Saturday, November 5, 2005

Hi, Baby: The Birth Story, Day 2 We arrived early and went back to the triage room. Triage is a word I learned from MASH - not in a good way. Triage - as I understood it - meant that there was blood everywhere, and people were missing limbs, and you were trying to sort out the people who were going to die from the people who might live from the people who weren't injured badly enough to worry about. There was no bleeding, no screaming. Instead, it was a nurse's station, with six glass-door rooms for expectant mothers. There were whiteboards with names and procedures written on them for each room. Our room had Mrs. B's last name written on it, and "3 miso." Mrs. B had had two misos the day before, and we had arrived to possibly get dose #3, and to definitely - definitely - have Mrs. B's labor induced. We went back into our room and Mrs. B assumed the position on the table. Then two (two?) nurses came in, and introduced themselves. They had vaguely similar names - Karen or Kelly, or Sharon and Shelly, or Rhonda and Rita. One was in training, and so she was shadowing the other nurse. Which, as it turned out, meant that after training nurse stuck her hand up to the wrist into Mrs. B, the other nurse would check and verify her readings. So up they went. Training nurse (TN) said something technical - "4 cm, partly dilated, moist," something like that, and supervising nurse (SN) went up and said, "that seems right." Let me tell you - it seemed cruel for a woman in Mrs. B's position to have to go through this in her position. I know that verisimilitude has got to be important for this job, and that they'd always have a real person instead of, I don't know, a full-size pregnant vinyl doll. But still, it seemed excessive. Thank goodness - things had progressed to a good point, and they got the doctor. Hey, it's our OB! We hadn't seen her all day yesterday, but here she was, and she decided that we'd just go ahead and skip Miso #3 and advance to the delivery room, across the hall. It was exciting. It was like we had won a prize. The labor rooms at Swedish Hospital are huge, and very well-equipped. The room had everything - a rocking chair, whirlpool bath, tv, CD player, and to top it off, an automatic bed with controls that looked thirty years old. I keep saying "we," but almost everything - down to the "squatting bar" that could be attached to the bed - was designed for the woman in labor. As for me, I had a fairly nice sleeping area - a wide cushioned area in the corner - and, well, that was enough. TN and SN came with us. They sat in our room the whole time, charting and checking R's vital signs. I thought it would feel like giving birth in the nurse's station, but soon enough I completely forgot about them completely." IV's were connected. TN tried valiantly to find a vein for the IV and missed badly, leaving R with a bruise that would stay with her for days after Oliver's arrival. Meters were strapped into place, and the pitocin drip began. And we got comfortable. It was Monday morning - we scanned the tv channels, watched "The View" and "Ellen." Mrs. B got her book out. We waited for everything to begin. There was a monitor similar to the one in the triage room for her contractions, and to monitor the little fella's heartbeat. This was a big deal - pitocin can cause pretty dramatic contractions, and can impact the baby if they come too hard and too fast, so it was important to make sure he was doing all right through the whole procedure. The monitor began spewing out folded paper with readings on it, like a seismograph. I went to get coffee at the hospital cafeteria after a while. We both somehow forgot that Mrs. B wouldn't be able to eat anything bigger than ice chips while she was in labor. She hadn't eaten breakfast before we arrived at the hospital. So I felt pretty guilty as I drank my coffee and ate my eggs. I can't provide blow-by-blow description of the whole labor process because I don't remember everything. I remember every second of certain moments, and there are entire hours that are gone. I really thought at the time that I'd remember every moment, but there was a lot of waiting and watching the meters during this time. The nurses would check her dilation, they'd read the paper and chart numbers, and we'd wait. I napped several times during the day. I somehow understood that I would need all of my energy the next day, so I tried to sneak as many naps as I could. I would curl up in my corner, sometimes pretending to watch tv, sometimes not even making a pretense. When things got slow, we played music. We had a stack of CDs from home, mostly gentle soothing music (James Taylor, Cat Stevens, and Oliver's first CD) and more upbeat music, in case R needed extra energy during the delivery (Beatles, Barenaked Ladies). I ordered lunch. Our OB had tipped me off that our room was eligible for meals as part of our hospital bill, so I could eat as long as I explained that it was for the patient. I ordered a burger or something. The food came via Bizarro World room service, on plates covered by hospital-blue rubber covers, and I ate, tucked into a corner so I wouldn't annoy R. Here's another important thing that I remember: the contractions got stronger. Well, not at first: they actually had to turn up the pitocin because R's contractions were barely registering. The nurse told her, "Honey, you've just got wimpy contractions right now." But then they really started to kick in. And then R was suddenly working really hard to breathe through the contractions - that Lamaze breathing you've