes in and says she is there to take me to see her. It takes about a half hour to get everything set up and wheel me down.

She's on oxygen. With an IV. She has a green pacifier, naked except for a diaper. She looks bruised and has hair on so much of her body. She has so much dark hair and is so tiny. 

She doesn't feel like mine. How could she? She exists outside of me now and I hadn't seen any of it. That will take months to heal, made worse when she's transferred.

I am not allowed to hold her. She is struggling with oxygen and they are worried about her, so I hold her hand. What kind of mother can't hold her own baby. We only stay for a half hour. 

I sleep fitfully. They brought me a pump, so I was doing that every two hours around the clock. The nurses joke that I'm doing so well because I'm getting 1 ounce every time only hours after having my baby. I don't know any different. They place the milk in orange snap top containers like what camera film was in. They don't tell me to not overfill it. Almost all of it had to be thrown out when we got to the next hospital because they weren't sealed and the milk wasn't safe. I had about 30 ounces when we went two days later, and they could keep maybe 10 of them.

I slept and ate and pumped and took meds and let them push my belly and showered the next day and got the catheter out and hoped I could hold my baby eventually. She was 24 hours old when I finally did, with the help of nurses because she was sent next door to the higher level nursery when her oxygen level needs kept increasing. 

I held her. She was so small. Five pounds. I didn't know what questions to ask or how to feel, just hoped it would make sense eventually.

My partner held her, all the while my mom was with us taking pictures. We stayed for an hour or so and then had to leave. My in-laws were there, meeting her through the window. The first grandchild for both sides. What a special time, right? 

Time passed, she never left the nursery, and we would get updates often with how she was. She was born Wednesday, by Friday they were talking about discharging me on Saturday, but she probably wouldn't be. I was able to walk to the nursery then and see her, but I still had to have a nurse escort me and stay with me, and it felt even more like I had no idea how to take care of this baby without someone making sure I wasn't doing something wrong. We didn't get to hold her again before Saturday, her oxygen needs kept increasing and they told us she might need to be lifeflighted to another hospital because she was almost at the limit they were allowed to give.

Nod. Smile. Hold her hand. Pump. Meds.

Friday afternoon the pediatrician came in to tell us she was being sent an hour away. The team was called and had to get her set up so they could go because she needed more help. 

Have you ever had those experiences when everything is in slow motion? You hear words but they don't really click and you wonder what is happening because it doesn't really make any sense? I knew she was being sent away. I knew I was still a patient at this hospital and couldn't leave. I knew my partner was not ok. So, I put everything I felt aside and prepared to go.

A wonderful nurse called the hospital and asked if we could have a place to stay while she was in the NICU, and they had a room set up for us in the PICU. It was evening and too late to set up at the Jubilee home, and they weren't sure they would even take me since they were hoping it would be a short NICU stay. I called family and let them know. I packed everything. I went to see her and had to leave because they had to get blood from her and I couldn't handle them poking her over and over.

She hadn't had any food up to this point. Just an IV. Getting her to bleed was an entire expedition, the team later told me. She was hydrated but it just wasn't enough and she had so many sticks that her heels were raw. It hurt to see it, and so I didn't.

They put her in a helicopter and left. We followed, after going to the store and buying a pump, and an hour later we were at the hospital. They got there long before we did, and as soon as we pushed the button for the NICU, a nurse was there to meet us and explain how we had to come in and wash our hands and prepare to see her. When the new hospital was built, it was so weird to go in and see the NICU wasn't behind a locked door and you only needed hand sanitizer to go in. We had a full sink, with timers on how long to was our hands. And this had to happen every time we entered.

We go into her room, and she already looks amazing. She's less red, she's breathing easier. The neonatologist, who would become one of my favorite people, told me everything that was going on. She didn't need to be intubated or put on CPAP, just the lower elevation may do the trick to help her breathe. He explained different things they had planned if anything needed to be done, and they had already got a feeding tube in and with the milk I brought, they would start to feed her to prepare for me to nurse her. 

