Ultrasounds and menstrual cycle told us we could expect our baby girl to arrive June 30, 2005. As a runner who does much better mentally if I set my goal for beyond the finish line, I kept telling myself she would probably come in early July. I thought that setting the finish line past the expected date would make the last weeks feel like less of a waiting game. John and I celebrated our anniversary on May 24, and laid plans to prepare for baby over the next month. We'd not done much of anything up to that point. I'd picked out some bedding and a paint color, and I'd ordered a bed. We'd had one shower and were looking forward to the other two to see what family and close friends had gotten us before we set out to buy everything else we'd need for baby. I had been focused on hammering out my dissertation with the hope of defending before June 30. One draft had been submitted and reviewed, and the second draft was on track to be submitted the last week of May. John had taken off work that same week to paint the baby's room, strip the trim (we were nervous about lead paint in our older home), install new windows, to refinish his grandmother's chest which will become the changing table, to have electricians finish some upgrades, and to have someone come in and redo the ductwork to ensure clean breathing.
While John was off, I planned for us to select and meet a pediatrician, to go on a tour of the hospital birthing center, to get a car seat and have it inspected once we'd installed it, and get that dissertation off my desk and into the hands of the committee members. I'd signed up for a June 13th breastfeeding class at Baby Moon, figuring I'd learn the basics and leave with a philosophy on how I would proceed in terms of bottles, pacifiers and such. All I knew at that point was that breastfeeding was difficult and very uncomfortable at first, but I knew I wanted to do it. We thought we were doing well to get everything in order a month out; we never dreamed that would be too late.
Thursday, May 26, I went for my regular 2-week doctor's check up. When the nurse took my blood pressure, I noticed that she went over and checked it against the other blood pressures on my chart. She mentioned it was a little high, and that we'd probably re-take it before I left. It was in the 140/90 range, and my normal is 120/75ish. After the check-up, Dr. Hansen had a nurse take me to a room with a comfortable chair and a low light, where she hooked me up to monitors for about an hour. The baby's heart rate was fine, and my blood pressure had returned to my normal. I was sent home with orders to collect urine for 24 hours and "lay low." Laying low for me meant continued work on my dissertation in bed. Friday night a group of friends was throwing a shower, and laying low for me also meant that it was fine to get together with friends to celebrate the coming baby. It meant I was fine to spend a few minutes at Louie's buying herbs to pot for the shower hostesses.
John returned home Friday night and we headed to the hospital Saturday morning around 11 to drop off the jug of urine and get a quick blood pressure check. I was re-hooked up to monitors (still wearing street clothes) and blood pressure readings began. Every 15 minutes the cuff would fill with air and we would get a reading. Unfortunately, those readings were consistently in the 140s over mid-90s. I was given a gown and told we'd be there for a while. Seven hours later we were released with the diagnosis of Gestational Hypertension and new orders to go on bed rest (which meant not leaving the house) and a prescription for Labetalol. I was told to take my blood pressure once in the morning and once in the evening, and to call the doctor's pager if the bottom number ever exceeded 100. The plan was to keep baby at bay for another 12 or 13 days, which would bring her to term.
Sunday I piled into bed and continued to wrap up the dissertation. John began clearing out the office, to begin its transformation into the nursery. I took breaks to write thank you notes from the shower the previous evening, to give John input on things like paint color, and to help organize borrowed maternity clothes into piles to return to friends. We decided to spend Monday night with my parents so John could return to the house the following week to paint, sand and strip without fear of affecting baby. Meanwhile, my blood pressure readings stayed in the 140s over 90s. Whenever it would shoot above 100 on the bottom, I would lose trust in the machine. I would re-check and re-check it (and it rarely stayed so high), so instead of calling the doctor, I just turned off lights and got very calm. I didn't have any of the other signs that led me to believe anything was really wrong (no headache, stomach pain or spots before my eyes.) In fact, it was very difficult to stay on bed rest when I felt so good. I was a good patient, though, and did as I was told by remaining in the bed.
Tuesday morning, May 31, a splitting headache woke me up at around 4:30. I took my blood pressure and got nervous when it consistently read 160-something over 105-ish (we wrote down the readings, but took them to the hospital and left them there.) I woke John up and asked if he thought we should call the doctor. We were scheduled to visit the clinic anyway that day, and (being a non-panic type) I thought maybe we should just wait until then. He figured it would be better to at least call and let the doctors know the readings, then they could tell us if waiting was fine. He called Labor and Delivery at UK, and was told we should come over right away. I grabbed a bag, threw in a magazine and a bottle of water, and downed half a breakfast drink as we headed out the door. I had no idea I had just packed my hospital bags and eaten my last meal for the next 40-some hours.
