Thursday, November 26, 2009

The Wind Waker

World, meet Zephyr. Here he is at two days old, in a room flooded with mizzled November daylight, during one of the fleeting early moments when his eyes opened to meet mine. This is the story of how we met.

On November 25, I arrived at my midwife's office for a routine checkup. It was my due date, and a pre-holiday visit seemed prudent. If I didn't go into labor soon, I would be induced on the following Monday. Women with gestational diabetes usually aren't allowed to go past their due date, but I was healthy, and besides, Thanksgiving was the next day.

Weight check: 187 pounds, even with shoes off. A nearly 40 pound weight gain over the course of the pregnancy, though I didn't really look like I gained it anywhere but in the front. "She's all baby!" people said about me while I was pregnant. And although I resent that women's bodies are suddenly up for public discussion when they become pregnant, I never minded when people said this about me, because I was so proud of my taut pregnant body. Well, except that in the past few weeks my legs had started retaining water and resembled sausages, and I couldn't wear my wedding ring anymore. And my face was starting to get a little puffy. I was kinda ready to have my body back.

Next routine check: blood pressure. 137 over 75. Ouch. Must be the coffee? Or that I was hurrying to my appointment? I felt fine. Midwife is concerned about hypertension, particularly with my diabetes, sends me to have a fetal non-stress test (NST), tells me to have another BP reading when I get there. Trena, the nurse who administers my NST, takes my BP again and it's actually higher. The baby sounds fine, she says, but she tells me to go ahead and plan on staying put anyway. I'm getting induced. I decide to start Tweeting my progress via iPhone.

(Twitter update: Gah, my bp is a tad high and midwife wants to induce. Like, *now*. Guess he's gonna be a T-giving baby after all! How a propos. :) 1:17 PM Nov 25th)

My options, what are my options? The baby was still posterior - I was hoping I'd have time to try to get him to move so I wouldn't have to endure back labor. I didn't want Pitocin. Under no circumstances was I to have Pit. Scott and I went to all these hyponobirthing classes and I was determined to have an intervention-free birth, but now that that was off the table I still wanted to start small. What about misoprostol? Ehhhh...still not what I really envisioned (soft moaning and rocking back and forth in a warm bath while I slowly meditate through labor), but it seemed like the least intrusive of the possible next steps, aside from just saying "peace out" and leaving the hospital, where I may or may not go into labor on my own, and may or may not risk harming the baby with preeclampsia.
I was already dilated about a centimeter and 80% or so effaced, so the miso might work fine. Sure, we'll try it.

My cell rings. It's my company's HR department. Jeff in the Seattle office has been trying to get a hold of me, but I'm not responding to emails or voicemail, and he doesn't have my cell number. Jeff must've missed the part where I told him the prior Friday that it was my last day, or my out-of-office autoreply that clearly states I'm on FUCKING MATERNITY LEAVE and have more important things to worry about than updating my corporate resume. I laugh into the phone and explain to HR man that I'm about to be induced to go into labor, and to pass that on to Jeff.

Time to kill. Scott runs home to grab some things (we'd been in the habit of bringing a suitcase to the hospital with us just in case, but I needed other stuff like my glasses, snacks for me and cookies for the nurses, champagne). He tells his mom, who is staying at our house, what's happening and she kind of freaks out a little and wants to hang out at the hospital and just pace a groove into the floor. He assures her that this is a terrible idea and that we'll keep her posted.

While Scott is out running errands I order something to eat and start signing forms and checking boxes for which procedures I'll allow or decline. I have to explain why I don't want my baby's eyes being swabbed with anti-gonorrhea ointment (I don't have gonorrhea) and don't want him vaccinated against Hep B yet (again, I don't have it). Resist the urge to go off on the nurse about the absurdity of universally vaccinating newborns against sexually-transmitted diseases. They make me sign waivers to decline their routine procedures.

(Twitter update:
Eating some hospital food (tastes like Lean Cuisine) and signing forms. Feel like a PITA for declining so much, but whatevs. My baby & body! 1:55pm Nov 25th)

The annoyance begins. My midwife instructs the nurses that I am to test my blood sugar every two hours instead of just after meals. I'm beginning to get pissed at the lack of control I have over this entire situation. After an hour, I am already officially sick of being hooked to the fetal monitor. They let me take a break to pee. This would be only the beginning of my long hate-affair with the monitor. Here's the imprint after three hours.

(Twitter update: Fetal monitor srsly cramping my style - stuck in bed hooked to it for 40 mins of every hour. This is bullshit. >:( 2:53pm Nov 25th)

I was so happy to get off the monitor for a half hour or so. By this point, the misoprostol had well kicked in and I was having plenty of contractions, but labor still hadn't kicked in. I spent my break in a hot shower to try to get enough nipple stimulation to kick things off, then walked in circles in the maternity ward for about 20 minutes. Still nothing. Scott and I start watching Wizard People Dear Reader on Youtube until I'm too distracted to pay attention.

