Wednesday, June 22, 2011

the other side

I've been putting off writing this entry, because it was obvious to me what the topic would have to be.  And for a long time I haven't wanted to write about it.  My second childbirth story has a happy ending: a beautiful nine pound baby boy, healthy and perfect.  As if in sympathy for me, he has been a lovely, easy baby for the last seven and a half weeks.  I've made a complete recovery, and have been cleared to exercise, meaning I'm finally on the road to reclaiming my body, and with it, parts of my identity I'd almost lost completely.  I'm actually grateful to be able to fret about the twenty pounds of baby weight I need to shed now.  I'm grateful to cart around my children on errands and to the park all day.  Because it means I'm OK, the people I love are OK, and whatever daily stresses I encounter, I actually have no real problems right now.

My water broke on a Saturday afternoon.  We had time to call a friend to come over to watch Julia, time to make sure we had everything I needed for the hospital.  We drove to the hospital at a leisurely pace, checked in, chatted with the doctors and nurses, and waited for me to go into labor, which I did within a couple hours.  The contractions started.  My partner and doula were with me.  I had a heplock IV in my hand, a blood pressure cuff on my arm, and a wireless monitor around my belly, and the nurses on duty kept tabs on my progress.  These were the more annoying, but expected aspects of a hospital birth I had been dreading, but I took them in stride.  Even when the contractions got painful, I was able to power through them and make jokes between them.  Until about six centimeters, that is, when everything seemed suddenly not funny anymore.  The pain went from just bearable to excruciating, and just as suddenly, all of the monitoring I had been tolerating, the machines, the cold room, the people coming in and out began to make me feel horribly self-conscious, vulnerable, angry.  My brave face fell to the floor, and the only thought that I could reliably form was, Make it stop.  Just make it stop.  So when the doctor recommended Fentanol (just a narcotic through the heplock, just to take the edge off), I said yes.  They administered it, and it did take the edge off.  For about ten minutes.  When the contractions came back I was officially out of my mind, screaming like a wild animal.  So they offered the epidural.  And I said yes.

Trouble was, the contractions were so strong and so painful, they couldn't get the catheter in my spinal column.  So they tried again.  And again.  When it seemed the epidural would be impossible the anesthesiologist offered the next weapon in her arsenal: a good old fashioned saddle block, which I took, and spent the rest of my labor disturbingly numb from the waist down.  When I was fully dilated and it was time to push, I could feel nothing.  Luckily, about an hour into the pushing, the feeling came back, and even though the contractions were as bad as ever, the pushing helped the pain.  The baby descended, but at +2 station, he would go no further.  I spent the last two hours of my twelve hour labor thinking that with one more push, my baby would be born.  But he wouldn't come, and his heart rate was dipping with each contraction.  They gave me more Fentanol, so I would sit still enough to get the epidural, with the plan that they would take me to the OR to continue pushing with the help of a vacuum extractor, and if that didn't work, I would have an emergency c-section.  As soon as they got me into the OR the baby's heart dipped alarmingly low, and I heard the doctor say, "That's it, let's open."  I agreed, of course, resigned to this outcome by this point.  The curtain went up, and I was prepared for the surgery.

The next thing I knew, I heard the cries of my newborn son, but moments after he was pulled from me, the machines started going off and the doctors noticed the blood, my blood, leaving my body rapidly and covering the floor.  I felt my breath leaving me, as a bulky oxygen mask was slammed over my face, which ironically, made breathing harder.  Panicked, I pushed it away only to have the doctor push it back over my nose and mouth over my weak pleas and protests.  At the same time, Karissa was thrown out of the OR.  For 45 minutes after she left, she had no idea what had happened to me.  My baby was crying on the other side of the room, and I hadn't even seen him.  When I asked if he was OK, the docs replied that he was, but their priority was me right now.  As I was stabilized, my breath returned and I felt a calm coursing through me.  Later, I discovered this was the morphine they'd put through my IV, and I understood why people become heroin addicts.  Finally, as they were finishing sewing me up, a nurse brought the wrapped bundle to me, announcing he had the biggest ears she'd ever seen on a baby.  Karissa was finally brought back in, and she got to feed him first.

So what happened?  My baby was so far down the birth canal and wedged at such an angle that as they pulled him back through, major blood vessels in my uterus ruptured causing the blood loss.  I'd lost half my blood volume in about five minutes and required a major blood transfusion before we could be transferred to the recovery floor. To further complicate things, he was so big that the incision they'd made in my uterus wasn't large enough, and it was torn, requiring many more stitches than with a routine c-section.  When they finally got him out, the umbilical cord was wrapped around his entire body, which they thought in retrospect caused the dip in his heart rate.

The strangest thing about this experience for me was that just as I felt completely undone, completely shattered, I had this new life in my arms, loving me, needing me utterly.  I couldn't fall apart, because he held me together.  He took to nursing right away, and in an effort to make up for the first few hours in his life in which we'd been separated, I held him for practically the next 72 hours.  In the hospital, I had nothing else to do but be with him, feed him, look at him and talk to him, and he showed no signs of the trauma we'd suffered together.

I had a lot of emotional baggage to unpack in the next few days and weeks.  When my doctors debriefed the surgery with me and asked if I had any questions, the first was, was this all my fault?  In my desperation to make the pain stop, I'd broken the rules I'd set for myself.  In taking the saddle block, had I caused the conditions that made the c-section necessary?  Of course they said no; what else would they say?  It didn't stall my labor, they said, and I'd pushed long and hard.  The bottom line is, he was stuck, and may have sustained injuries to his head or shoulders had I managed to push him out.  And then the question came to me later, did THEY cause my c-section, or at the very least, make mistakes that led to the hemorrhage?  Not that I can see, not that they'd admit to, but frankly, I don't think it's possible for me to ever know.  I can only trust that the doctors tried to help me and were honest with me about what happened.

The biggest hurdle was coming to grips with what had happened, as it was so far from what I wanted, and what I'd been told might happen.  I hadn't bothered to prepare for the possibility of anything like this coming to pass; he was my second baby, the first labor had been so fast.  The feeling I was most hoping to avoid this time around, that I'd felt so distinctly with my daughter's birth, was this sense of my own mortality, this feeling of peering into the abyss.  I think I was so desperate to avoid it, that when the signal came, i.e. when the real pain came, when I knew I was heading down the same road, the one that ended over a cliff, I relented to the drugs and hoped against hope to insulate myself against it.  I'd wanted to spare myself the intensity of feeling that is perhaps unavoidable under these circumstances, because only hours later, I was on the edge again, terrified for my life.  Whatever way our children come into the world, they remind us of what life is, the journey we're on, and how fragile it is, how unstable, how fleeting.  And I was afraid to be reminded.  

After the first weeks, I'd weaned myself off of the drugs.  The narcotic-induced nightmares stopped and I began to feel like myself again.  And when I felt that shattered feeling, that fear of falling, I made myself look into the mirror and say, "Whatever comes, just be here.  Be present.  For you, for them."  My new son reminds me every day that some things are worth suffering for, and some things are made all the more precious for the suffering.  Childbirth is relatively easy for some women.  I had to face that easy would not be a part of my story.  And yet, there are much worse stories.  My story had the best of all possible endings.  So there's no room for regret and recrimination.  My children, my partner, my family and friends need me.  And here I am.

1 comment:

katherine said...

Jenn, you are a beautiful writer! Please don't stop!