By the time we got to the hospital, my blood pressure was approaching 180/120. At about 7:30, the doctor announced it was time to have a baby. She gave us the option to have a c-section (which would be quick), or to induce labor, which would be slow and had a 30-40% of ending in c-section anyway. The upside to inducing labor was that a successful vaginal delivery would benefit the baby, so it might be worth the extra time and effort. The night before I had prayed that we not have to induce labor, but that I'd have peace with whatever happened. In spite of that prayer, I had been mentally preparing for a drug-free birth. I told the doctor I wanted to go as natural as possible, so she announced that we would induce. By 8:00, a nurse was hooking me up to magnesium to ward off seizures and a doctor stuck what looked like a flat, cardboard tampon (and what felt like a dry tree branch) up next to my cervix to start the ripening process. At that point my cervix was considered unfavorable [unlikely to respond to induction]. Each doctor or nurse who came through reminded me to expect a very, very long road ahead.
The magnesium was not as bad as people had said. It didn't make me loopy or blur my vision once it took effect. As it entered my system, though, it made me feel very warm and then made me very light-headed. Turns out, the dizziness was a result of the drop in blood pressure, which regulated relatively quickly. After a few hours a doctor came in and inserted a little water balloon up next to the cardboard in my cervix. Once I made it to 3 cm dilated, it would fall out to let the doctors know how far I'd progressed. After 12 hours, the cardboard piece was replaced (more comfortable procedure the second time around).
I began to ask questions about my options for labor. Could I get up and walk around? No. Could I use my birthing ball? No. Could I take a shower to relax? No. Could I get up to go to the bathroom? No; a bedpan would be my toilet. My job was to remain calm and relax, and labor quietly on my side in a hospital bed. Still, the first 24 hours passed relatively quickly. Visitors came and went, John's parents arrived from Alabama, the TV shows were good, and the magnesium didn't make me as loopy as everyone had warned. In fact, my vision never went blurry. I felt very good, just very hungry and very thirsty, as my sole sustenance was ice chips. My grandmother called from Louisville to let me know dad's side of the family was praying for me. She read the last verses of Psalm 91 and prayed with me. John and mom thought I'd passed out at first, but quickly remembered who was on the phone!
At about 3:30 Wednesday morning, the balloon fell out, signaling I had reached 3 cm dilated. At 6:40 a doctor came in and broke my water. Dr. Hansen was positive about the progress, saying it was going better than expected. The doctor who broke my water guessed I'd have the baby by noon. Once I had reached 3 cm dilated, I was told the pitocin would be added to my IV soon. I'd been told that the magnesium, which had been acting as a muscle relaxer, would be working at odds with the coming pitocin, which was supposed to bring on contractions. I'd heard about pitocin-driven contractions, and I was very nervous about them. I was hungry, thirsty, tired, and a little nervous.
I began to pray about the options for pain relief. Should I accept an epidural? I didn't want to. I had been adamant about a natural birth, and I didn't want to give up. I knew the magnesium was already passing the placenta and going to my baby, so she would be a little lethargic when she was born. I wanted to protect her from more drugs. I'd been told sometimes an epidural can make labor last longer, and I certainly didn't want that. I resolved to stick to my original plan and push through. But contractions were already a little uncomfortable and I was already out of energy. I wanted so much to birth the baby naturally, but as I looked at how the hours had progressed and considered my options for dealing with pain without being able to move from my side-lying position in the hospital bed, I changed my mind. To that point, nothing was natural about my labor. Labor had been done to me; my body was not ready and my baby was not ready. An epidural promised to take the edge off, and at that point, the edge needed to be removed. Why agonize through labor if a pain-free alternative were available to make things enjoyable? I decided I'd do "natural" the next time around, when I'd be more able to deal with things naturally. I told the nurse to go ahead and call for the anesthesiologist.
At around 6:40, a bag of pitocin was added to my IV. John woke up and helped me brush my teeth and wash my arms and legs by alternating a soapy washcloth with a wet one. I put on some makeup to hide some of the tiredness I was feeling. The clean-up felt wonderful, and I felt good about the decision to move forward with the epidural. I was in good spirits and ready to face whatever was to come. As John sponged my legs, a headache that wouldn't go away with Tylenol-- or even a Percoset in the night-- subsided. I commented to him that I was feeling better than I'd felt since we entered the hospital. I also noticed that one of the tubes in my arm was red. I asked John if the pitocin in the bag was red; it wasn't. I figured the addition of pitocin must have required the release of blood into a tube; no big deal. A few minutes later, my nurse entered and kind of gasped. She asked if I was light headed. No, I wasn't; in fact I was feeling wonderful. She pointed to my right side and I realized a cap had come off the IV and my blood was streaming from the tube. I was lying in a puddle of it! The positive side to the accident was that I got to get out of bed. I was able to sit up in a chair (wonderful) and change the gown I was wearing. The egg crate mattress pad and a pillow were thrown away because they were not salvageable, then my sheets were changed. It felt delicious.