It was surreal. This high level facility, where things were locked down and we had to wash like surgeons was treating me more human than I had felt in the last two weeks. They helped us get set up in our room, brought a hospital grade pump for me to use, containers for my milk, and cleared an entire shelf of the fridge for me. I was included and seen. This was not what I expected.

Saturday she increased her food intake each meal, getting ready for me to start nursing her on Sunday. Her oxygen needs were going down, she looked great. She had lost a lot of weight, over a pound, but they were excited at how much she was improving.

We went to eat with family, shopped around town, the last Harry Potter book came out and my mom bought it for me for something to do. I read it before we came home the next Wednesday. We hung out with our daughter for a couple hours every day, but I was young and inexperienced and had no idea what to do, and it was easier to let the nurses do it. 

Sunday we started nursing. It was so weird. Why did no one tell me it was so weird?! But she was doing ok, though not eating as long as they wanted her to. She still had the feeding tube, even though now I was pumping 4 or 5 ounces of milk every two hours, so that definitely wasn't an issue. But it was just because she was small and tired and they wanted to make sure that she was still being fed. The lactation consultant came in and was so rough with me, and I still had no idea what I was doing when she left.

And then a nurse came in. She sat with me while I felt overwhelmed trying to get my baby to eat, told me I was doing great, that she was doing great. She answered my questions, but mostly she just made sure I was okay. 

We take that for granted sometimes, I think. I didn't really need her, but her presence made all the difference to me. I still didn't know what I was doing, but I felt more like I could handle it after she left. I don't remember her name, and that is one thing I regret. She made such a difference to me and what happened, and I am forever grateful.

Monday brought jaundice. I knew I had it as a baby, but they were growing increasingly worried. Her levels were 15 and then 19 and then 21. They told me if they got to 22, she would get a transfusion. She lived in the bili bed on Monday and nursing was hard because she was so tired. But, she was finally pooping, and was still eating every couple hours, which was huge. Monday night I got to her room to nurse and they were so happy to tell me her level was down to 19 and things looked like they were getting better. She still needed the lights, but it was less dire, and we were doing it.

I nursed every 2 to 3 hours, and Tuesday brought hilarity when she ripped out the feeding tube herself. I should have known then that this baby was going to be a spitfire and do things exactly how she wanted them. They thought about putting the tube back but decided to see if nursing would be enough and left us to it.

We had to watch these videos before she was able to leave and they wanted us prepared, so we watched one on abuse and one on feeding and I think one on carseats, but I don't remember much anymore. Tuesday was over so quickly and it was surreal that she was almost a week old.

Wednesday my partner decided to drive home and go to work, and I swear, he had barely been there for 20 minutes when the hospital told me she was going home today. She had been off oxygen for about 30 hours and was doing so well, her jaundice levels were down to 12, and it was just unreal that this was our life.

She had to have a carseat test and her hearing screen and they had to explain everything to me. She was being sent home with oxygen because we lived 3000 feet higher and sometimes babies just have a hard time with the elevation. We had an appointment to see her pediatrician on Friday and he would tell us what to do.

By 1pm, we were out the door.
With a baby. 

How in the world did you take care of a newborn???

Crash course, here we come.

How Did I Get Here - Part 2

Part 2 of my new series about what brought me to midwifery and birthwork.
This part is the ECV and cesarean. It isn’t pretty. I’ve written this story so many times over the last 16 years, and this feels the truest. I continue to give myself grace, but I also see now how dehumanized I was through that entire day.

To read the other parts, head HERE

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Do you ever have those moments where you know your life is going to change, and your gut is telling you to go back to bed because it's not a great change but something that will irrevocably hurt? 

Waking up on the morning of my ECV was like that. We had to be at the hospital at 5am, and I didn't sleep well the night before, mostly nerves and excitement that I could possibly meet my baby that day. I didn't think I would, but it's that tiny part of your brain that thinks about what could happen? And I foolishly thought that even if we met our baby that day that everything would be great. 

