A Story of Will

I was browsing in the granite aisle.  I was feeling the chill of an overly air-conditioned warehouse full of huge slabs of stone, when I stopped and closed my eyes to breathe through a contraction.  I looked at the contraction timer I’d downloaded earlier in the day, and sure enough…they were regular and about 6 minutes apart.  I looked over to Rick to relay that information.  After being induced with my first when I went two weeks late, and knowing my family history of going to 43 weeks or more, I was reluctant to believe this was really it.  We both pursed our lips and tried to play it cool, but it seemed more and more like this was labor.

We finished up our granite shopping and made our way home though late afternoon traffic on I-70.  The regular contractions were slightly uncomfortable, but not enough to  make me squirm in the car, so we talked through our plan if they continued.  My mom, who was ready and waiting at our house, would take over if we had to leave for the hospital in the night.  We had written out the information she needed to watch our older son, so we felt like we just needed to determine when the time was right.  Until I got a more sure sign that labor was imminent, I was operating under the impression that this was just a false alarm – as I’d experienced a few times with my first.

At about 11 pm that night, as my contractions worsened I went to the bathroom and found that I had bloody show.   This seemed like just the sign I’d been waiting for.  I texted my doula, told her my contraction pattern, and she decided to drive up and see us. When she arrived, Rick was pacing and antsy.  As the contractions worsened, he worried that we needed to go to the hospital.  When  Stacey arrived, however, she sat down to watch the contractions herself and after about 20 minutes of watching me as I sat on my birth ball she agreed that we should make our way to the University of Colorado Hospital, about 25 minutes away.  Rick had loaded our bags in his nervousness, so we hopped in the car and made our way there – which was a rough ride for me, as I clutched the door and console trying to ease the back labor I was experiencing in the car.

We arrived and checked in.  They took us to triage to determine whether I was ready to be checked in.  After a brief check of my cervix, my midwife said we’d need to wait a bit longer before they would check me in.  She welcomed us to pace the halls, or head home and come back later.  We were a bit confused as to why we couldn’t stay, but decided that our home, which was undergoing a kitchen renovation and housing our two-year old, would not be a restful place.  We booked a room at a hotel nearby and went there to rest and ride out the labor a bit further.  My husband laid down to sleep.  I, on the other hand, laid down to close my eyes, but every few minutes would leap up to ride out a contraction.  I couldn’t handle them lying down.   This continued for about 4 hours, until my water broke and we headed back to the hospital.

This time we were checked through with no issue.  We got into our labor room and hunkered down.  I was awfully tired because it was now morning and I’d not slept.   My doula wanted me to ride through several contraction while lunging with one leg on a chair.  I did that in an effort to bring the baby down in a non-asynclitic way.   But after a while, my tiredness was getting to me so we moved to the bath.  There, my laboring consisted of me dozing off between contractions.  It sounds insane that one could do that, but my body was in some sort of energy conserve mode.  I’d wake up as the contraction started, ride it though, and then lay my head back and sleep.  Apparently I was even snoring.  I did this for a bit in the tub and it was lovely and gave me some rest.  Then my doula suggested I start dancing.  Some people might think it a strange thing to do, but given the way my first birth went I was game for anything that would get me the VBAC I hoped for.  I had hired te best doula I could find and I wasn’t about to ignore her advice. So, we danced.  I did hula-like moves for what felt like several hours.  The hope, in all this, was to avoid what had happened with my first – a posterior and asynclitic babe, resulting in a cesarean.  My entire pregnancy had been targeted toward this goal. I’d been doing months of chiropractic, religiously sleeping on my side, taking probiotics, reading voraciously, exercsing – and it felt like it might just work.

As the contractions began getting stronger, somewhere deep down, I knew that I was experiencing back labor.  With each contraction I’d squirm uncontrollably to take the pressure off.   I decided that something to take the edge off might be nice.  I asked if they had some laughing gas, and before long  had a mask that I could use to “make the contractions not bother me as much.”  The anesthesiologist (who I maintain was a Seth Rogan doppelgänger), was very honest about the fact that nitrous does not mask the pain, but helps you handle it better.  It did.  And, before long I had made my way to a point where I was very tired, wanting to push (well, that had been going on almost since I checked in because the baby was SO low), and wondering if I had the stamina for transition.  I was starting to consider an epidural, but I hadn’t had a cervical check in several hours so Rick suggested that before I go for medications, we should see where I was.  Well, it turns out that I had gone right on through transition without too much drama and was fully dilated!  This was fantastic news!