(Twitter update: Contractions about a minute apart! Still can't really feel them, but back starting to ache a little. 7:29pm Nov 25th)

After two more hours go by, I'm only about 2.5 cm dilated. My midwife is long gone, leaves me with the OB. We discuss next steps. She mentions that she'd had some success inducing with a Foley bulb. This will mechanically dilate my cervix, after which I should go into labor on my own. They would insert a rubber hose into the opening in my cervix and then inflate it with saline to push my cervix open. I'd have a little Ambien to help me sleep, then they'd come wake me up at around 5:30am and my cervix should be at 5cm. This doesn't sound too bad, and I'm totally sick of being there, so I agree to it. It doesn't hurt going in, but it's awkward getting up to pee my usual 4 or 5 times with a fetal monitor strapped to my belly and a rubber hose dangling from my vadge (taped to my thigh).

(Twitter update: Gah, still no labor, though having plenty cntrxns. Trying foley bulb to get the next 2.5cm, Ambien, will try to sleep it off. 9:27pm Nov 25th)

Thanksgiving day. I am awakened by the nurse at 5:30am, and the bulb must've worked because it falls right out with a slight tug. They take my BP and blood sugar again. BP still high, glucose normal. The misoprostol wore off a long time ago, and my contractions have stalled. The OB comes in, and we discuss Plan D. I am informed I basically have three options left: breaking my bag of waters, Pitocin, or Cesarean section. I realize that fighting is futile, and decide to let go of anguish over not having the birth I planned, and concede.

(Twitter update: 5cm/90% effaced/-1 position after 6 hrs sleep, still no labor. Gonna get a whiff of pitocin to get things going. Not devastated. 6:03am Nov 26th)

After I get a shower and some breakfast, the OB returns to my room for another BP and glucose check. She decides to go ahead and try breaking my water first. This sounds like the best idea since I am adamant that I am at least afforded the opportunity for a vaginal delivery, and I know that Pitocin often leads to an unplanned C-section. She inserts a poking object into my cervix, and I feel a lot of warm liquid running out of my crotch into the Chux pads under me.

(Twitter update: Broke my water (waiting on Pit) and now it's gush and ouch time. 10:40am Nov 26th)

This feels different. Whoa, Nellie, this is definitely different. I chug a fruit smoothie and try to bring my A game. I am a little afraid I can only muster my B game. This is only the beginning. This is back labor. After writhing in bed for awhile, I suck in my guts and Scott helps me waddle down to hall to the jacuzzi. The thought of jets hitting any part of my body sounds dreadful, so I just lay in the water and try to breathe.

The contractions came in thunderous waves that crashed me against the rocks and left me awash in a steely sweat, eyelids crunched shut. I was unable to merely breathe through them, and began to mewl and curse.

After my fingertips began to wrinkle I had to crawl out of the tub and back to my room, where the world's most grievous bed awaited. After spending two days in it, I fucking hated that thing already, all rigid plastic and hard seams, but now it felt like I was in Eli Roth's version of the Princess and the Pea. I think only an hour or so had passed since the beginning of the intense contractions, but it could have been two or three. I had no idea what I had coming ahead of me. I begged for a little something so I could catch my breath, and was given fentanyl. I couldn't tell if it did any good, but I did feel like pushing.

When it's time to start pushing, your body just knows it. Zephyr's head was down low and he knew it was time, too. The only thing I was aware of in those two or three hours of pushing was when it was time, after a 30 second break, to summon my inner Viking and bring my strength. When the contraction surged up and crested, I used my core and bowel to push back with an equal magnitude. Rest for a second to catch my breath and slow it back down, then surge up and push down. The only consciousness I have is the strength I need to bring. My hips ache, my belly is raw fire. Breathe. Move him down further, further, one millimeter at a time until Zephyr is at my womb's nadir and he is spanning his two existences.

His head is stuck. His heart rate drops. The OB: "Do you want an episiotomy or shall I use the vacuum?"

Get him out as quickly as possible. Get him out. "Vacuum."

She affixes the vacuum to his head and I scream out the last fervent push as I am cleft in twain and feel my son spill from me. His cord is wrapped around his neck. Twice. It is cut and clamped before it can pulse the last hale nutriment to him. I demand to hold my baby and he is unceremoniously slapped down on my belly for a splitsecond then pulled away again before I can know his face. He's not breathing and he's wearing an ashen pallor. He is ushered to the other side of the room and three or twenty nurses work quickly to remedy this.

Maxine the OB distracts me by asking me to deliver my placenta. She says it's a good, hearty placenta and asks me if I want to keep it (I don't, particularly). Zephyr is announced to be 9 pounds 11 ounces, and 22.5 inches long. I had no idea he would be so big. Maxine mops me up and is amazed that I have no tears. "You were built for having babies," she says, and tosses her gloves and my placenta into the biohazard bag.

Zephyr is taken to the nursery for monitoring and Scott goes with him. I'm alone in the room for a moment, in shock at the sudden silence. A nurse reenters and tells me that everything is fine, and I believe her. She congratulates me again on a job well done. I feel like a fraud and admit that I had asked for a shot of pain relief. She laughs. "That wore off in 45 minutes. You only got a half dose."

(Twitter update: I did it! 9lbs 11oz. Vag birth, no epidural. So fucking tired & sore from 8 hrs of contractions & 2 hours of pushing. More later. 7:26pm Nov 26th)

An hour later, I am holding my new son and giving him his first taste of my breast. After two days of recovery and monitoring (his blood sugar, my blood pressure and demeanor), we are briefed on how to care for him and released to go home. We're still getting the hang of things, but it feels like Zephyr is a good, easy baby. His needs are all obvious (as long as we're paying attention), and he rarely cries. Being a new family is strange and wonderful, and I can scarcely remember life without him.