First Birthday

Middle turned five years old this past week.  We had a great party featuring a bouncy house, scavenger hunt, and a coloring table.  I made a Hello Kitty cake which turned out quite fabulously, if I do say so myself.  Observe:

 

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This birthday felt particularly momentous, not because she was a “whole hand” old now or because five years old means kindergarten this fall, but because this was her first birthday, as a girl.  Instead of singing “Happy birthday to [Boy’s name]”, we sang “Happy birthday to Middle”.  In many ways this felt like a first birthday party to me, rather than a fifth.  I am surprised how easily, after four years of thinking of her as a boy, her girl’s name flowed so easily off of my tongue when it came time to sing; how now when I imagine her as a baby I think of  her as a baby girl without any effort at all.  I have a tradition that the night before each child’s birthday I sit down by myself with come chocolate and read through their birth story.  One of the best things I ever did as a mother of a newborn was to write down each child’s birth story in detail.  Those accounts are the closest thing I have to reliving that momentous day (or in Older’s case, days) and I am so glad I don’t have to rely on my memory alone to remember.  This time, as I read through Middle’s birth story, it was jarring to see all the references to “he” and “him” and “baby boy” when referring to her.  So today I went back through the story and changed all the pronouns.  I kept the original version too, but this is the right one for us now.

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Over the last couple of months of pregnancy I had been waking up a maddening two to five times a night to pee and two night’s before Middle’s birth  was no different. I woke up around 5:00 am with some mild, irregular contractions thinking I had to pee, but before I got out of bed I realized that I felt a small “gurgle” of fluid with every contraction. I lay in bed for a bit, analyzing the sensation and came to the conclusion that my water had likely sprung a leak. I thought about what that might mean, made the obligatory trip to pee, and then came back to bed. Despite the early hour I told Husband who seemed surprised, given that I was only 37 weeks pregnant, but rather unconcerned (I think he was quite tired). Husband promptly went back to sleep and I decided that barring any frequent contractions or a gush of water breaking I would simply wait until my already scheduled morning OB appointment to tell anyone else. I couldn’t get back to sleep properly and lay in a state of semi-awkeness in the semi-darkness and contemplated the feeling of the little gurgles and what it might mean. I didn’t want to believe that my water had broken and wondered if what I was feeling was a true break and whether or not the distinction between a break and a leak was relevant or merely semantics.

Our day generally started when Older woke up and we got out of bed when we heard him call for us down the hall. We took our showers, prepared Older for school, and got Husband packed up to take the train to work. I had just finished working and gone out on maternity leave a few days earlier.  I was still feeling little gurgles of fluid and each time I felt a new gush of water my anxiety level rose. I finally broke down a bit and asked Husband to please go to my OB appointment with me. Seeing how upset I was, he agreed. We dropped Older off at school (clearly both distracted – forgetting his lunch at home) and headed over to the doctor’s office to confirm what I already knew. We didn’t have to wait long and after being called back and weighed I climbed up onto an exam table for an ultrasound. I told the ultrasound tech what I had been feeling, she took a look, determined that the amniotic fluid was basically non-existent, and declared that we would be having a baby that day. I expected as much, but I still didn’t know what that meant for us. I was 37 weeks so by the standards of gestational age I could give birth at home. Yet I wasn’t having any contractions and I wasn’t sure how long our OB, Dr. P. would be comfortable with waiting for them to start. We moved from an ultrasound to a non-stress test and discussed options with Dr. P. Her preference was for us to go to the hospital and start Pitocin to induce labor right away. I resisted, wanting to give my body a chance to give birth on our own. I have to admit that I was not feeling confident. My previously ever-present contractions had become very weak and irregular – not at all giving me the feeling of imminent labor. We continued the non-stress test and then as the time for the test was nearly up we heard the baby’s heart decelerate significantly during a contraction and I knew with a sinking feeling that we would be heading off to the hospital. I wasn’t particularly concerned about the baby’s immediate health. I was more concerned with whether or not being born at 37 weeks would mean that she might have a slow start nursing be taken from me right after birth to be assessed. My overwhelming feeling was that of wanting to stop time but knowing that it was impossible.

After looking at the decel Dr. P. all but insisted that we head off to the hospital to be induced. I had contemplated bringing my hospital bag with us in the car to the OB’s office, however, I had left it at home. I think that subconsciously I knew that there was a high likelihood that after my visit I would be sent straight to the hospital and I wanted an excuse not to go. I still wonder how events might have unfolded had I simply gone home and attempted to get contractions started with natural methods for 24 hours or so. but after going through a scare over the nuchal ultrasound, another scare over the baby’s heart only four days previous, and a diagnosis of potential low fluid levels and interuterine growth restrictions, I truly wondered if there might be something wrong with the baby or the pregnancy and I just wanted to get her born and safe into my arms.