Walking into the hospital my gut was *screaming*. This isn't right this isn't right this isn't right.  Over and over and over. It's like you're watching it happen to you in slow motion but there is nothing you can do to change the outcome. 

I walk up to the nurse's station, and they have NO IDEA I'm supposed to be there. There are no orders, no forms, absolutely nothing saying that I am having an ECV at 7am. I'm barely 20 years old, I've done everything I'm told this entire pregnancy, and now they're saying I'm wrong and shouldn't be there. I stare, bewildered. 

A nurse takes pity on me and takes me to a room and says they will call the doctor and figure it out. She hands me a gown, tells me I just need to take my bottoms off but can keep my shirt on (this is an issue later, just like everything else that day). 

And we wait. 

And wait.

And wait.

Finally, at 6:30, the nurse comes in and says that they got it all figured out and the anaesthesiologist is on the way to give me the epidural, and they just need to get my IV set up so everything can start. 

It's like a giant rush at this point. No one was prepared but now they know they're on a clock and if they aren't ready when the doctor gets there, it's his time everyone is wasting, and somehow it's my fault for coming in without orders (even though there were, they just lost them along the way). 

The epidural is placed, which I would never ever like to live through again, meds are placed, I start feeling a bit loopy, and finally my midwife and the doctor come in, all smiles. At 8:30am. What even is time anyway? 

Ultrasound.

More meds.

Ultrasound.

So much talking.

The bed flattened and I'm lying on my back with my head a lower than my body to pull her out of my pelvis.

Pushing.

It's hard to breath.

More pushing.

Swearing.

Hands leave my belly.

Ultrasound.

"We got her halfway and then lost our hold and she went right back, we have to try again."

Pushing.

Pulling.

My whole body is jerking on the bed.

It's hard to breathe.

Pushing pushing pushing.

Finally release.

Ultrasound.

"We got her head down, everything looks great, good job! We need to keep you on the monitors to make sure baby is okay, just rest while the epidural wears off."

It worked. My baby is head down. The epidural needs to wear off and I can go home. I breathe a sigh of relief, knowing that everything is going to be okay. 

I try to sleep a bit, but an hour later I wake up with my legs spasming on the bed but I couldn't feel them. I then proceed to have a massive panic attack, Blake can't calm me down, yells for the nurse. She comes in and helps me breathe and relax, but the twitching won't stop and I still can't feel my legs and what is wrong and why is this happening and when can I go home and and and and and….

They never told me a side effect of the meds was anxiety attacks. 

Just chalk that up on the board of things I was never told, which gets longer by the second. 

Slowly the feeling comes back to my legs. It's around 11am at this point. 

And then my room is filled with nurses. Her heart isn't looking as good as they want, and oh crap, there is a pool of fluid on the pads under me. 

During pregnancy, I remember being told over and over that if you have contractions 5 minutes apart, lasting one minute, for one hour, to go in to the hospital because that's labor. I was admitted twice in pregnancy for this - once when I was so dehydrated from puking nonstop for 24 hours, and once at 35 weeks. They laughed at me because the vaginal check showed nothing, even though the monitor showed contractions. I was patted on the head, told it's "just braxton hicks" and to come back when it's serious.

With your first baby, how are you supposed to know it's serious? How are you supposed to know that the 5-1-1 rule is bull when your uterus contracts every second of every day no matter what you do? 

The list of things just gets longer.

My panic subsided with the adrenaline now filling my room, but I have no idea what could be wrong. The doctor comes in and tells me the baby isn't handling things as well as we would want, and my water might have broken, so they need to do tests for that and monitor me more closely to see if the baby perks up or if I'm in labor.

Um. Ok? This wasn't part of my plan. I was supposed to be going home.

Vaginal check. Dilated to a 1, same as 35 weeks. 

