Relapse

Neoma initiated a flare-up of my neurosis again. She told me I might be pregnant. I will admit, I am surprised that my cycle hasn’t started up again yet. I went through several weeks where I only nursed Rhys about once a day, and once or twice not at all. But apparently that wasn’t enough to kick start the system. As I sat in the temple several weeks ago wondering what instruction the Lord had for my life right now, I received the distinct impression not to rush weaning Rhys, so I’ve since backed off and he’s back to nursing several times a day.

I’ve been trying to get my body into a more fit condition, so I have been carefully tracking what I eat and maintaining a reduced calorie diet to reduce the calories stored in my body J. But I know that it is not good to be in a caloric deficit when you are pregnant or exclusively breastfeeding, so I have been hoping to make really good progress on weight loss before I get pregnant again.

Then Neoma had to go and say something about maybe I’m pregnant again. I can’t even remember what it was about, but she was serious, and so I suddenly started seriously questioning my calm acceptance that I would not get pregnant again until having at least one period. The latest two symptoms have been:

1) A couple of days ago I was sitting with Kevin on the couch and suddenly my lower abdomen got very tight inside—a particular long tightness that I recognized as experiencing when I was actually pregnant only once or twice right around 3 weeks along. I don’t know of anything else that causes it for me.

2) The other day I leaned over on one foot to kiss Kevin, which is not an uncommon thing for me to do, when all of a sudden I was falling over and had to grab on to Kevin for support. When I was pregnant with Rhys, before I could even notice any change in my shape, it suddenly seemed as if my center of balance had shifted and I would fall over whenever I did simple balancing things (squat down on the balls of my feet, lean over on one leg) that normally don’t take any thought at all.

So this is why I am pregnant right now. But I still don’t actually think that I am, but I do think that I am a little bit. And so it is time to go back on my medication: taking my temperature every morning. That keeps my hypopregnia in check because if I am not pregnant right now, then my temperature should be entirely inconsistent and swing widely because I’m also not menstruating. But if it is consistent, particularly if it is consistently on the high side, then I will know. I’ll keep you posted.

Willow's Birth Saga--Part Seven

Even as I grew very quickly into my role of mother and nurturer to this tiny body, I still fought with the devastation I felt at the circumstances I had just undergone. I talked a lot about it with Kevin during our few recovery days at the hospital. It helped me a lot when I finally realized that what I was feeling was mourning. I was suffering a very deep loss. Even though it was not the loss of anything physical, it was the loss of an experience that I had held as very, very dear and was looking forward to as if it was already a part of me. A part of me had been cut out along with the baby in that surgery, and it was a part that I would never, could never get back. I tried very hard not to be melancholy, and I was very quickly falling in love with this tiny girl we chose to name Willow, for the elf-like look she had from birth. But I was very glad when they took her to the nursery for some blood tests and Kevin went with them so I was finally alone in my room for half an hour. I finally had a chance to cry without pretending and with out explaining. I didn’t have to tell anyone why I was sad, what grief I was feeling. I wept in great heaving sobs, all alone, until I finally slept in exhaustion. I didn’t feel all better after that, but I didn’t feel as great a need to cry all the time. I still cried when I discussed the experience, and I’m actually crying as I’m writing this right now, but I think that was the beginning of my healing.
I am not glad that I had that experience. I do not think it is necessarily something I needed in order to learn something specific or become who I needed to be, but it is what happened, and I am able to see ways that I have grown emotionally and spiritually because of it, and I am grateful for that. I can go back and analyze all of the points where I would have changed the decision that was made and I believe there is a very great possibility that if things had been handled differently, it would never have come to a C-section. I hold absolutely no animosity toward any of the people involved. I truly believe that they were acting on their best understanding for the best good of the situation. I do fault the hospital procedures that put higher priority on expediency and liability avoidance than on best medical practice (i.e. remote fetal monitoring stations and the requirement of a 10 minute tracing). I am grateful for what I was driven to study and learn about childbirth options—particularly about midwifery and homebirths, and I am even grateful that I was driven/directed to leave the state for the birth of my second child because of the incredible people I was able to find in Utah to help me through my first successful natural birth. I don’t know that I would have made it through successfully if I was here in this medical climate, even if I had not had a previous Caesarean.
But that is another story for another installment—Rhys, my other birth.