After a little while, the anesthesiologist came through to give me the epidural. I had to sit up and curl my back so he could stick me. The sting wasn't terrible, and the sensation of cool water pouring down my back was kind of nice. The doctor repeatedly asked if I was feeling queasy or dizzy or lightheaded, seeing spots, etc. I wasn't until he quit asking. As he wrapped things up, I started to feel very dizzy. I felt like I never completely lost it, but I was fading. I threw up a few times (although there was nothing to throw up at that point) and John said a lot of docs came in to bring me back. I don't remember any doctors coming in, so maybe I was less "with it" than I thought. Apparently my blood pressure had dropped again (77/something). Once they brought it back, I felt better. In fact, the epidural had taken effect, and I felt good. I was able to relax and doze off.
The nurse entered and inserted a catheter soon after the epidural had taken effect. While I was glad the bed pan was no longer necessary, the catheter felt awful. For about fifteen minutes I had the feeling that I had to go to the bathroom very badly (awful feeling.) Another tube was inserted when the external monitor was failing to pick up a lot of the contractions. The monitor was placed next to my uterus and was painless, although it was funny to feel the cord do little flips. It felt like a mouse between my legs. The nurse told me it was a little mouse, named "Cookie." (Since we hadn't yet announced the name, each person had a different way to refer to baby, including Roxie, Lady, Sassy, and Cookie.) As the baby would move her head, I'd feel the cord move.
By 11:00, I had progressed to 5 cm dilated and 70% effaced. Things were looking positive for a vaginal birth by sundown. Because my water had broken, they decided to space out the checks, so I didn't see anyone again until 3:30?. Mom continued to rub Aveno cream on my ankles and shins to encourage contractions. She'd been doing that much of the day before, and while it may not have been working, we were willing to try anything. As 3:00 approached, I was starting to feel the contractions, and they were strong. John would rub a spot on my back to create counter pressure (on my left side). He would get a hot wash cloth and push as hard as he could until I was over the hump of the contraction. He also talked me through relaxation, and I practiced focusing and breathing slowly. All of those things helped, and with each strong contraction, I would comment that it was a good thing I had an epidural, because the pain was nearly unbearable with it. I couldn't imagine coping without it. Although the anesthesiologist was sent in numerous times to up the dosage, I still felt the pain. I knew that a doctor would be coming in to check progress at 4:00, and I was hopeful things were progressing toward pushing at any time, but I was very nervous about what the report might be.
At about 3:30, I broke down. I was hungry, thirsty and exhausted. My nurse had helped me put my labor into the perspective of a more natural labor. For the first 24 hours I experienced the portion of labor that takes place in the weeks before I would have realized I was in labor. The cervix begins to ripen and contractions begin to push baby downward. From 3:30 to around noon, I experienced the labor that would take place at home. At around noon, my nurse had announced, "now you'd be coming to the hospital." I knew that a hospital labor could last 12 or more hours, so I knew a marathon could still be in front of me. My blood pressure was up and down, but baby's heartbeat was very consistent. I began to wonder if the induction was really necessary. I was feeling out of control of what was happening and when things would end. I couldn't see the light at the end of the tunnel, and I was getting nervous about hearing that things hadn't progressed at the 4:00 cervix check. When the doctor came in to check, through tears and a tight throat I asked her not to tell me if I hadn't progressed. She did the check and said nothing. The nurse asked for an update, and the doctor told her that I'd asked her not to tell if there was no news. Since nothing had changed, she didn't tell us anything. I cried harder. That's when the attending physician came in with the new plan.
We knew what was coming. We had known all along that if I stalled out, a c-section would be necessary. We really weren't surprised when she told us we'd be heading to the operating room within the half hour, but it still hit us kind of hard. When she told me, I continued to cry, but I wasn't sad or disappointed. More than anything, I was ready for things to end. I'd heard people say they felt like less of a woman if they had a c-section, or that they were depressed as a result. Well before we entered the hospital, I had resolved to be okay with whatever happened (although I didn't think c-section would be necessary for me, and I never dreamed I'd be a high risk patient with dangerous blood pressure readings.) After the 32 hours of laboring in bed, I was very ready to have the ordeal end. C-section wasn't my choice at first, but it meant things would end within the hour, that I could drink water before bedtime, and that I could finally eat something. I think the tears were a result of the overwhelming fatigue. I knew things would be okay.