We told Dr. P. that we needed to go home to get my bag and I proceeded to have two of the most stressful hours of my life. We called my mother-in-law and my sister to come to take care of Older. We picked up Older from daycare. We walked into his classroom together to find Older sitting down at lunch eating a yogurt. He looked surprised but was happy to go home early with Mama and Daddy. I picked him up and carried him out to the car (he insisted on taking his yogurt) in a bit of a daze. We arrived home and I asked for some space while Husband gave Older a proper lunch in the kitchen. I flung my hospital bag on the bed and unpacked and repacked it. I don’t recall what I put in and what I took out but it felt important at the time. I hadn’t yet eaten anything all day and once my mother-in-law and sister had arrived and Older was ready for his nap I sent Husband off to procure us some sandwiches – including an extra one for me to consume during labor. Finally, a bit after one clock I took Older into his room and nursed him for the very last time, just the two of us, a mother and her only child. And after what seemed like far too short of a time he fell asleep. I held him and a few tears sprang to my eyes. I knew that I needed to get going, but I just wanted to freeze time in that moment. To sit and soak it up until I was ready to move on and become the mother of two. It doesn’t work that way and after about ten peaceful moments of holding my first baby I gently laid him in bed and went off to give birth to his sister.

We drove to the hospital and I remembered driving there to give birth to Older. On that drive I had prayed that I wouldn’t bear too many contractions in the car. On this drive, I wished for strong contractions. We arrived at the hospital, gathered up our things, and went to check in. It seemed like a quiet day in L&D and after filling out some paperwork we were escorted to a room. I realized that we had forgotten something at home (neither us can remember what it was) and sent Husband home to retrieve it. I put the quilt and pillow we had brought from home out on the bed, pleased with how nice it looked but saddened that it could clearly not cover up “the hospital”. While Husband was gone I tried to walk around the hospital while listening to my “upbeat birthing” playlist on my iPod but was overwhelmed with the phone; fielding and making calls to Husband, our midwife, our doula, and an acupuncturist that had been recommended to come to hospital to try to induce labor naturally. I felt like an air traffic controller – not like a woman about to give birth. I was miserable. I felt alone, scared, and completely unable to focus on myself and my baby. I did manage to make a few laps around the floor, but I felt very conspicuous. There was no one other than nurses around and they would glance in my direction but basically ignore me. They probably thought I was nuts for thinking that taking a stroll around a hospital floor would get labor moving and the truth is they were right. I wasn’t having any contractions to speak of and it was hard to believe that such a non strenuous walk could stimulate them. Only a couple weeks earlier I had been pushing our big stroller full of groceries and Older on four mile walks uphill and down around town and certainly hadn’t gone into labor.   As soon as Husband returned I handed the phone over to him and instructed him to deal with whatever calls might be needed.

After I was settled in and “on the monitors” Dr. P. came by. She told me that as long as I was being monitored and the baby and I looked good I could stay there for days without an induction. She did warn, however, that if the placenta was failing or there was anything stressing the baby the longer he was in there the greater the possibility that the birth would not go smoothly or that he might need additional assessment or treatment after the birth. I told her I wasn’t ready quite yet, but that I certainly wasn’t interested in waiting around for days. I hadn’t yet decided when to consent to an induction, but I was thinking hours – not days. Dr. P. said she would return after the work day and she left an order for Pitocin when I was ready.

Late in the afternoon, acupuncturist quietly came in. She had a calm, serene presence and was instantly soothing. She outlined what she would do to attempt to induce labor and I really didn’t feel at all nervous, despite the fact that I had never had acupuncture before. We turned out the lights, I lay quietly on the bed and she began to work. I was surprised by the lack of pain or even sensation when the needles were placed. The whole process took on the order of half an hour and she left me with very small needles still placed in key points, with pressure to be applied during labor. While I didn’t feel any closer to labor, I did feel much more centered and ready for the work ahead of me. As promised, Dr. P. came back after the office day was complete, just as the acupuncturist was leaving. There was a bit of an odd moment as the two practitioners, traditional and alternative met, but it seemed to me to typify my pregnancy – a blend of the necessity of modern monitoring with a desire for a natural progression. As I wasn’t really contracting, Dr. P. again encouraged Pitocin and I told her that I was agreed to beginning a medical induction as soon as I had taken care of a few things: namely the arrival of our doula, a shower, and a visit with Older.