Willow's Birth Saga--Part Six

In the operating room they prepared me for surgery and Kevin put on a gown and cap and face mask, and I think even gloves. They hung a blue sheet in front of me somewhere at about my chest so I couldn’t see what was happening. I was calmly fighting grief as I tried to prepare myself to welcome my baby. I don’t know if the Anesthesiologist saw me struggling emotionally and wanted to help, but she kept reassuring me as if I was afraid of the knife. She would pat my hand and tell me it would be OK, everyone knows what they’re doing, it will be over soon, it won’t hurt, kind of thing. I’m sure she thought she was being helpful, but she was very obviously not actually paying any attention to me or what I was really going through. I wasn’t afraid of the surgery; I was crushed by the fact that I was having the surgery. It was as if she had just put on her “comforter” demeanor she keeps as a one-size-fits-all for her patients. It really was annoying, but I didn’t think blasting her for her attempt at kindness would make either of us feel better.
I had heard of people watching their own surgeries via mirrors, but had not ever seriously considered the possibility that I would be having an urgent Caesarean, so I had never discussed my desire with my OB, and now he was on the other side of the drape, and I couldn’t talk to him. I was desperate to feel in some way connected to the birth of my child, so I asked the only person besides Kevin on my side of the drape—the anesthesiologist—about the possibility of getting a mirror so I could watch. She simply said, “Oh, that wouldn’t be a good idea,” and ended the conversation. Kevin had been instructed that he was to stay close to me and make sure I was OK—that was his concern, not enjoying watching the birth of the baby for himself. He dutifully filled that office, and neither of us realized until afterward that I would have had a lot more comfort out of his presence if he had been where he could see the other side of the drape and give me a play-by-play of what was happening. The anesth. was sitting where she could see the other side of the drape and communicate with the surgeons as they operated on me while she monitored my drugs. I occasionally asked her what was happening, but she would only give a brief two or three word answer of what had just been done, “He’s testing for sensitivity,” or “He’s cutting,” that didn’t really let me know what was going on at all.
Once I was numb, the surgery was surprisingly quick. I didn’t even know my baby had been born yet until I heard a baby crying all the way across the room. I knew logically that there shouldn’t be any other babies in the room, but I had no basis for believing it was mine, because as far as I knew, my baby was still inside of me. Before closing up, the OB said he took out my uterus to examine it and then put it back in. He told me I have beautiful ovaries. Thank you very much. As they sewed me together, Kevin went to investigate the baby cry we heard and got a little video of the newborn baby being examined (she didn’t have a name yet).
After what seemed like forever and being informed by the anesth. that she had given me a shot of morphine (What?! Isn’t that, like, a major drug you should probably at least inform me of before administering? Maybe I didn’t want it.) I was presented with a tiny bundle entirely enveloped in a hospital blanket with a newborn cap pulled down to her eyebrows. All I could see of her was two enormous, nearly black, blue eyes and full red lips extending clear across her face. I have seen brand new born babies before. I was prepared for all of the awkwardness and gangly, slimy, pasty, wrinkleyness that they can be. Up until a few hours previous, I was entirely consumed with trying to wrap my brain around a new child about to enter my life. I was awash in a fantasy of my perfect birth. I was so confident in my resolve and ability to handle childbirth that I didn’t ever spend any time thinking through the possibility that circumstances outside of my control might take the experience in an entirely undesirable direction. And now I was trying really hard to come to terms with a very sudden major surgery that will permanently affect my body and very possibly my entire childbearing future, not to mention the entire disregardance of my carefully constructed and dearly held belief system of natural childbirth and all of the coping techniques I never had chance to use. And on top of all that, I had never even made it to 5 cm, so my mom, on whom I was counting to guide and mentor me through the whole process, never even came. I was devastated, but I still had this new child, and I was her only mother, and I needed to mother her, but all I could think when I first heard her was “Is that my baby? I have absolutely no way of knowing whether that is my baby. They could put up this sheet and bring me any baby and I would never know the difference. I have absolutely no evidence that they even took a baby out of me. For all I know it is still there. For all I know it was never there in the first place.” (I was getting a little hysterical in my own mind—when this thought came, I knew that I was being entirely irrational.) And then when I finally saw her, the only thought that I could think was, “This looks nothing like any baby I have ever seen, or even imagined.”
Being still flat on my back on the operating table, it was really awkward for me to try to look at her being held upright next to me. I wanted so much for this moment to be beautiful, but Kevin and I were both crying, and not out of happiness. Kevin hurt in ways he couldn’t express from seeing the emotional pain that I was in. Kevin brought our new daughter to me and laid her on my chest. I studied her tiny little face, with those enormous features. I discovered a teeny tiny nose hidden in the midst of them, and a dimpled chin, that I recognized. Then suddenly I recognized the huge blue eyes and the full, wide lips—the lips, the eyes, the chin, were all Kevin’s. This was Kevin’s baby, and it didn’t matter how much I didn’t see of her birth. This was Kevin’s baby, and Kevin’s baby was my baby. Even if I had been entirely passed out when she was born and I didn’t see her until the next day, I would have known it was Kevin’s baby, and my baby, too.