Thankfully I had already had the epidural, so that was taken care of. I knew the doctors would just turn up the drugs to numb me completely, then begin the procedure. After a drinking a bitter antacid, I was transported to the operating room. Once there, I was moved from the bed to the operating table, and as the drugs were turned up, the table was tilted to distribute them. The doctors began using a needle to prick my arm and then different parts of my belly. I was to tell them if I felt the same sensation in both places. From the first prick on my belly, the sensation was the same. Each time I would tell them I could still feel the prick, they would turn up the drugs. The doctors had maxed out the anesthesia, and I continued to feel the pricks. Finally one doc asked if I could move my legs, and I pulled them up toward my chest. Oops! That was their indication that the epidural had not taken, and that was my indication that maybe I was feeling for-real contractions earlier that afternoon. I was asked to roll onto my side and curl into fetal position. My nurse held my hands since John was not yet allowed in the room. The first epidural was removed and another was administered. Apparently that one was misplaced, however, so it was removed and another administered. By then I was facing complete breakdown. I am not sure what I would have done if a fourth epidural were given. I was ready to just tell the doctors to go ahead and cut me open without anesthesia, but (thankfully), that one took. My legs got very heavy and my body went completely numb. Even my lips and tongue were tingly. Finally the pin prick felt like nothing more than a little pressure.
John was asked to enter the room. He came in and stood over me, with scrubs covering all but his eyes. John said he entered and introduced himself as Dr. Sampson, here to film my tummy tuck. I barely recognized him, and barely registered that he was talking to me, much less joking with me. The doctors were talking with me the whole time, but I had a very difficult time both registering what they were saying and responding to their questions. I remember them saying I was a marathoner, and I remember "marathoner" sounding like a really odd word. I remember them asking what John does for a living, and thinking "resources" didn't fit with "human." I remember trying to tell them I was a research assistant, but all that sounded right was "research." I told John that it sounded like everyone was talking very slowly (including me.) He said it was like when Will Farrell gets shot with a stun gun in Old School and everything moves in slow motion. That didn't register with me while I was on the operating table, but once I was lucid, I agreed.
I could hear the docs talking as they cut me open. I couldn't feel anything until they pulled out the baby. It felt like a suction, like if you're pulling a glass--open side down--out of a tub of water. A huge weight was lifted off my belly, which was a very interesting feeling. John was giving me the play by play: "I see the head, oh, they're pulling her out!" The next thing I knew, I heard crying, a confirmation that we had had a girl, and doctors guessing her size. It was 5:52 June 1. I heard Dr. Hansen ask John if he wanted to see my organs. She showed him the sac, the placenta, and even my uterus and ovaries. She gave me a clean bill of health and began sewing me up. John left to attend to baby, and returned after a few minutes with little Lauren Clay. She looked tiny (she was 5 lbs 11 oz, 19 inches.) I expected to feel an overwhelming sense of joy when I first saw my baby. Instead I felt a sense of relief that everyone was still alive, I felt nervous that my earlier request for immediate skin-to-skin contact would be granted and that I would drop the baby (I had no feeling in my arms), and I felt absolutely exhausted. One of the doctors asked if I wanted to give the baby a kiss, so I leaned over and sort of smacked my numb, dry lips near her face. She cried and I told her I understood, and that I'd had a long day, too.
I was moved to the recovery room, where mom and dad visited and got to hear the name. Melanie came in, too, and we talked for a while. I could feel warm, heavy blankets over me, and I felt a very sharp pain in the pit of my stomach. I thought I was feeling the incision, but I later realized the incision was much lower. I guess I was feeling a contracting uterus, or a very sore and tired muscle. I asked for water and was given more ice chips. I ate them quickly, and was advised to slow down, to avoid nausea. Ugh-- I thought once baby was born, I'd be given a big glass of water and a five course meal as a reward for the long, starved labor. Turns out, I wouldn't eat more than some Jello until the next afternoon.
