Saturday, October 30, 2010

Baby Story, Redux

When I heard that Kim at It's a Beautiful Wreck was collecting positive Cesarean birth stories to post on her blog in October, I knew immediately that I wanted to submit Nico's story. (The blog that initially published the story has disappeared, so I'm reposting the original version here.) I've been reading birth stories for ages, and I can't recall a single happy C-section story from all my years online. I'm sure they're out there, but the horror stories and sad stories and disappointed stories are the ones that stick in your mind. I still believe that the C-section rate in the United States is unnecessarily high. I still believe that natural birth is a worthwhile goal. But I know now that a surgical birth does not have to be an unhappy birth and that a totally gutted birth plan doesn't equate to failure.

I'm sure most of you have heard the story before, but I'm really proud of how the new version--infused with nine months of perspective--turned out. So, if you please: Surrendering:  a Positive Cesarean Birth Story

I wanted a natural birth. I’d been ambivalent at the beginning of my pregnancy, but before long I was totally converted. I read the Bradley book, I forced my husband to watch Your Best Birthon DVD (I don’t think he found it as empowering as I did), I practiced breathing and relaxing and visualizing. Having read over and over that doubt can be the downfall of an otherwise-possible natural birth experience, I tried to quash my nerves. I tried to read only positive birth stories. I read about how to minimize intervention, because my biggest worry was that I’d be pushed into an induction that would fail and result in an emergency C-section. We took classes, we wrote a birth plan, and we discussed everything with my OBGYN. She was on board even though she did warn me to keep an open mind about an epidural, and she agreed that we could wait until 42 weeks to induce, provided that the baby stayed healthy and happy until then. I was nervous, I’ll admit it. My husband was given the responsibility of keeping me focused and helping me hold out against the inevitable temptation of drugs when labor finally started.

Everyone predicted that my baby would be born by Christmas, even though he was due on the sixth of January. We finished his nursery on January 2, and I was hoping that moving the furniture and folding the laundry would spark labor. No such luck. My due date came and went. I lay in bed at night visualizing my cervix opening like a flower, analyzing the twinges of Braxton Hicks contractions that faded and finally disappeared. At 41 weeks we went in for a non-stress test and an ultrasound, and discovered that our previously head-down baby had turned transverse. (A friend later did some Googling and told me the odds of a full-term baby turning breech were 1 in 2500. It’s not exactly what we had in mind when we told the baby he would be exceptional.) As soon as the ultrasound tech turned on the monitor, I saw the baby’s head and I knew I’d be having a C-section. I watched the rest of the scan in a daze, trying to marvel at his toes and fists and hair, but feeling more than a little shell-shocked. Sure enough, the first thing my OB said when she walked into our exam room was, “Let’s book your C-section. How’s Friday?”

I asked if there would be any chance of getting him to turn, but at his age and size it was not recommended. She confirmed that I wasn’t crazy, the baby had definitely been head-down the week before, and told me that it was possible something had prevented him from dropping properly into position to be born vaginally. Later I would read that the etiology for breech babies is almost never discovered. We went home and told our families about the new plan. I made jokes about grounding the baby for his transgression, emailed friends who’d had C-sections for advice, complained on my message board. We wrote a new birth plan and brought the baby’s clothes and changing table down to the living room so I’d be able to get to them easily during the six weeks of post-surgery restrictions. I repacked my hospital bag. And then I had a spectacular breakdown and sobbed in bed for an hour. All the natural birth sources I’d read emphasized taking control of your experience, standing firm behind your choices. I had completely lost control and no longer had any choices.

Our appointment was at noon on Friday and we were supposed to arrive at 10:00 to begin prep. I couldn’t eat anything after 4:00 AM, and the last thing I dreamed about before waking up around 8:00 was going to a wedding reception with an all-you-can-eat pancake bar. We finished packing our last-minute things, I took a long hot shower, and we took our dog over to my parents’ house. I woke up calm but grew increasingly nervous as we approached the hospital, and was downright jittery by the time we got there. Once all the prep procedures started I actually felt better, maybe because everything was fully out of my hands and I was at that point part of an organized process that was pretty much routine for everyone else involved. Our labor & delivery nurse described what would happen during the surgery, which was nice even though I’d read about it.

Around 11:30, my OB stopped in and told us there was another patient who would be needing an emergency C-section, so we’d be pushed back just a little bit. The anesthesiologist popped in and explained the spinal block to me, then popped back out, our nurse had my husband MB change into his scrubs, and I decided I’d try to get a few minutes of sleep. It seemed like as soon as I settled in to rest, it was time to go. They wheeled my bed down to the operating room, and we had to leave MB at the door until after the prep was done. That was the hardest moment for me, because I knew that if the anesthesia didn’t take, I’d have to be put under and he’d miss the whole thing. He later told me he was waiting in the hall for fifteen minutes, but to me the prep seemed to go by in just a few minutes.

My nurse had me get up and walk from the inner corridor into the OR, which I thought was kind of funny. When we entered the operating room, there was only one other person inside, but before long there were at least half a dozen, maybe more. The anesthesiologist arrived and I sat on the bed and hunched my back the way the nurse had explained while he gave me a numbing shot and put in the block. It was crazy cold in the OR and either because of that or the nerves or the meds, I was shivering. I remember trying to hold really still while keeping my spine curved over and my head tucked down. At this point I discovered I would have a use for all that deep yoga breathing I’d practiced for months, and it really did help. The nurse stood right in front of me with her hands on my shoulders, and though I usually don’t like strangers in my personal space, it was very comforting. They’d told me that once the spinal was in, my toes would go numb right away, but I didn’t realize they meant instantaneously, and before they even got me all the way onto my back, I felt like I’d been Novocained from my toes to my hips. It was a slightly disconcerting experience — I could still feel my toes and legs, I just couldn’t feel any pain or move them at all.