Willow's Birth Saga--Part Five

The doctor came in to talk to me and Kevin about the situation. It had now been a few hours of heart rate dips, and they didn’t want it to continue without some evidence of progress in the labor. They gave me the option of getting an epidural to see if it would help me relax enough to allow dilation. I did not want an epidural. I was managing the pain, and I really did not feel tense, physically. I felt like if I could get up, it would help. I really felt like the most helpful thing would be to get up. No one would tell me what the bad thing that would happen was if I got up. No one would tell me what “the baby doesn’t like it” meant when I moved. I was never allowed to shift positions, because when I started moving, they said “the baby doesn’t like it” and I had to move back to the position I had been in instead of coming to a stop where I had moved to. We specifically asked to try the Jacuzzi, which had been the salvation of my sister’s labor a month earlier (they were on the verge of giving up on their natural childbirth choice until they were allowed to use the Jacuzzi. Once she got in, she dilated so quickly that she was surprised out of her relaxation by the urge to push). We were refused without any explanation of what the danger would be.
Typically options mean there are at least two alternatives you can choose between, but this option was actually the only one presented. The unspoken option was mostly unspoken because it was viewed as more of an eventuality than an option—Caesarean Section. The epidural was implicitly presented as “We are preparing you for a C-section. The first step in that is an epidural. However, we will allow you to wait for a while after getting the epidural before we decide that the C-section is necessary, because maybe it will help you and it won’t hurt us because we are efficiently moving you toward a C-section anyway and won’t need to backtrack.” And I do mean that sincerely—I don’t think that the “trial of epidural first” was just eye wash and they were going to steamroller me into a C-section all along, but rather that they would be just as happy as I would be if an epidural only actually worked and surgery wasn’t used, but they wanted me on that path toward a C-section and weren’t going to present me with or agree to anything that deviated from it. Faced with this, and grasping at the last hope of a birth in the natural route, if not a “natural birth,” we consented to the epidural.
Having the epidural put in was the most excruciating event of the entire experience. I had to lie and curl over in a ball through intensely hard contractions and hold still so someone could find space in my spine to insert a needle. While they did this, I could not have anyone push on my back, which had been my sole means of ameliorating the pain up until this point. Finally, though, that was over, and I settled in to wait and see if it really was secret tenseness I didn’t even know about that was preventing my progress. After an hour, or maybe only half an hour of trial with an epidural, I hadn’t progressed any further. I know at some point I went from 4 cm to 4.5 cm, but that wasn’t considered enough progress to let it keep going. So after a few minutes alone with my husband, we consented to a Caesarean.

