Sunday, January 13, 2008

You think you're prepared but you have -no- idea..

(Originally for BabyGaga labor story contest)

By the time my third trimester hit my feelings could not have been more mixed, on the one hand I couldn’t wait to meet my daughter, on the other – nothing short of terrified.

I became a single mother the moment I told my then boyfriend that I was pregnant and keeping the child, a side-note for the mothers who are single or without their significant other during pregnancy and/or labor by choice or circumstance: remember, you’re not the first woman nor the last to do this alone, you can and will get through this - you must; when it’s all over, you won’t regret it and the hardships and pain won't matter!

Having gone through the ups and downs of pregnancy alone and already being used to the idea that I in fact was actually anything but alone - it was me and baby coping day by day. For some time I contemplated whether or not I want someone beside me during labor. However, I knew that nevertheless of what was in store for me I preferred to go through it solo, no mother, no friends. Brushing my worries and fears aside I made the final decision that when the time comes, it'll only be my daughter, myself .. and the birth center staff.

Another firm decision was to have a drug-free, minimally-medicated (preferably not at all) birth was set in stone but the truth is, I was petrified. I wanted this because my pregnancy was unplanned, I wasn't sure if I will ever have another child, I wanted the full, complete and natural experience because I may only get this one chance. I knew my daughter will be scared; being scared out of solidarity along with her only seemed fair.

Most of my fear was because I had no idea what to expect, no matter how much I read or asked I knew that each experience is individual. I was measuring up to 6 weeks too small, so I was hoping to go the full 40 weeks but things didn't go according to plan in that aspect.

My bag had been packed for weeks (courtesy of the endless sleepless nights I was enduring since the beginning of my last trimester) most of the baby things I’d need immediately had been bought and everything seemed to be ready – I was not. I had been feeling 'off' for weeks, after a fall I took down the stairs at 33 weeks 4 days. This is a depressing and frightening subject, that will take away from my original intention, and that's recounting my birth story while memory is still fresh. So, countless ultrasounds, injections, steroids and the like later, worry, suffering, tears and fear, bought me some time, a few more weeks. 

After my pelvic exam on January 11th I realized that I could have gone without one, as curious as I was to find out my progress, it was uncomfortable and uncalled for - I can go as far as saying that I regret it. Alas, there's sort of no better way to tell what's going on 'down there', aside from getting digitally checked, so at the time, I had an 'it is what it is' attitude, I was nothing short of emotionally exhausted.

Later on in the day, I was faced with the bittersweet realization that sooner or later it’ll be my turn because not one, but two of my e-buddies were in labor. I was up on Gaga all night, like the most responsible due-month thread buddy, updating my fellow Gaga ladies on any progress or change. ‘How ironic it would be if all three of us are in labor at the same time’ I joked and ended up not going to to bed that night.

Hospital bag:

It wasn’t until later or rather, very, very early that morning, on January 12th that I noticed a cramping in my lower back. It was very much like a menstrual cramp but more intense. Something told me that the pelvic exam could have provoked labor. Never wait until your water breaks or until the contractions get too severe, go in to L&D or call your midwife.

I'm glad I took action when I did because when my water did break,  it turned out to be green, which indicated that my baby had passed meconium and could be in distress. Just to give that a quick mention - I didn't feel anything 'break' .. water just flowed, and not much of it at all, which explained why I measured so behind, not only was my baby small but I didn't have much amniotic fluid either.

But before all that fun, let's get back to approximately 8 am, Jan 12th: I started timing these so-called cramps but they were so piercing that each threw me off count and I just gave up, had breakfast and read magazines. By 10 am it was decided - I talked to my mother trying my best not to alarm her. So, I took things slowly, had a shower and tip-toed around the subject but by noon my mother finally convinced me to call my doctor. I did and proceeded to tell him about my ‘'17-40 second discomfort every 2-4 minutes' (which was not by any means accurate, I never did get the hang of timing my contractions). He was insistent that I come in for a check, by the time we worked out the details I was quite certain that I was in fact, in labor. My so called discomfort turned into full blown contractions lasting around a minute by the time I hung up, I believe it was around 11 45 am.

It was time - my hands already shaking and heart beating like a drum, this is the day and events that I have gone over and over in my head, I had it all calculated, worked out and memorized to an extent where you'd think it was a psychic prediction of the events that were about to happen. It was all on paper too, in point form.

I tried to keep all my emotions and feelings organized and assorted.

Plan A was to remain calm and rational, to go through all the 'to do' things listed in that simple point form (which had suddenly become so complicated and useless)  titled 'Before Hospital', Plan B was panic and/or faint - I was implementing both at the same time, I was panicking and rushing through all the things I wanted/needed to do, on the inside I was terrified but remained (or attempted to remain) calm on the exterior, double checking the contents of my labor bag. The only reason I even had a list was because I presumed it would help me stay calm, it failed, I was nervous and afraid.