I started to push.  I was good at pushing!  My midwife was psyched seeing the progress my baby made with each push.  She said she saw the head move nearly two inches each time I gave it my all.  They were readying me to meet my baby any minute and I was thrilled.  There was a part of me that had assumed I’d never get this far, and here I was pushing and being told the baby would be out very soon.  I was elated.  I’d heard people say that pushing felt good.  It does, in the sense that you have some agency in what’s happening, unlike in the earlier contractions, but I can’t say that the sensation was enjoyable.  I was ready to see this baby and have it be done!

After about 45 minutes, the midwife voiced concern that the baby was moving back each time I pushed – more so than normal.  And, worse, the baby was having late heart rate deceleration.  This is language I’d heard before with Cody – not good news.  They called the OB team and a pediatrics team into the room where I was laboring.  Soon, it was just me, Rick, my doula and about 12 doctors, nurses, and other support staff.  About this time I began thinking how grateful I was for having grown up playing sports because without that, I doubt I’d have handled the chorus of 15 people around me yelling and urging me to bear down between contractions nearly as well.  I was also glad for my health and fitness, because it was a lot of work after already laboring for over 24 hours!

The OB introduced herself and told me that they were here to help me get the VBAC I wanted.  First, she felt for the baby’s position.  Posterior – again!  And, asynclitic – again.  She reached in and attempted to manually turn the baby but it was unsuccessful (and very uncomfortable because I was still unmedicated).  They offered two options then – forceps or a vacuum – to help move the baby into a better position.  Vacuum was their recommendation and so we went ahead with it.  A vacuum assisted delivery involves attaching a vacuum pump to the baby’s head to help pull and re-direct it during each push.  So, at the next push they attached the vacuum and I pushed with everything I had.  The OB was literally standing and pushing with one foot on the edge of my hospital bed to help her pull, but the vacuum popped off.  It was a VERY painful experience with no medications and the amount of pressure that she was exerting as she pulled down.  It felt altogether different from just the contractions and pushing alone. Apparently, many women who have a vacuum assisted delivery already have been given pain meds, but I was completely unmedicated and the nurses kept having to remind the OB team of that as they were pulling.  Though I handle pain well, it felt like they were going to rip me apart.  I can’t really even describe the feeling of being on a bed, with 15 people who I barely knew, surrounding me in a state of undress I would never otherwise be in, pushing as hard as possible, with the OB pulling as hard as she can – a sensation that feels like it will rip my insides out, akin to trying really hard to extract a cork from a wine bottle – and everyone yelling at me to push, and bear down, and curl around the baby.  It was insane. Like, definitely not the birth scenario I imagined even when readying myself for the challenge of VBAC.  A second attempt at the vacuum resulted in a pop off.  And finally, my third and last chance.  My midwife and doula both looked at me gravely before the contraction hit and said I needed to give it every ounce I had (as if I hadn’t already been doing this through the two previous attempts).  The contraction started, and I curled hard around the baby as I lay on my left side, giving over every fiber of muscle in my body to the pushing.  The contraction began to wane, and I kept pushing to keep the baby from sliding back, but as the OB pulled, the vacuum popped off for the third and final time.  The OB and my midwife slowly approached my head and said that the time had come to move to a cesarean, they asked my permission as I panted and collapsed onto the bed, exhausted, and I said yes.  In seconds I was being wheeled out of the room, too tired and overwhelmed to even realize that Rick wasn’t with me.  It wasn’t until they were prepping me for the spinal block that I realized he was nowhere to be found.