Willow's Birth Saga--Part Four

I had a couple of Angel nurses. I really liked them, and they genuinely seemed concerned about me and wanted to do what was best, but they would come in with orders that apparently came from someone else that they had no authority to question, and I was never privileged to interact with. Everything was so entrenched in the hospital’s administrative mentality that personality and preference were subjugated to the will of the institution.
As I was lying docilely on my side, managing the contractions by focusing on relaxing through them and embracing the discomfort as something that was good and productive, they were steadily getting stronger. However, there was never a point where I said, “Oh, this is different, this is labor.” They felt the same as the contractions I had had before, just progressively stronger, and progressively concentrating more and more in the small of my back. At one point, my lovely nurse applied counter pressure to the small of my back during a contraction and it beautifully felt as if all pain was removed. She continued doing this through each contraction and showed Kevin how to do it for me while she was out of the room. I didn’t realize how strong the contractions had become until once when she was out of the room and Kevin didn’t know to start pushing on my back as the contraction started and it was so painful I couldn’t even articulate what I needed him to do to make it go away.
By the time I had been there for several hours I had only dilated another cm or so and they still didn’t have a clear 10 minute tracing of the baby’s heart rate. They decided to put in and internal monitor, which would take a continuous tracing, even if I got up. I was so ready for anything that would let me get up and move around that I readily agreed. They also put an internal pressure sensor up inside to monitor contractions. As soon as they plugged in the contraction monitor they went “Whoa! You are having contractions!” as if they didn’t believe me prior to that. Additionally, they put in an irrigating catheter that would slowly inject fluid into my uterus because, they said, my fluid was low, and it might help to “float” the baby out.
With the internal monitor, they finally got a 10 minute tracing of the heart rate and realized that the baby’s heart rate was dipping (Kevin thinks it was spiking. What ever it was, it was an irregularity) with each contraction. My OB said that this was not a problem yet but that it would be a problem if it continued for many hours. Because I wasn’t actively dilating, averages dictated that it would take longer than the hours they would want to allow the heart rate dipping to continue before I got to the point of birthing the baby. My husband and my OB, who are both holders of the priesthood, administered a blessing to me. I continued to wait, trying to be calm and confident in the hand of the Lord, for half an hour or more, focusing on my body and visualizing opening and welcoming this baby into the world. I was examined again and was told there had been no progress. They didn’t think petocin would help because I was already having contractions as hard as was advisable. My Angel Nurse suggested I shift to lying on one knee and almost on my stomach, which is a position she said frequently facilitates dilation. I started shifting and rolling over, but had no sooner completed the revolution that would have brought me into the suggested position, if I had had a moment to relax into it, than there was a flurry of concern and I was told to go back immediately, it was no good for the baby. I don’t know how they could tell that that position was no good for the baby when I never actually got into that position. I continued to lie there, and now, in my near despair, even the counterpressure that Kevin so faithfully applied couldn’t shield me from the pain of contractions that weren’t working!

Willow's Birth Saga--Part Three

Wednesday, 1 day after the due date.
1:30 am: I woke up to a Snap! It wasn’t a sound, but rather a very definite and sudden sensation of release in my abdomen, as if a taught rubber band had just broken (without the painful backlash of the suddenly free and flailing ends of rubber). I think perhaps I had been waking slightly with each contraction through the night, which must have been continuing, and then falling back asleep between them, because I was aware enough when it happened to know exactly what it was that had woken me up so thoroughly. I laid there for a minute until the contraction passed thinking “what was that?” when finally I wondered if it was my water breaking. There was no sensation of fluid down there, but I rolled off the bed and waddled to the bathroom. I sat on the toilet for a while and felt liquid slowly trickle out without any way to control it. This would not be entirely inconsistent with the experience of peeing in general at 9 months pregnant, but when I wiped, I noticed a distinct greenish cast to the fluid. I tried to call back down the hall to Kevin without bothering our upstairs neighbors, but he was sound asleep. So finally I found a maxi pad and waddled back down the hall to shake him awake. We called the doctor’s answering service, who this time called our doctor directly, and he confirmed that we should, indeed, head to the hospital. He said that the greenish tint was most likely due to meconium (a thick, tarry intestinal lining in the fetus, aka newborn poo) in the amniotic fluid, but in the absence of other signs of distress, he was not worried about it at all.
Digression #3: I love my OB/GYN, and I will argue anyone down who claims he is not absolutely the best there is. He is, as a general rule, very laid back, very personable, ready to talk and be friendly, answer any questions without a hint of condescension, and genuinely excited about and awed by the miracle of childbirth. In addition to all of this, he is a member of my same faith, and as such there is a common basis of understanding—I don’t have to explain or argue my code of moral conduct or views on the importance of parenthood. Additionally, he was a very good friend of my parents (he was my mother’s OB for her last baby, my little brother), he has attended and been loved by several of my sisters (one of whom preferred him so greatly, she decided to travel by ferry an hour each way to prenatal visits with him, and to the hospital rather than stay with the options for prenatal care available closer to home when she moved away.) If I ever need an obstetrician, he is the only one I want.
At the hospital, I climbed up onto the bed and they checked me—I was at 3 cm. Just in the last month, with labor imminent, I suddenly realized that I really, really wanted a woman there at my labor and birth who had done it before and done in naturally, and felt as strongly about it as I did. I asked my mom, who would be in town visiting, if she would come to be with me during the labor, and she agreed. So after we got to the hospital and my water had broken and I was still having contractions, we called my mom. She asked how far dilated I was, said that was wonderful, then asked me to call her back when I was at 5 cm and she would come.
The nurse put the monitors on. They said they wanted a 10 minute reading on the baby’s heart rate and then I could get up and walk around or use the Jacuzzi or sit on a rocking chair or exercise ball, or whatever. I wanted very much to move around and use all of the great labor and birthing techniques I had studied, so I laid very quietly so they could get their readings and I could get going! Again, they couldn’t get a good reading on the baby’s heart rate and the contractions I kept telling them I was having hardly even registered. (At one point I said to a nurse, or assistant, or whoever it was that was there, “I feel a contractions starting, I’m having one right now,” and she actually looked at the read-out and said, “No, you’re not.”) The nurse would adjust the monitors and their little stretchy belts to a place where they were getting a reading and then leave the room. The monitors would promptly slip and stop giving a reading, but they wouldn’t be constantly looking at the monitors, so they would come back in a few minutes later and have to “start over” for the 10 minute continuous tracing. I was told that if I need to go to the bathroom, I could simply stand up, unplug the monitors from the machine that interpreted them and go, then plug them in when I got back. I did this several times over the hour or more that they were trying to get this 10 minute reading. Until one time I got up to go to the bathroom and before I had even sat down a nurse was knocking on the door with great urgency asking, “Is everything alright?” “Yes, I’m just going to the bathroom.” I was told it is very important to keep draining your bladder during labor so it doesn’t get so full it interferes with the baby’s descent. But this time as I returned to the bed, the nurse told me not to get up any more, and if I needed to pee, to use the bed pan. This was rather tricky, since they only wanted me to lay on my right side, that being the position where they had the most luck in finding the heart rate. The next time I had to pee, I tried hitching myself up so I was on the bed pan, but in that position with the bed flat, my hips were tilted all funny, practically above my head, which is awkward in the best of circumstances, let alone with a watermelon-sized uterus in active labor. I couldn’t pee in that position, and I didn’t for the rest of the time after that.