My dad shaken awake, upon hearing that I needed to get to L&D still half asleep asked if I was certain that I couldn’t take the bus – which is funny now but at the time my heart was racing, I could almost feel each blood vessel thud with anxiety.

Outside the air was cold and crisp and almost made me dizzy. Not panicking or getting overwhelmed turned out to be extremely excruciating work – it was barely after noon and I was ready for my nap, I remember at some point even contemplating if I could/should nap .. maybe for just 15 minutes? But the crushing pain in my lower back said ‘no chance’. Suddenly, the realization that I will be in labor, running on literally, no sleep whatsoever dawned on me. I tried not to get to upset but failed quickly, so I wiped my tears off my cold cheeks and carried on, I didn't want to cry in the taxi.

The best way to avoid or lessen panic at that point was to take each event in one by one: at first I decided to come to terms with the fact that I was in labor, that it was time and that now I need full control over my thoughts, emotions and body, the second event to deal with was the fact that the pain was about to get worse. The third, I promised myself it'd be okay to cry once I got everything 'done', at the time, it felt like a reward of some sort to look forward to, I don't know why.

I was admitted to L&D by 1:30 pm, feeling excited yet anxious, still shaken a little but ready to deal with the next ‘event’ . The whole process of being driven to L&D, getting admitted, changed into appropriate clothing, showered again and just general chit-chatting with nurses moved thoughts of the pain somewhere to the back of my head, I was in pain no doubt, but I was busy. This was much better, that alone, I figured, was worth coming in for. ‘I can do this’ I kept saying to myself, all cliché and full of myself, I kept reminding myself of the fact that my pain tolerance is much higher than your average person’s, ‘in fact, I bet it’s not as bad as it’s made out to be’ I remember thinking, purposely ignoring the fact that I was about to push a human being out. It seems like I went from emotional and frail to arrogant, I was aware of this but I 'allowed' myself this.

The nurse on duty gave me a pelvic exam and indeed, the previous day I lost a chunk of my mucous plug, lost the last of it during the pelvic check and had a bloody show right after, not a sight for the weak, they don’t call it a bloody show for no reason – don’t be alarmed, if you haven’t spotted at all during pregnancy and forgot what the sight of blood looks like, it’s easy to panic at that point - try not to; keep saying ‘normal’!

I was between 5 and 6 cm and no doubt, in active labor.

Ensued a few unpleasant procedures such as having an IV catheter put into my arm. A student nurse got to do this and had to poke me several times before she got it right - I was not at all amused, but I was trying to be my best, chirping self and even made jokes about how now the catheter is in, hence the worst part of my labor is over. My arm ached and throbbed, it was uncomfortable and awkward to have this foreign object stuck in me. It was distracting.

However truth be told, I am really glad they got that procedure over with before the contractions got worse - I can honestly state that I was so tense (which is the wrong thing to do) during the contractions and so aggressive, that sticking something in my arm would have been very, very difficult.

It's always good to have a plan, a rough idea of how you want things to go and what you could do in order for them to go your way, but remember, things don't always go according to plan don’t worry if you get off track, work with the situation at hand to make it into something you’re comfortable with. The best strategy is to go with the natural flow of things but remember that you play the biggest role, try your best to stay in control.

I knew that I would do everything my power to avoid a c-section unless there are complications where medical intervention is inevitable. I was not at all in cahoots about having my skin, lower abdomen and insides sliced open with a very, very sharp scalpel, the bleeding, the stitching, the scar .. did I mention the bleeding – not my idea of a perfect labor. I had previously seen a video of a c-section and the first 2 minutes were enough for me to agree to a natural labor.

My first step towards ensuring that: my contractions, keep them coming in strong, move around as much as I could, as tempting as it was to just cuddle up in bed, I knew I had to be physically active, my daughter was kicking, I was optimistic.

My labor progressed slowly and steadily and I was doing alright, I walked around a lot, bounced on a birthing ball, talked on the phone and even read magazines; during the early stages of labor It really is best to move around as much as you can, helps you to not concentrate on the pain if you can help it, much to the shock of my O.B who expected me to panic and/or get hysterical by that point, I was very confident and assured him that I won’t.. but alas, never say never.