They put the drapes up and the anesthesiologist explained that I wouldn’t feel any pain, just pressure, especially during one part of the procedure, and that he’d warn me when that part was about to happen. At some point he put an oxygen mask on my face, and told me it was more for the baby than for me. I don’t know if that was true or not, but it did help to take deep slow breaths through the mask. I was still freezing, but after they had my arms positioned on the arm rests sticking straight out from my sides, they draped a warmed blanket across my arms and chest, and it felt wonderful. My OB came in and joked that she’d taken it easy at the gym the night before because she knew she had a transverse baby to lift out the next day. I remember the anesthesiologist saying “Let’s have a baby!” and hearing one of the nurses ask “Should I get the husband?” The anesthesiologist told me cheerily, “They’ve actually already started,” and I remember simultaneously knowing they wouldn’t get to any of the good parts before MB got in there and wanting to ask them to wait for him.

They told us before we went in that the delivery itself would probably take five to seven minutes, and I’d be surprised if it was any longer than that. MB sat on a stool near my head, so I could turn to the side and see him, and I’m pretty sure he held my hand. I heard the OB say, “We’ve got boy parts!” and then “Oh, look! Strawberry blond hair!” and then I heard the baby cry. I remember being grateful that he cried right away and didn’t give me any time to worry. It was a strange experience lying there seeing only blue paper and hearing my baby squalling in the corner off near my feet out of my sight. MB was called away and I could hear the nurses telling him to take photos of the baby and the numbers on the scale. At some point he came to me and held the digital camera up so that I could see a photo of our son’s face. I remember thinking that the baby looked like a total stranger to me, not familiar at all. Later I found out MB got to trim the cord and put on the baby’s first diaper. It didn’t seem like much time had passed before MB was back at my side, the nurses were slipping the baby inside his scrub shirt to lie against his skin, and I saw him for myself. One of the nurses took over camera duty at some point, and there are photos of MB trimming the cord, applying a tiny diaper to our tiny son’s behind, and of me beaming at the baby from beneath my oxygen mask. I’m not sure if it’s common practice at our hospital for a nurse to offer to take pictures or if she just did it out of kindness, but the photos she took — whoever she was — are among the ones I treasure most from that day. The nurses had to call MB away again briefly to suction mucus from the baby’s lungs, but shortly after that they were back by my side and the whole thing was over. The most surreal part was near the end, when I could hear one of the surgical assistants counting, and I knew they were counting clamps and scalpels to make sure nothing had been left behind.  The moved me to a gurney and then someone asked “Do you want to hold your baby?” I said, “Yes, please!” and they put him on my chest under my hospital gown and tucked a baby blanket across us both. I couldn’t really see him, but I could feel him there.

Physically, the worst moment of the whole thing was when they wheeled me out and down the corridor toward the recovery room. It felt like they were sprinting, and I got extremely nauseated. I don’t know if I said it out loud, but I recall promising the baby that I wouldn’t throw up on him. More yoga breathing, which saved me from puking, and then we were in the recovery room and done. The baby was checked again and swaddled and brought back to me and I got to nurse him, and it felt like the most right thing in the world. All of a sudden, I was his mother.

Despite the complete gutting of my original birth plan, I don’t feel any lingering resentment or deep sadness over the experience. Of course I’ll always wonder what I missed and be a bit disappointed, but under the circumstances it’s hard to be upset. The facts are that our baby couldn’t be delivered naturally, and I feel lucky to live in an era and a country where the medical staff was fully equipped to deliver him safely and competently. There were moments of intense nervousness and jitters, but I never had any moments of fear during my delivery. When I look back on my surgery, I remember feeling safe and trusting that I was in good hands.

Without exception, every nurse and tech who participated in our care was fantastic. I never felt that any of the doctors who saw us condescended to us, and no decisions were made about our son’s care without our input. I had trouble with my milk supply but even when his weight loss exceeded the generally-accepted 10% drop, the staff respected our request that he not be given a bottle. And the hospital’s team of lactation consultants were absolutely amazing. Once my supply problem became evident, they swept in and literally saved our breastfeeding relationship and continued to work with us at weekly weigh-ins until my son was declared a normal nurser at 10 weeks old. Our experience proves without a doubt that having a stellar hospital staff can make all the difference in the world. We were set up for a terribly disappointing birth after most of our hopes and plans were pushed aside, and yet it was an overwhelmingly positive and joyful experience.

After my initial breakdown, I faced the new reality of my birth plan and I embraced it as best I could. I didn’t waste much thought on the what-ifs and the why-nots once we arrived at the hospital. I let go of my disappointment and refused to carry a chip on my shoulder. I made the choice to make the best of the birth that awaited me. All the natural birth info I’d read emphasized surrender, how I needed to surrender to the pain of labor, to the ability of my body to carry me through. Ultimately, I think surrender was the key: surrendering to what needed to happen in order for my baby to be born safely. And once they placed him in my arms, I knew without a doubt that he was worth it all.

(bonus baby pics from Nico's aforementioned nine-month photo shoot)

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