At about 7:45 pm our Doula, M, arrived. Because who knew when I would next have a chance to be clean and because I needed a few moments alone with myself I decided to take a shower. I had shaved my legs that morning and it didn’t take long to wash my hair so it was over all too quickly. I very consciously took few moments to look down at my heavily pregnant belly and run my hands over it – stretch marks and all – trying to imprint the feeling of being full of child on my mind.   I thought about this baby and the way she moved – often, but not frantically, as if with purpose. As I was drying off and putting on my black, non-hospital issue nightgown, I heard Older and my mother-in-law arrive and I hurried up so that Older wouldn’t feel scared in the room without me. Older and I had only ever spent two nights apart and I was so happy to see him. I stepped out of the bathroom and announced that I was ready for the Pitocin. I truth I really didn’t feel ready but I had resigned myself to the reality of it and I didn’t think that waiting any longer would serve any good purpose and might in fact do some harm. At 8:39 pm the nurse started the Pitocin drip. A few minutes later I was reading Older a bedtime story, “Walter the Baker” when I felt the first stirrings of contractions. I nursed Older briefly, kissed and hugged him goodnight and then he left with his grandma.

The contractions were picking up as the level of Pitocin was increased. We had turned out the harsh overhead fluorescent lights and turned on a small lamp brought from home. It was quiet and not unpleasant, although a current of anxiety seemed to run through the room. We chatted about everything and nothing – Husband, M, and I. I wish I could remember exactly what we talked about but it is lost to the fog of labor. I sat on the birth ball and would sway through the contractions as they built in intensity. I made a conscious effort to eat and drink all the while munching on half of a sandwich, fruit bars, chocolate chip granola bars, orange juice, cranberry juice, and of course, water.   I used the food as a reward, for example, telling myself, “get through the contractions until 10:00 and then you can have a granola bar.” I grew more tired and started to want to lie down and rest. M suggested that I try lying on the bed and she would provide counter pressure to my back. I did so and was pleasantly surprised by the relief that the counter pressure provided. It turned the “volume” down on the pain by at least half and made it feel totally manageable. M found the perfect spot on my lower back and then later pressed my hips together and down which felt amazing.

Somewhere around midnight I began to feel my labor turn. Thoughts of I don’t want to this, I didn’t want to be here crept into my mind and the night loomed long ahead of me. My midwife arrived at the same time that I was really starting to feel torn apart by the pain. I had to go to the bathroom and went gritting my way through a couple of contractions. The contractions were awful alone in the bathroom, but it was also nice to be alone for a few moments, although stressful knowing that everyone was worrying about me outside the door. During both of my labors I had fantasies of birthing entirely alone with no one to think of save myself and then baby. While in the bathroom, I was disconnected from the monitors and looked longingly at the shower. I hated being in the hospital. I wanted to be at home. I wanted to take a shower in my own bathroom, walk around my hardwood floors, scream where no strangers would hear me. My midwife came into the bathroom and checked me – a couple of cm. Not surprising, but not encouraging either. I also felt somewhat nauseous and wondered internally whether that last half of a sandwich was a good idea. The contractions were truly horrible – intense and surprising. They felt like someone was flipping a switch – with the Pitocin, there was no time for a natural build-up of endorphins. I was so tired. I was sitting on the ball, leaning over onto the bed and wanted badly to lay down. So I tried lying down again with M providing counter pressure during contractions. What had provided relief earlier I now found unbearable and quickly asked everyone to keep their hands off of me. I had no idea how long it would be until the baby was born and I looked ahead and saw a vision of hours of torment and an exhausted, defeated birth. I remember thinking that I could do it at home but not here and I felt a part of me just give up and asked firmly for an epidural. It wasn’t so much that I couldn’t take it anymore; it was that I didn’t want to take it anymore.  M and my midwife agreed quite quickly with my desire for an epidural, but Husband did a bang-up job of trying to dissuade me (against his better instincts). I had asked him not to let me get an epidural easily. He somehow knew just the right number of times to protest on my behalf and then when to give in. Once the decision was made everything seemed to happen quite fast although in reality it took about 45 minutes. I asked for an epidural at 1:49 am and also insisted that the Pitocin be turned off until the epidural was administered. The contractions continued at a less intense level and the pain became more manageable. The epidural was administered at 2:28 and the Pitocin was turned back on.  I really didn’t feel a thing save for a slight stinging pinch when the local anesthetic was administered. Initially, it felt weaker than the epidural I had been given during my first labor and I was pleased that I was in no pain yet could still move my legs comfortably. The nurse examined me and found 2 – 3 cm dilatation. It was the middle of the night, everyone (including me) was really tired, and with the epidural there was really nothing more to do but wait so we all settled down. My midwife, about six months pregnant herself, stretched out on a mat, while M and Husband attempted to get comfortable in some chairs. I craved the closeness of a homebirth and asked Husband to hold my hand and  not let go. I lay on my right side facing Husband in his chair . We all chatted a bit before we turned off the only light and fell asleep.

