Sunday, January 26, 2014

Processing My REAL Birth Story

I haven't visited this blog for a long time and the reason may seem silly. While I could say that simply having a newborn made my life far too busy to blog the reality was that seeing the pictures in my last post upset me. I felt upset that instead of having the fabulous homebirth success story I had imagined, I had a horror story that included the words "I nearly died." When I wrote that post at 36 weeks my very worst fear for the birth was that I would go overdue, or that I would go into labor when my husband was at a difficult point in his graduate course. I wasn't afraid of having a homebirth. I was confident in my midwife and my choice in birth attendant. I felt very in control.

At 37 weeks we received a very disturbing letter from my health insurance company stating that despite the fact that they had paid for homebirth's attended by my midwife in the past, they were no longer covering them and in addition, if there was something to go wrong in the birth that would require a transfer to a hospital, they wouldn't cover that either. Could we really take that risk? This question required some soul searching and serious conversations with my midwife. According to her own record, the majority of women who transferred to a hospital during a birth that she supervised were first time mothers who did so for pain relief. I had already had given birth without an epidural so I felt pretty sure I could handle it. We felt peace about our choice.

On Friday July 5th, the day before my due date, I started to feel really grouchy, uncomfortable, nauseous and crampy. It felt like I was about to go into labor so I started to down red raspberry leaf tea in hopes to kick things into gear. Friday went by, then Saturday, then Sunday...UGH. But then, in the wee hours of Monday morning I woke up in labor. Hurray! I stayed up for about a half an hour but then decided to just go back to bed and get rest while I could. At 5:30 AM (for some reason I looked at the clock just as I was waking) I startled awake to a POP! My water broke! I shouted the news at Andrew as I rushed/waddled to the bathroom. Andrew started giddily chatting away, asking if we should call the midwife and then he heard me from the bathroom say, in a tone of voice he said he hopes he never hears again, "Oh my God."

I don't think I have ever used the Lord's name in vain in my whole life but in that moment there were no other words. Instead of seeing amniotic fluid pooling around my ankles (or cankles as they were at that point) I saw blood; lots of it and it just kept on coming. I knew something was very wrong but all I could do was peel off my wet clothing and sit on the toilet in shock. As Andrew told the midwife what was happening, she asked Andrew if there was more blood than half a cup and if I had felt the baby move. The answer to the first was "yes" and the second "not sure." She said she would meet us at the hospital and that she would call them first to let them know we were on our way.

I put on an adult diaper and a pair of capri's and somehow had the idea to grab my kindle fire and charger (just in case!) and with a couple of towels for me to sit on, we rushed to L&D. Luckily on the way there the baby gave me a sharp kick and I knew there was life still there. Arriving in record time at about 5:50, my contractions were about four minutes apart but with each one I could feel more blood gush out. Upon entering the Labor and Delivery bonehead at the front desk of actually tried to make me sign in despite my fairly obvious distress! I said forget it and rushed to triage. While in triage they made me wait, AGAIN, so that they could verify my insurance information. Finally I was assigned to a triage room where the nurses joked about my "broken water waddle" but were quickly silenced when they saw that in less than 20 minutes I had completely soaked that adult diaper.

They hooked me up to a monitor and the baby's vitals looked great. My contractions were steady and at that point I still held out some hope that I might be able to have a vaginal birth. Obviously, I didn't realize that I was slowly bleeding to death. My midwife arrived shortly after and then the attending OB AND the residents AND more nurses. There were a lot of people in that little room trying to assess the situation. Then the on call OB arrived and she checked my dilation (only 2 cm) and pronounced that not only had my water not broken (the pop was probably from the pressure of the pooling blood popping my mucous plug) a c-section was in order. We asked to speak with my midwife alone and in that short conversation one thing that she said really stood out: "Sometimes the decision is really clear." So the call was made.