Amniotic swab. Negative. What could this liquid be if not amniotic fluid?

Oh. They never placed a catheter. I had peed all over myself. Just great. Exactly what I want to hear when someone is sitting basically in my vagina. 

Looking back, the most dehumanizing part of this is how they would talk about me like I wasn't there. I'm lying on the bed, still too numb to walk but getting feeling back, and they are talking to each other over me like they're talking about the weather outside. Like I am not even there to hear them. 

At that moment, I knew my baby wasn't acting right on the monitor, I had in fact peed myself instead of my water breaking, and I wasn't in labor. They kept asking each other if they should put a catheter in, if they needed to walk me to the bathroom, if they needed to call the doctor, if they should flip me or sit me up, or or or or. 

Never once did anyone look at me, explain what was going on, and ask if I was okay. Not once. 

It's noon or 12:30, and baby is still having decels and I am now contracting regularly. But no dilation, after another incredibly rough vaginal exam that this time I can feel because I am no longer numb. 

Still no words directly to me. Just at me and around me.

1pm, the doctor comes in. Finally, eye contact. 

"Your baby isn't handling the version well, it's time to do a cesarean. Are you numb still?"

"No."

::turns to nurse and talks to her, never looking at me again::

I'm shaved.

Anaesthesiologist enters the room again, adds more medication to the catheter because they never removed it. 

Notices I'm wearing a shirt.

Chaos ensues.

It was just a T-Shirt, but I have an IV, the epidural, and monitors all over my body. Taking the t-shirt off was a nightmare. And they had to do it quickly because the OR was set up and waiting. 

The nurses ended up lifting and pulling me like I was a rag doll as they got the shirt off around everything, and then put my gown back on as if I had any shred of modesty or respect for myself left. None of that existed anymore, I didn't feel like a human at that point anyway. I was invisible.

The meds aren't working and I can still feel everything. Every couple minutes the doctor uses a pin or something to poke my legs to check if I'm numb. I'm not. Over and over.

He tells me that the dose he gave me is the same as earlier, but it isn't working. So he gives more. And more. And more. By the time I start to go numb, he tells my husband he's given me three times the normal dose, and he has to monitor me really closely. 

Not to me, my husband. 

Invisible. Still. I'm a body housing a baby that needs to come out. Nothing more.

They wheel me out of the room, Blake enters the OR after they get me set up, no one knows if I'm numb, but they start to cut and the anaesthesiologist says "oh good. She's numb, or else she would not be still right now."

Pulling.
Burning.

Pushing.

Talk about what they're doing after this.

Pulling.

Then the room is silent.

"We have a daughter."

No crying. No sounds.

I watch Blake's face as he watches them take her to the side of the room. 

My arms are going numb from being strapped to my sides.

No sounds.

Finally, two small cries, then silence again.

They ask Blake if he wants to go with them to take the baby to the nursery, she's having a hard time breathing. He goes, and I am knocked out.

I wake in recovery, foggy and unaware. The nurse says I'm doing well, the baby needed extra care, and I go to sleep again.

It's a couple hours later when I wake up in my room, completely alone.

How Did I Get Here - Part 1

Every Monday, I will post a new part to my own personal birth history. This will not be happy most times, but over the years I’ve given myself a lot more grace and love, and I hope the story reflects that. I don’t know right now how many parts this will have, but it’s going to cover almost a decade of how I truly got to where I am. I’m not going to gloss over hard things, and be aware there is talk of cesarean sections, the NICU, repeat miscarriage, infertility, blood, and possibly more that I don’t even realize right now. I may include pictures sometimes as well. This is my life, as best I can tell it, and I hope it gives a little insight into who I am beneath the sarcasm, emo music, and C-3PO level of know-it-all I carry around the world.

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I was a Navy brat, moving every couple years, and almost never going to the doctor for anything unless we couldn't fix it at home with time, rest, or OTC meds. I didn't have a distrust of the medical system, more that they were there if we couldn't handle it. I also knew my birth story growing up, along with a lot of my ancestor's stories, something I've learned others didn't have.