Back in the OR, I was too exhausted to be upset at the need for a c-section.  I was hanging on, sitting on the edge of the bed through the strong contractions waiting for my spinal to kick in, which took a few minutes.  Soon though, they had me on the table and pulled the curtain up blocking my view, explaining that they would move it down when things calmed as the baby was born – the hospital had a gentle cesarean option!  I was so thrilled.  But, that time never came for me…

Soon Rick was at my head, and I could tell something was happening on the other side of the curtain.  I assumed they’d tell me when they started th surgery, but they didn’t and it was underway.  It was going slowly.  Very slowly.  As I later learned, when they cut me open they found an abdomen cemented together with very bad scar tissue from my previous cesarean.  So much so that they were forced to do the internal incision higher on my uterus as the scar tissue had cemented other organs and tissue in place over my previous scar.  It was a lot of work to get in, and when they did, Will was in bad shape.  He was in the birth canal, so he had to be pushed out from below and pulled by his feet from the incision.  It was obviously not an easy birth, and it took a lot longer than my first surgery.  I was beginning to fade in and out of consciousness on the table by the time Will was finally removed.  He didn’t cry. The room was very quiet. They didn’t show him to me or Rick.  All I saw was a limp baby being rushed to the other side of the room where a table was set up for resuscitation.  It says something about my mental state that I was so sleepy and figured it would all be ok.  My recollection of this period was several people around Will working hard with a CPAP and doing CPR, Rick shaking above me and crying and sternly telling me not to fall asleep – though the drugs were saying the opposite.  I can’t give you a clear story about this piece, and whenever I ask Rick about it he gets so emotional he can’t really express how he felt.  It was very hard on him seeing Will and I in such precarious positions.

Finally, after several minutes they got Will breathing.  He had an APGAR score of 1 at birth, and 5 minutes out he was a 7, but he wasn’t totally out of the woods.  He spent a night in the NICU because breathing wasn’t coming easily for him.  Me, they stitched back up and wheeled into the recovery room.  The OBGYN took a moment to try to share with me that if I choose to have more children, I will need to have a c-section, because at this point between the new incision placement and the scar tissue it is too risky not to.

I certainly didn’t comprehend the gravity of the situation we faced during Will’s birth.  Each time a doctor visited me they asked in a low voice how I was doing because I’d had a traumatic birth.  To me, honestly, the birth had been a mixed bag.  I was incredibly happy and proud to have labored through what I did, unmedicated and without interventions.  When it came to having had the vacuum assist and eventually the c-section, it seemed to me that I had given the VBAC my all including months of chiropractic, herbs, probiotics, exercise, and working in advance with a team of exceptionally talented people.  I felt confident that under those circumstances, if a c-section was needed then it was truly a necessary intervention.  That said, it wasn’t until a follow-up with my doula that the gravity of the situation struck me.  She said “In situations like yours, we have to be glad for the option of c-section or you and Will wouldn’t be here.”

Wow.  I could have left my toddler without a mom, my husband without a wife, and died in childbirth along with my baby. Holy shit.

So, there has been much to process in the follow-up to this birth.  New life, an expanding family, potential mortality, and the higher risks of choosing to have another baby in the future.  Honestly, this has been much of the reason I haven’t written about Will’s birth. I vaccinate between feeling scared, triumphant, bewildered, and this unshakable feeling that I am a let down.  That, in the evolutionary scheme of things, I’d be a dead-end if it weren’t for surgical intervention.  It is a feeling I wrestle with daily.  As I workout and try to get back to a place of fitness and health postpartum, I wonder if this is me recovering and healing after my final baby?   Would be best if I never have any more babies?  The risk is bigger than I’d like or than I anticipated, and I sort of feel that I should just let things lie as they are even though I’ve always wanted more kids.  I am really struggling to get my head around this.  And, I think that though I know now the experience of laboring and feel proud I was able to handle it – I also feel that it is more obvious than ever that something is amiss inside me that causes my babies to be poorly positioned and therefore makes vaginal birth a real challenge.  But what is it?  Why can nobody answer that question?  And now, two surgeries in, I’ve foreclosed any previously available options where I might have been able to correct the issues…

But hey, I know that wading into these questions only causes me to go in circles wondering about things I’ll probably never have answers to.  I have two beautiful, healthy kids.  I am healthy and healing. These are the truly real, concrete, and important things.   But, man, birth really brings out a lot of dark, weird stuff – exposing your insecurities and challenging your self-confidence while also bringing these wonderful beings into your life.  What a crazy thing life is.

I wish I could say more.  As I said, I’m still dong a lot of processing internally and wondering what it all means for me and my family.  I will do my best to report of this more regularly here.  I feel it is important to share this information, though I’ve found it incredibly hard to talk about.

 

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