In no time at all I was shaved, IV'd and hair netted. This is where the midwife's presence was invaluable. She reminded us we wanted skin-to-skin with the baby directly after birth not to bathe the baby or wrap her in blankets; told the surgery team that and instructed Andrew to take off his shirt before he suited up into his sterile gear; all things to help ensure that breastfeeding could get off to the best start possible. She got Andrew food because she knew that he probably wouldn't be able to get anything for several hours. Her presence gave me the courage to ask for things like a double suture on my incision, to give me a better chance at a successful future VBAC, and to leave the umbilical cord to pulsate. I so wanted her to be allowed to come with us to the operating room but to that request the surgeon very staunchly refused.

I was wheeled to the operating room and as we were about to enter they asked Andrew to wait outside until I was prepped for surgery. It was at that point that I broke down and started to sob. A nurse asked me why I was so upset and I couldn't give her a reason. I should've thought that it would be obvious. So with my naked butt on a cold, cold stainless steel operating table I was told to round my back as they inserted the spinal anesthesia. They kept shouting at me to make it rounder (my back not my butt). Andrew said this whole process took about fifteen minutes while he fretted outside.

Spinal in place, legs growing increasingly numb, I was laid down on the table in a pose that was disturbingly like Jesus on the cross with both arms outstretched. With sterile drapes Andrew was allowed back into the room and he held my left hand while the anesthesiologist was monitoring my vitals at my right. At this point it gets fuzzy. Lots of pulling and tugging and then PUSHING! I felt like my ribs were breaking and then at 7:14 AM people shouting "Big Baby! Big Baby!" and "She is holding onto to the umbilical cord and won't let go." As soon as I heard her gurgled cry I started sobbing again. Andrew immediately left my side to be with her. Her stomach had to be suctioned because there was so much bleeding into the amniotic fluid. Andrew kept trying to touch her and the neonatologist kept telling him not to. This whole time she was screaming and all I wanted was to hold her. It brings me to tears again just to write it. Also, I was all alone, aside from the silent anesthesiologist. When I started to shake he injected something in my line to make it stop and when I started hyperventilating he gave me something good to calm me down (I do remember telling him that I really liked that "stuff"). It was sometime during this period of alone time that I heard the surgical team counting as they put me back together. When I have flashbacks to the experience, that and Lorelei screaming is what I hear. Eventually baby Lorelei was given to Andrew where she cried softly, zipped up in his surgical suit but I couldn't even see her face.

Surgery over, the OB surgeon told me that it went well; that she was able to do a double suture but that she wasn't able to do delayed cord clamping because there was too much bleeding. I had lost nearly a liter of blood. She told Andrew that the placenta was 50% detached at the time of the c-section and it was, as she expected, a rare complication called a placental abruption, though mine was only partial. The abruption had been going on for a while, no idea how long, but long enough that Lorelei's meconium was bloody for several days after her birth, freaking all the nurses out who changed her diaper.

While I was still numb I was moved to a gurney and sent to post operative care where I was able give Lorelei her first breastfeed with the help of the nurses and finally get a good look at her. I was really out of it and felt nothing when I looked at her. I was so disconnected and then I started shaking violently and at that point I wanted nothing less than to be holding a baby. Andrew happily took her back. As soon as I could wiggle my toes again I was moved to my own room to recover and learned, to my great sorrow, that I was on a liquid diet until I was able to pass gas. Happily, as the drugs started wearing off, in a few hours I felt I was able to begin to bond with Lorelei. Our successful breastfeeding definitely helped with that. She was, and is, a champion. Born July 8: 8 lbs. 15 oz., 21 inches long.

A few hours after surgery

It took me over six months but I finally got it all out. I still have nightmares about it and I have struggled to come to terms with the physical ramifications of a c-section. My body is different in so many ways. I also developed mastitis/abscess that required additional surgery which my lactation consultant believes would not have happened if I hadn't been so worn down recovering from the surgery. Given time I think I will be able to come to peace with it. I still have so many questions about why it happened, if I should risk having more children, if my body is just really broken/unhealthy...but I am glad to have my daughter and to be alive. I am trying to focus on that.