I was taken back to my room and re-hooked to the magnesium. This time I felt loopy. I also itched miserably as the feeling returned to my legs and back. As nurses came through, John and I asked when we would be able to see the baby. I had read about the importance of immediate skin-on-skin contact, and felt frustrated with having to wait and wait to hold my baby. They were cleaning her up, we were told. Finally, four hours after she was born, the nurse wheeled her in and let me hold her. She did latch on and have a little snack. The nurse who took over the next morning encouraged me to take off her shirt and just hold her next to my chest. I did that for a good two and a half hours. There's nothing like that. I think it was the next morning when the nurse wheeled her into my room after her "slumber party" in the nursery. The nurse handed her to me (John was still fast asleep), and her eyes were open and looking around. That was the first time it hit me that I was holding our baby, and I finally felt that overwhelming joy I had envisioned.
Over the course of the day June 2, I cautiously sipped water and loved on the baby. My IV had been reduced to magnesium and saline. Once I was told that the magnesium would be turned off when I was drinking enough water (and once I was assured the nausea was over), I started drinking water like crazy. My urine output jumped way up (the doctor was shocked by the amount!) The magnesium was, thus turned off. The catheter was later removed, and the epidural was undone. The removal of that epidural was wonderful. The doctor said the removal of the tape might hurt, but it was a welcome relief for my itching back. In fact, it would have been nice if he would have put another strip of tape on my back and ripped it off quickly. I felt the same wonderful itch-scratch when the tape was removed from my leg, although the removal of the catheter that the tape was holding was not so wonderful. Even less wonderful was having to go to the bathroom for the first time after the catheter was removed. I felt like I needed to go to the bathroom, but I couldn't make myself go (very frustrating.) And even worse was trying to get to the bathroom with heavy, half-numb legs and shooting pain in my abdomen. It took two nurses, a lot of arm strength, and dealing with the worst pain I can remember, to go to the bathroom that first time.
I learned, however, that movement—as difficult as it was—was actually very helpful in dealing with the pain. I had to put up with a little extra pain, too, because I asked for the pain killers to be cut in half after the first dose. I was given two pills in that first dose, and within about 20 minutes, the room felt like it closed in, I got very sweaty, and my ears were sort of ringing. I would rather feel some pain than feel out of control.
I was moved to the mother and baby unit on Thursday evening and stayed there until Saturday evening. Each day showed marked improvement. Saturday night I stood in the shower, holding a towel to my abdomen, while mom and John washed my hair. The washcloth against my back and behind by knees was wonderful in dealing with the itch. The shower helped me feel like a new woman. It was the first I'd showered since Tuesday morning.
A couple of times each day, holding onto John, dad or the baby's crib, I ventured into the hall and attempted to walk. Thursday I made it to the end of the hall and back. Before I left, I was able to walk the loop of the unit. It was tough, but the athlete in me enjoyed the challenge. Tougher than the walk, was getting up from the bed to go to the bathroom. My arms got a good workout (they were sore by the time I left the hospital!) By Friday I'd figured out how to maneuver myself in and out of bed and to the bathroom--quad strength was the key. I couldn't pick up the baby on my own until after I returned home, but I was mobile within a week.
Breast feeding was the theme over the next few days, with lactation consultants offering me their philosophies on how to feed a thirty-five week, five-pounder. One had me give the baby formula through a bottle, another had me give it to her through a tiny tube as the baby latched onto my finger. One brought in a pump so I could add the colostrum to the formula. Another said nature would take care of things and I didn't need to worry about all the extras to get the baby through. I was in the all-natural camp, but hadn't done enough research to know if that would hurt the baby, and I certainly wanted to do what was right. I did what the consultant on each shift suggested, which was confusing and frustrating (not good for a postpartum mom.) On day 4, my milk came in, and whoa... my chest tripled in size. With that, all the consultants agreed to drop the formula and go natural. I was happy to leave the hospital with some resolution.
By the time I left the hospital, the itching had subsided (although the swelling would last for a good week.) I was hurting a lot, even with the pain medication, but each day I felt much better. Holding a pillow to my abdomen helped tremendously if I needed to cough or laugh. By two weeks out, I'd weaned myself off the medication, and the pain was bearable, even in the middle of a deep laugh. I am anxious to resume exercise, and to break out the baby jogger to start working up to running a marathon. And on that subject, I'd always wondered how running a marathon and having a baby would compare. They're similar in that they're both tough and both mind "games," but a marathon is 26.2 miles, is over in about 4 hours, and you can eat and drink along the way. Childbirth is not so well defined, and food and water were out of the question. The reward for a marathon is a medal at the finish and a sense of satisfaction; for childbirth, the reward is a child. My childbirth experience makes a marathon seem like a breeze, but it's absolutely worth the pain. The reward is such a joy, and I'm ready to face the childbirth race again.