I was a cesarean, though my mom planned an unmedicated hospital birth. Most of our family doesn't take any pain meds unless we need them, and birth wasn't when we needed them. My grandmas all had unmedicated births in the 40s, 50s, and 60s, something odd for the time, but for me just made it a given that I would also want and have an unmedicated birth. The pain didn't scare me, even knowing my birth story. My mom didn't have the birth she planned, but she knew anyone could have an unmedicated birth and should try for one. 

This isn't to say we trusted anyone outside of a doctor. We didn't see the chiropractor unless it was cheaper to get my physical for sports. We went to our well visits, had our vaccines, used antibiotics for things without question. It was a strange dichotomy to trust them but also not see them.

When I got pregnant with our first, I didn't question the hospital birth. I called the doctor my mom had with me (I was back to living where I was born), found out he retired, and his patients were being seen by the hospital midwife. That felt strange, since I had never seen a midwife, and also was slightly distrusting of them because I had never seen one, but I went along with it. They couldn't get me in until I was 12 weeks, but I figured it I needed anything, they would provide. I knew absolutely nothing about this process, so I accepted everything they said without question.

My friend from highschool, someone I recently reconnected with, had a baby right before I got pregnant. She had him at a birth center, which I thought was insane. Not having him at the hospital? What was the world coming to! He was great, she was great, but that was still a step too far for me. What would happen in an emergency? What if they had died?? She laughed it off, but looking back I know it annoyed her how worried I was about them both. As if she didn't know what she was doing? Compared to me, she was practically a doctor herself with the knowledge she had of the process and what she wanted. Her doing this was absolutely not enough to change my mind on anything, and I blissfully went along with my midwife and hospital experience thinking everything would be great, I wouldn't have issues, and I would have my unmedicated birth whenever my baby was ready to be born.

That was another aspect I learned from my family history - babies are born when they're ready. Induction was a strange topic for us. My grandma, my mom's mother, had a baby way outside her "Due window". They gave her a due date that she didn't agree with, and then stayed pregnant for weeks after her water broke because she knew he wasn't ready to be born. And even when he was born, she knew he was earlier than he should have been. Their dates be damned. So this concept of the body and baby not knowing when to be born and needing to be forced out was so foreign to me. I was "overdue", it was normal, so why rush it? 

A lot of this eventually colored my own education and experiences in finding a preceptor, but for my first pregnancy, my wants aligned with the midwife I was seeing, and I didn't question when things weren't how I wanted them, because the end goal - an unmedicated birth - was what we both wanted for me. 

I ignored the lack of time with her. When I saw her, it was for maybe 15 minutes, but growing up seeing Navy doctors, that didn't seem odd. Just par for the course. She was excited when we said we didn't want to find out what we were having, she said it was really rare for anyone to choose that and was so excited to tell me at the birth. My choice was colored by two people I knew, my mom and my friend that birthed in the birth center, finding out what they were having just for it to be wrong at the birth. I didn't want that, so finding out was the much easier choice. 

We talked about breastfeeding, I knew I could do it because all the women in my family did without issue, and that was that entire conversation. 

I did the blood tests they recommended, had my first ultrasound at 21 weeks, drank the horrible glucola drink, and said yes yes yes no matter what. 

I told her often that I was still throwing up and sick, and she would laugh and tell me I just needed to want to be pregnant more. "Obviously you just don't want this baby, which is why you're making yourself sick." This was a very wanted baby. I may have only been 19 years old, but it wasn't an accident, even if she thought it was. When I was admitted to Labor and Delivery at 27 weeks with contractions that wouldn't stop and dehydration so severe I needed 3 bags of fluids to even bring my blood pressure up, she still asked why I wasn't bonding with my baby and was making myself sick. 