Willow's Birth Saga--Part Two

Sunday, 2 days before due date
I laid at home on the couch (except for the 90 minutes spent at church) trying really, really hard not to feel as bitter as I wanted to, and not experiencing a single contraction. I finally realized later that the most likely reason I was ordered on bed rest was because I was at the hospital on a Saturday night. They didn’t want to have to deal with me on Sunday (otherwise they would have had a follow-up non stress test the next day instead of 2 days later), and they didn’t want any liability for anything that might occur over the weekend, so they had to be covered by being able to say that I was ordered on bed rest.
Monday, 1 day before due date
I went to the fetal non-stress test, which showed ablsolutely no irregularities, then to my regular prenatal visit. The internal exam was much more uncomfortable, even painful, than typical, and afterward the OB said, “you will bleed a little from that one.” Which I did.
He’d had the readings from the Saturday fetal monitoring sent to him so he could look over them. I asked him about it and he told me he actually couldn’t see any reason why I would have been ordered on bed rest. I was really upset about this because that means he concurred with the on-call doctor on Saturday night without actually having any basis for his opinion. He didn’t even tell me that he was concurring only because he trusted the doctor and didn’t have the means to make an informed decision against it over the phone. On Saturday night, it sounded like he really thought for himself that it was the best option, and it was like pulling teeth to get him to agree to let me go to church.
Digression #2: I think bed rest is the panacea placebo for all obstetricians. It is prescribed for an infinite variety of conditions, circumstances, or potential complications, but there is very little evidence that it makes a difference in the outcomes of most pregnancies. It does, however, serve to make the OB feel like they are doing something to be in control of the situation. There may be a few, very limited situations in which “horizontal positioning” is a legitimate remedy, but I can’t believe that OB’s really take into account the huge impact that not being able to get up has on a woman and the running of her household for as flippantly as I have seen it ordered.
Tuesday, the due date
I had contractions regularly all day. Never were they strong enough to say “woah! These are real,” so I never bothered to call the doctor. They did get stronger throughout the day until bed time when I said to myself, “If I can sleep through them, then they are not strong enough to worry about,” and went to bed.