heard about. But it's so much worse when you can see the actual pain on the person's face, instead of fake-agonizing pain on an actress' face, followed by a snappy one-liner. No, that was real pain on R's face, and I did my best to support her. She concentrated on not agonizing in pain, and I sat with her, held her hand, rubbed my hand along her forearm in rhythm with her breaths. It seems silly to write it, but we did that for hours, her breathing and me moving my hand along her forearm, and I felt like I was helping as much as I could. She kept reporting her pain level to the nurses. She was getting an epidural, but she wanted to wait until the pain was up to 7, on a 1-10 scale. So she went up the scale - three, four, five. I could see her wince, and brace herself for the next one. Six. The nurses offered to run her a bath, and she gratefully accepted. I came in and kept trying to talk her through each contraction, rubbing her arm in what seemed more and more like a futile gesture. Tears were in her eyes now. Seven. She told the nurses to call the anesthesiologist or anesthestitian or the guy who gives you the bloody epidural. He came quick, said gentle comforting things to my agonizing wife, and inserted a needle and then a tube into the epidural space, right next to my beloved's spinal cord. Now, let emphasize this. He inserted a tiny stringlike tube that seemed to be twelve feet long and threaded it into her spine. I tried furiously to think good thoughts (about pain relief and blissfully easy delivery) and not bad thoughts (complications, complications, complications that I can't even write four months after the fact.) It went in smoothly, and like a passing wave, her agony subsided. Sometime around here, Mrs. B's mother - my mother-in-law, who shall hereafter be referred to as MLBS - arrived. She flew in from New Hampshire and was kind enough to take a taxi to the hospital so I wouldn't have to leave R's side. She works in health care and has for decades, and is possibly more at home in a hospital room than any of our nurses were. At one point, R needed to have a catheter inserted, and the nurse gently offered MLBS the opportunity to leave. She replied, "Oh, it doesn't bother me. I've seen hundreds of catheters." I believe that the nurse was then struck by sudden performance anxiety.  Thankfully, the catheter went in as planned.  (A catheter's just not something you want to go wrong.) Time wore on. I walked MLBS down to the hospital cafeteria so she could eat dinner. She ate pizza, and in her oddly courteous way, she heaped praise on the fine quality of the pizza slices. I drank coffee, anticipating that I would need it. As the night arrived, we decided that I would drive MLBS to our apartment for the night. It would be impossible for both of us to sleep in that room, and we wanted at least one of us to get a full night's sleep. So I drove her home, showed her where her bed and the coffee maker were, and said my good nights. She would take a taxi to the hospital in the morning. I promised to call her if Oliver arrived before she returned. I remember driving back to the hospital a little punchy and a little giddy. I could see the empty car seat through my rearview mirror. I thought, the next time I drive here, I will be bringing my wife and our child. Our baby will be coming home. The night wore on. We listened to NPR, and I tried to doze some more. The night shift nurse came on. I don't remember her name, but she was Canadian, and kind. She made us feel safe and in good hands. Our local public radio station broadcasts a Canadian news program, "As It Happens," at 11 pm. When it came on, our nurse got excited. She told us that she listened to the show on CBC all the time when she was young. The theme song made her feel like she was home. I remember the next show was Diane Rehm, interviewing Bob Dole. I must have been sleepy, but I remember being struck by how professional and friendly Diane was with Senator Dole. She was at her best, giving him the entire hour so he could tell jokes and talk with gentle hindsight about his career. I remember R's voice waking me up. I had been sleeping for a while in my little corner. It was early on Tuesday morning, and things were happening quickly. Her cervix was nearly dilated the full ten centimeters. I rubbed the sleep out of my eyes and took a post next to the bed. Around 3 am or so, our nurse announced that we had hit 10 cm, and we were ready to push. She gave instructions - how to push, how to breathe, and we waited for the next contraction.  She would count to ten, and R would push like the dickens until 10, and then rest.  "Okay, push!" She counted to ten, and R pushed with everything she had. The nurse praised her. It was only one push. We would do this over and over again - thirty times? Fifty times? A hundred? Our nurse praised her. She gave her tips - "Okay, you're making good progress!" (Progress pronounced Canadian-style, the first syllable rhyming with "know.") "Remember to push down. Lift your bum just a little!" I liked our Canadian nurse. Everything seemed so foreign and strange to me, and having a nurse that spoke a slightly different version of English was weirdly comforting. She kept pushing, and the nurse checked to see where Oliver was. She could feel his head. We were encouraged, and R kept at it with new resolve. I did all that a husband can do in this position. "You're doing great, honey. You're doing such good work. I'm so proud of you." I said the same words again and again, and every time I meant them more than the last. I was so proud