I think that I actually slept rather well for an hour or so. At least I don’t remember. After awhile I became aware of things again – the sleeping forms of Husband, M, and my midwife around me, the chilly middle-of-the-night hospital air, the soft whoosh of the baby’s heartbeat on the monitor – and alternated between dozing and thoughts. I felt that “something” was happening and thought the baby might be passing through my pelvis. I had short internal debates: on one side arguing with myself to fully wake up and ask to be checked and on the other arguing that I still had a ways to go and that I should sleep while I could. After perhaps an hour of debating I had the ever growing feeling that I was very close to having a baby but I was so comfortable I really didn’t want to disturb the moment. Finally, the voice in my head would not be quieted and I woke everyone up and asked to be checked. I was instantly awake and tried to sit up. I realized, much to my dismay, that my legs had gone completely numb. No wonder I had been able to sleep. The nurse came in to check me and found that I was 8-9 cm, completely effaced, and the baby was at -1 to 0 station. I urgently asked for the epidural to be turned off and began trying to move around hoping to help the medication dissipate faster.   Husband called his mom and told her to wake up Older and come on in. Everyone was quite casual but I was beginning to feel almost panicky – that I couldn’t really feel my legs (I did not want to give birth lying down without feeling anything) and that Older wasn’t even on his way yet – I really wanted him to be there for the birth. After another 20 minutes or so the nurse checked me again and I was completely dilated with the baby at +1 station. I was ready to have this baby. I made Husband call his mom again and hurry her along as fast as possible. I mentally resolved to hold the baby in until Older arrived. Many jokes were made about my not coughing or laughing lest the baby basically fall out. Dr. P. had not yet arrived and we half-jokingly and half-seriously asked the nurse, a young redhead named Rachel, how many babies she had delivered. She answered nervously that she had “seen it done” but didn’t indicate that she had actually ever done so herself. At that point my midwife gloved up saying that “someone should be ready to catch this baby” and I thought how amusing it would be if she ended up catching the baby even though we weren’t at home. By 6:15 am the feeling was returning to my lower half with a wonderful wave of sensation and I had the distinct feeling of a baby’s head ready to emerge.  It was an oddly calm few minutes – just lying there with a baby about to pop out while everyone bustled around. Dr. P. arrived at 6:23 am and quickly gowned up as the baby was starting to crown. I wasn’t really in any pain, just feeling a large amount of pressure and near panic that Older wasn’t there. Just then, M spotted Older and his grandmother out the window and raced to meet them. M picked up Older and they made a mad dash back to the room. I talked to Older for a few moments and then asked if everyone was ready. Dr. P. said “ready when you are” and I began to squat. I took a couple of deep breaths and tried to remember the mechanics of pushing. As if merely thinking about pushing was enough, I felt the baby move downward on her final decent and said “ahhh there” and there she was indeed.

She emerged small (around five and half pounds), but so wonderfully healthy looking  – very pick and covered in thick cheesy vernix. I was relieved when she began to cry right away and then immediately wanted to comfort her so that she would stop. She had quite a bit of mucus about his face and Dr. P. suctioned it out while I hovered over her wanting to pick her up but not quite feeling as if I could yet. Husband and I both reached out our hands to her tiny ones to forge the first link to us in the outside world. I spoke gently to her telling her that “Mama is here” I found myself a bit shaky and eased myself back to sit down while someone warned not to sit on the baby. I was a bit insulted by this comment, really I hadn’t taken my eyes off of her, I certainly wasn’t about to squish her. After less than a minute her immediate needs were taken care of and Husband picked her up and handed her to me. She was so very warm and quite sticky and utterly perfect. She began passionately trying to get her fingers in her mouth right away and after a few minutes she worked up to rooting at my breast. I held her close and began to help her to nurse. I was struck by how inept I felt at nursing a newborn after nearly two and a half years of continuous nursing. I was determined though and it didn’t take long before we had latched together and her crying subsided into an exhausted contentment. The next hour was spent with me holding our new little baby, getting me taken care of, and introducing Older to the baby. I don’t remember much of what was said, but I do have a fond memory of Older exclaiming “She’s nursing!” and clapping his hands with glee at the sight of a firmly attached baby. Older and grandma left to go home to sleep and a couple of hours after the birth the exhaustion of the past twenty-four hours began to overtake me.  I longed for sleep. The baby began to fuss a bit . I tried nursing, but she seemed uninterested. I was a bit at a loss of what to do when a sudden thought occurred to me “put her on her tummy on your chest and rub her back – she will like that” I did so and she calmed down and fell asleep within minutes. I felt a real connection to this new little baby – it was not a position I had ever really held Older, yet I was struck by the thought that this baby would like it and she did. The morning sunlight streamed through the windows and I dozed contentedly with my new little baby purring away on my chest. It wasn’t the way I had hoped and imagined the birth of our second baby, but in that moment it was bliss.

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