So I stopped talking to her about it. I was slowly gaining weight, though it only ended up being 16 pounds total by her birth, but she was happy with it. I was still spilling ketones and throwing up multiple times a day, but she was happy and I didn't feel like a failure every appointment.

At 35 weeks, I went in for my appointment, got the GBS swap which I was not ready for because they didn't explain anything to me, and then she said "And your baby is head down, things are getting ready for birth, oh wait." She looked at my chart, realized she had never check the baby beyond heartbeat, and had me lift up the gown. She pushed on my belly for a bit, and then said I needed an ultrasound because she thought my baby was breech. Did I understand any of that? Nope. Did she explain? Nope.

I hadn't had an ultrasound since 20 weeks with the anatomy scan. That was my only one up to that point because it wasn't something we wanted or she offered. 

So off we went to get a scan. For what reason? We had no idea.

They took pictures, it was really cool to see her, but no one told us anything. I got a call later that afternoon that I was immediately placed on bedrest, that my baby was frank breech and my fluid was low. I had to come in the next day for her to talk to me about what that all meant. 

I wasn't worried. I wondered why she sounded worried and panicked, but to me everything felt exactly as it had throughout the pregnancy, and she was kind of overreacting. And yet, I listened. I went into work and put in a leave of absence, my mom came over to help me clean a bit, and I laid on the couch. But not really, because to me it truly didn't seem like an issue so why was I on bedrest? So I was just as active as I had been, rolling my eyes at her the entire time in my mind.

I went in the next day and she explained that my baby's head should be in my pelvis, but instead it was her butt, and on top of that, the ultrasound showed she had no water, and that meant she was not doing well. So I had to have another ultrasound the next day to check on her. Before she even finished these thoughts, she told me she was no longer allowed to be in charge of my care and I was being transferred to an OB I had never met. 

Way to bury the lead, lady.

I had an appointment scheduled for later that afternoon with the OB she most referred to, and she would still be involved, but I couldn't see her for my care anymore. 

Honestly, not much changed aside from where I went in the hospital to see them. Pee in a cup, sit on the table, take my blood pressure, and wait for them to come in and see me for a few minutes, then go home.

The only difference was this time I was given "choices" of what we could do. 

1. Go to Salt Lake City and hope the University of Utah would deliver her breech, because no one closer could.

2. Have an external cephalic version (ECV) at 37 weeks and hope her being smaller meant she turned easier and we could go home to wait for labor, while also being transferred back to my midwife if so. If she stayed breech, we try again at 39 weeks.

3. Have the ECV at 39 weeks which probably wouldn't work because she was bigger, and then be immediately induced if she turned. If she didn't turn, a cesarean that same day.

4. Schedule the cesarean for 39 weeks without trying anything else.

To say I was blindsided is a small thing. I had no idea what to do. He gave me too many choices without explaining any of them! My mom had a cesarean and came out fine, so should we just do that? Or do we schedule this ECV? The only one that would not happen was driving to Salt Lake. We were poor college kids, my husband had to work, and that just seemed stupid. In hindsight, I wish we had, but that's life. 

So we chose option 2. Which is what he wanted us to do. Because if I hadn't asked questions the entire pregnancy, why start now? 

We had 3 ultrasounds a week those last two weeks before the ECV. My fluid levels rose, but they were still so worried about it I had to keep coming back. I didn't get why, but again, why start questioning it now.

I got the call the night before the ECV to be at Labor and Delivery at 5am, no foods or liquids after 10pm, and they would get things started.

What you need to understand is that they explained to me the process of getting the ECV, but I didn't truly understand what that meant.

• An IV for medications to calm my uterus

• An epidural so it didn't hurt

• An ultrasound before to make sure she was still breech and then ultrasounds during and after to make sure she was still head down and doing ok

• Hooked up to monitors to check her heart rate and to make sure I wasn't (or was) contracting. That depended on who was talking to me, making it super clear. Not.

Cool. Lots of meds, monitors, people, and then my baby would flip and I would go home. No big deal.

I wish it had been.