of this woman, sweat pouring down her forehead as she struggled to move our baby out of her own body and into the world. Then a glimpse of black matted hair. His head! Thank God - his head was coming out first. No weird breach baby stuff. A couple of contractions later, R was able to reach down and feel the top of his head. She laughed, exhausted but giddy at touching her own child for the first time. The nurse touched the call button. The nurse's station responded. "Can you send the doctor in here, please? I think we're going to have a baby pretty soon." R kept pushing, and the work was starting to strain. As our nurse finished her ten-count, R would let out a gasp of complete exhaustion, and immediately she began to gird herself for the next contraction. Sweat began appearing on her forehead. The nurse hit the call button again. "Can you tell the doctor to hurry? We're going to have a baby here in the next thirty minutes." Minutes later, our doctor came in, scrubbed, gowned, and chipper. The doc said something light and gentle to relieve the pressure, and R smiled. And then she started pushing again. The head was coming out, but each time it was going back into the birth canal. Out - and back - and out - and back - like he was playing peek-a-boo with the top of his head. After a moment, the doctor realized what was wrong. The cord was wrapped around our baby's neck. She pulled his head out just enough to expose his neck, caught the cord - it wasn't tight around his throat, thankfully - and clamped and snipped it. And a moment later, out he popped. When you see the birth movies in classes, it looks completely odd to see babies springing out of women as if they're springloaded. But that's exactly what happened. His head and shoulders were bigger than anything else, and once those big obstacles cleared, there was nothing left holding him back. And so - sprroing! He popped out, wet, bloody, his limbs looking like frog's legs, all akimbo and quivering. It was 5:32 am, May 31, 2005. We were officially parents. The doctor grabbed him and cleaned him off, and then handed him to another nurse to finish toweling him off. Two nurses had somehow joined the party - they went to measuring him and checking limbs and fingers and toes and inserting silver nitrate eyedrops. He was 7 pounds, 13 ounces. He was twenty inches long.  He was healthy. He had his fingers, his toes, his eyes, his ears. One of the first things that happens to a baby is an APGAR test, checking for proper breathing, reflexes, etc. Oliver made this easy - his color was good, his reflexes were good, and he bellowed his first cry. He also could pee and poo without trouble - he peed a full stream from his bassinet to the sink three feet away. (That talent will come in handy later in life.) The doctor woke me up from my stupor. "Hey, got a camera, Dad? This is picture time!" And I did have a camera, I snapped his squirming body on the scale, and screaming in that little Plexiglass bassinet, and then I took the first photos of him in his mother's arms. They put Oliver in her arms, and in her exhausted near-delirium, she could only say, "Baby. Oh, hi, baby." And she laughed, very light and tired laughs, but the relieved laughter of someone who's worked so hard and finally is bathed in the light at the end of the tunnel. "Hi baby." There was, of course, more to do. R's placenta was making one last attempt to scare the hell out of us. It didn't come out all the way, and R was bleeding pretty seriously. The good doctor stayed working with stainless tools that snipped and scraped, and finally they got the last bit of placenta cleared away. There was a lot of blood. R never saw it, but I saw the blood pouring out of her. After an eternity, the blood flow stopped, and the doctor stood up, still smiling despite the red-soaked sheets before her. Our doctor had nearly set a personal record that night. She had delivered seven babies that night, including two cesarean sections. She was off in two hours. It was morning on Tuesday, and the work and the fun for us had only just begun. 2:31:36 PM    Speak up!  []

9, 1, 5: The Birth Story - Day 1 We knew that today, the great and terrible ordeal was beginning. It was time. Due date #1 (May 21) and #2 (May 26) were both in the rear view mirror. Today, we would begin the process of moving Oliver out into the real world, whether he liked it or not. Because R's cervix wasn't quite ready yet for delivery, she was scheduled for three doses of misoprostol today. the miso would soften her cervix and ripen it (isn't that a great term? A nice, vivid, moist, squishy word - ripening. We would have quite enough moist squishiness in the next couple of days for both of us.). Her nurse told us very little about how this would go, except that we would have to go to the hospital for each of the three doses, and that it was possible that with the cervix ripening, labor could just start on its own without needing to go all the way to pitocin (which was just fine with us.) She said only one descriptive thing about the day. "Nine, one, five." That was when we would have to be at the hospital. 