3 pm: My contractions got intense enough for me not to be able to concentrate on anything but each contraction, the pain was dull yet so prolonged and took over my body, looking at my daughter’s heart-rate on the monitor and listening to songs on the radio helped a lot. I barked at the poor nurses who wanted to know if I was okay as I clenched up with every contraction or if I needed anything, suddenly there was nothing comical about the situation anymore, I was demonic, I wanted nothing to do with anything that breathes or moves. They kept reminding me to breathe which at the time, made them my worst enemy because my only coping technique was to mentally 'clench up' and hold my breath if need be, to get me through to the 'calm' in between contractions.

I longed for the contraction to be over the very second it began, I wanted silence around me but yet I was mad about the fact that the radio wasn’t on loud enough, I was starving but nauseous, I had a headache and wanted to sleep but my body was tense and I was wide awake, I was mad at my friends for not being in contact with me at this crucial moment but yet I was furious when a text message ringtone interrupted my chain of thoughts. Anything gets on a woman’s nerves when she’s in labor, even a fluffy, white stuffed rabbit becomes your worst enemy. Each contraction was a lifetime long.

It was at that point that I couldn’t move anymore – I was in bed, hurting and miserable, suddenly tempted to accept that epidural, heck at that point I wanted it all, an epidural first, then a c-section oh and don’t forget to knock me out all together. At first I attempted to stay focused on the clock, watching its hands move slowly – almost ridiculing me, but quickly realized that the best way to get through my contractions was to ignore them, not endure them.

From lack of anything to do, after I was done mentally double checking all the things I need for the baby, going over all the things I read about caring for newborns .. even reminiscing about my teenage years (with myself mind you, I had banished everyone from around me.. yet I was so, so lonely!), I remember thinking that I wished I had attended more birthing classes, I never took the time to work on my breathing exercises and couldn’t keep a rhythm so they were of no use to me. Vocalizing was not for me, I don’t like screaming or moaning, I tried moaning once, finally giving in the the nurses' urging, in case it would be miraculously therapeutic but realized that it was only making me panic and my heart race faster, my head throb from my own voice, so I got through my contractions keeping to myself, closing my eyes and trying to stay quiet. ‘If women have done this before then there’s no reason for me not to be able to’ I kept saying to myself like some sort of mantra, that and ‘by tomorrow this will all be over, this is nothing but time and time passes’. 

When it finally got too much to endure, I took myself to a darker place - a back injury I suffered many years ago. I made myself think of that and the level of pain, what I was feeling now -still- did not compare. I made myself think of that some more, and make myself grateful how the pain of labor was STILL not as bad. But then, my fear of the unknown took me to a darker place - what if labor was going to get worse, what if the pain was going to indeed, end up being the worst I've ever felt in my life. I feared I would have to give up then.

Around 3:30 pm my O.B convinced me to get Pitocin because my baby’s heart-rate was dropping and my contractions were slacking off. Even though Pitocin was the last thing that I wanted and probably unnecessary medication in so many cases, I reluctantly agreed because I was ready to go through the intense pain only to get labor over and done with. At that point I was delusional enough to agree to just about anything, little did I know the Pitocin is the most evil thing created by the human race to date. It made me feel as if my blood was lava and I suddenly felt all the more nauseous; I had a lingering, strange taste in my mouth.

My contractions became intense, my head was spinning, I couldn’t sit or stand. The feeling of 'pressure' described when the baby's head starts descending down the birth canal, to me felt like a bulldozer making its way out. At one point I thought my pelvis was about to shatter.

Several minutes later, which to me seemed like hours at that point, had me exhausted, I even remember telling my O.B that I couldn't do it anymore, that was it, I couldn't, which is when he said '10 more minutes and the beginning of the rest of your life' which was basically telling me to get myself together because it’s about to be over. 

I remember my constant, panicked rambling and nagging which I'm rather embarrassed about now, I don't remember everything that I was saying, begging for that epidural, two if possible, c-section and/or to be knocked out altogether, ‘either or all would be nice’ I remember muttering, ‘not necessarily in that order either, really’, but it was the fear and exhaustion talking, I couldn't keep going, that I just wanted to give up and sleep.

Soon enough my body was ready, there was no mistaking it. It was no longer the urge to push, it was suddenly my body needing to push, the physical need to, in fact my body was almost pushing by itself and I couldn’t control it anymore, the doctor said ‘okay’ and with the urging of an elderly nurse and two younger ones , the encouragement of my doctor I did push, three times and then I felt my baby’s head 'drop'.

The adrenaline rush of knowing that I’m about to see her, the anxiety and excitement completely overtook, exhausted and in pain, but it was about to be over and my daughter, I was seconds away from seeing her. My doctor was amazing and explained to me that I should push from the bottom of my stomach and that I should try not to vocalize because the efforts would go into my scream instead of the contraction. No need to tell me twice not scream - the intense physical sensations were so much, I don't think I could speak little yet scream.

That simple, two more pushes - one for the head, and one for the body, and then it was over, quick, painless even.