9, 1, 5. So we thought that this would be a day of commuting. We'd drive over to Swedish, a nurse would place a misoprostol capsule - next to her cervix - (a delicate way to describe the process), and then we'd go home for a couple of hours and wait. Go back at one o'clock, repeat steps 2 and three. Ditto five o'clock. That was how we imagined our day. I packed the suitcase (you know, THE suitcase - really just a duffel bag with clothes and stuff) just in case. We arrived at the hospital. R. undressed, put a blanket over her lower parts. She had two belts stretched over her tummy to measure contractions and the baby's heartbeat. We waited for a little while, and then the nurse came in to examine her cervix. (Nothing exciting yet: 1 cm dilated, long., sorta soft, but not soft enough. The cervix is like the steel door that protects the uterus during pregnancy, and usually it's pretty long. Between 3 and 5 cm in length, in fact. But when it's time for labor, it needs to get soft enough to pass a baby through, and it needs to shrink in length. In other words, it needs to stop being a steel door and turn into a soft, paper-thin passageway. Once it's short and soft, then dilation can start.) Miso capsule #1 was put in. And then the nurse told us that she'd be monitored for the next couple of hours. Uh oh. "Would you like some magazines?" said the very kind nurse. (I think her name was Heather, but I can't remember for sure.) "We keep a lot of magazines around here." So we got some People magazines, and Marie Claire, and Redbook, and etc. I know that when I look back on the story of Oliver's delivery, I will remember Tom and Katie, and Oprah, and Renee and Kenny Chesney. I had lots of time to study them during those long, long hours in the triage room. We waited. We listened to the whooshing of the fetal monitor. I kept thinking of the spaced-out experimental side of Electric Ladyland - the monitor reminded me almost perfectly of the roaring outer-space sounds of "Moon, Turn the Tides...gently gently away." At other times, the constant pumping - and it's not a sound of an actual heartbeat, not the way we're used to it, it's literally listening to the blood rush through auricles and ventricles - I remembered the bell's toll in the elongated bridge of "1983, a Merman I Should Turn to Be." Waiting, waiting, marking time and knowing that something is happening, even if you can't see it. Something is happening in there. The nurse came in, checked Mrs. B's cervix again, and dismissed us for lunch. We rushed home and grabbed the books that we had foolishly left on the coffee table - they were NOT getting left behind again. We had learned our lesson. I brought a paperback of Neil Gaiman's "Stardust." It's essentially a fairy tale, a boy's adventure. A young man goes to the outskirts of town, past the gates where no one ever goes, and goes off to the hidden lands to seek his fortune.  Seemed appropriate. We wolfed down food. I seem to remember I did some insignificant cleaning - I vacuumed the living room, or I wiped off the kitchen counters. It seemed very important at the time. We were back at the hospital by 1. Our kind, and thankfully, not perky, nurse strapped R in again and checked the cervix. "2 centimeters," she announced. It was moving! Now, one centimeter is a ridiculously small increment, but it was the most movement that had happened in weeks. We were excited. Something was happening in there. Miso capsule #2. There is really no way to describe watching someone else's arm go into my wife up to the elbow, but I felt fascinated (in a completely medical way) and ashamed and voyeuristic. I averted my eyes. More waiting. More magazines. R could feel some movement, and the monitor helped convince us that things were changing, softening, opening. Woosh woosh woosh. R had to get up more than once to use the bathroom. The first few times, we asked the nurse to come in and unplug her, and she would go off down the hall, a blanket wrapped around her like a toga, holding the monitor plugs in her hands like electric tails. We had a tremendous amount of time to think about the significance of the moment. It was starting! The whole new chapter in our life was starting! But we felt like we were trapped in a wating room. I can't say that there was anything foreboding or mystical about the whole adventure, at least at this point. Our nurse came back to examine R. The miso had run its course, but her cervix was contracting away on its own. We went to dinner at some bistro on Capitol Hill. I remember two things about the whole experience. I remember dessert: we shared a huge berry cobbler, all baked in a big earthen pot with ice cream melting all over. It was amazing. And I remember cigarette smoke. The bistro had big glass doors that they would open to let in the air during the summer. (It was the summer, after all.) And some Capitol Hill hipster types were smoking like chimneys on the patio, outside, and letting their smoke blow into us. My pregnant wife, about to give birth, was being forced to inhale these people's cigarette smoke. Didn't they know she was pregnant? !  Didn't they care?! I finished the berry cobbler in a state of quiet rage. "Don't you smell that?" "No, not really." It didn't matter. Secondhand smoke could be odorless. If anything at all went wrong with the pregnancy, I was coming back here with gasoline and matches. We had to go back for the third miso treatment. R steeled herself - it was eight o'clock already. It was going to be a long night. Our nurse was off for the night, so another nurse came to take over. But after the inevitable monitoring, and the cervical exam, the new nurse dismissed us. "Your cervix is already working too hard. We don't want to overstimulate it." Apparently, if they gave her a third dose of miso, she would contract all night, and induced contractions can be extremely painful. So we gathered up our books, R got dressed, and we checked out. We were due back at 7 am the next morning so R could be induced. 2:21:12 PM    Speak up!  []