The pushing itself was not painful, I think by that point my body got used to the constant pain and had gone numb, in fact it was a relief to finally push. I remember that as soon as I realized that my daughter had been born my body suddenly wasn’t in pain anymore, only ached slightly - it was bliss, almost. Passing the placenta did not hurt at all, in fact I have no memory of pushing it, it felt like it came on its own.

Blissf instantly became terror and panic – my baby was not crying, in fact I heard no sound from the baby at all. 

My worst fear had just become my life. Only stress and panic from the doctors present, no crying. I remember at that point I tried to get up but was restrained by two nurses, I arched to try and see what was happening, I did get a glimpse of her, she was moving heavily, arms flailing but barely, as though she felt restrained, chest pushed upwards. I realized that though she was alive, she was probably not breathing. This thought felt like a punch to the head and I was seeing black and white dots and I think I was about to blackout, I felt my head fall backwards but as though a shake from something else inside, I remember forcing my head to jerk up and I commanded my eyesight to stabilize, though at that point, it was next to impossible to see through the tears.

My daughter was born on Saturday, 12th January at 5:25pm, 8.8 on the Apgar scale, a petite 6 pound, 19 inch bundle of perfection. The next moments of my life were the worst and longest. I never thought that I’d be so eager to hear a child cry. Another doctor looked at her right away, they were all swarming around her and medical equipment was being passed around. All of the nurses went from looking very grim in the face, to suddenly more relaxed, several seconds afterward, I heard strange gurgle, a cough and then, finally, an angry, air-starved cry. It was like music to my ears, she was okay. She was brought to me for just a few seconds, tiny indeed, pink but a little purple at the same time, very afraid. It broke my heart that I couldn’t hold her.

My body was shaking uncontrollably, I couldn’t stop the shivering or put a fist together, as soon as I realized that my daughter was alive and well, I had the urge to pass out and sleep, It’s not selfish to feel this way – labor is the most exhausting experience one can imagine, the feelings, urges and emotions during and after are hard to control or justify logically. In fact nothing that you think, feel or say during or even after labor is anything to feel guilty about, and the people around you should understand and accept that beforehand.

The shaking did not stop for several hours, about two or three, I think. 

The complications were because of the priorly mentioned meconium leak and I didn’t get to hold her until 16 hours later. After I got minor cosmetic stitching, very unpleasant – I could feel being pierced and stitched throughout the whole procedure, but the adrenaline kept me awake and going, I walked a flight of stairs to her incubator and begged the on-duty nurse to just let me stay there, I did for hours it seems until I was sent to bed, to rest. I was numb from shock, still. My lower body muscles hurt, my stomach felt empty.

I’ll go on to say that there’s nothing wrong with not feeling an amazing bond with your child right away, the shock of giving birth had me trembling until early morning and I was in complete awe and I knew that I adored her from the start but we didn’t bond from the very second she was born, it took some time.

I woke up that morning before 6 am, and asked if I could nurse her, being told no was like a slap in the face with the coldest hand but then finally at 8 am she was brought to me, I had her in my arms. I was never even sure if I wanted to breastfeed or not and even though it was a struggle to get her to latch on  – it felt so natural and our first moment together was nothing short of ideal.  Now that she was in my arms none of that mattered anymore, she didn’t look like neither him nor me, she looked like herself and absolutely flawless. 

She even opened her eyes for me, she was a perfection only I could understand and appreciate, such a surprise and only a few hours old but my undoubtedly my greatest accomplishment to date, she then became and still remains my Heaven.

I thought I always knew what I would name my daughter, but suddenly none of the names that seemed so perfect were worthy of her, she looked nothing like that. Yet another part of the plan that never worked out. Like pieces of a puzzle, a song I was listening to, how I felt about her, what she was to me all came together and behold, the perfect name.

I’m glad I had a minimally medicated birth, at least what I think of minimally medicated, and that I opted not to have any pain relief medication, it was something worth going through and every second of my labor prepared me for motherhood in its own way, my daughter and I shared our very first experience together and I have no regrets.

I had cosmetic stitches and no complications during my healing process, except general discomfort. I was weary of using the bathroom after labor for the first time, but it wasn't all that bad (took me about 8 hours after delivery to pluck up the courage). It wasn’t until several months after that my body was back to functioning properly, as it used to before pregnancy and it took over a year for me to look the way I did before pregnancy but all that is trivial now, I’m too busy appreciating and adoring my daughter, and guess what .. now that it’s all over, I can say that it wasn’t all that bad, yes it hurt, hurt a lot but it only hurts that day, in that moment and that’s nothing compared to the rest of your life as a parent! 

At hospital, going home:

First night at home: