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Close to my heart: The birth of Luke

I’ve really hesitated in sitting down to write a “birth story” for Luke. At the moment he is sound asleep in my arms in the most adorable striped pajama outfit. I want to remember moments like this when he is too big to hold and when he doesn’t need me to help him fall asleep/stay...

cpagliabirthbhotos-005I’ve really hesitated in sitting down to write a “birth story” for Luke. At the moment he is sound asleep in my arms in the most adorable striped pajama outfit. I want to remember moments like this when he is too big to hold and when he doesn’t need me to help him fall asleep/stay asleep. I love the sweetness of his small hand resting on my chest as he sleeps. I still sometimes can’t believe that God has given me such a beautiful gift … and that he’s ours! Now that he’s here, and nearly four months old, I have a hard time remembering what it was like to feel like I was going to be pregnant forever. Luke arrived a full five days after the original “guess date” of September 9, and 12 days after my second guess date of September 2. I thought all along that I would go into labor on my own.
I went in for my appointment on Friday, September 9 to see how things were looking. Our midwife wanted to do an ultrasound to check my fluid levels (since I was “officially” 41 weeks) and everything looked good, so we went home, planning to return Monday if baby didn’t make an appearance over the weekend. So we were back again on Monday. Another ultrasound made it seem as though my fluid levels had dropped a bit and we also did a Non Stress Test to check Luke’s movements. Apparently he was sleeping during the whole thing (even after I drank an entire Sprite) and was deemed “non-reactive.” The midwives kept alternating who was giving us information, and so one came in and told us we needed to go to the hospital that very afternoon and get induced. This possibility came as a shock to me and I was completely unprepared for it. Finally, in the lobby after we had debated and debated, the main midwife came out and reamed us for not immediately saying yes to getting induced right then and there. She was beyond angry that we had called our doula for advice. She ended the conversation with, “Well, how long is too long?! You don’t want your baby to DIE do you?”
We drove home and I was in tears at the prospect of not being allowed to go into labor on my own as well as still reeling from the last conversation with our once jovial midwife. We were able to plan to go in the next morning, September 13 at 8 a.m. to start the process. That night we made all of our final preparations, knowing that the next time we came home would be with Luke in our arms. I went for acupuncture in hopes of inducing labor, but it was without much success.
It was so strange to walk into the hospital with no contractions, get settled in and just wait for things to start. I had the IV with the pitocin drip and fluids and two monitors strapped to my belly—one for Luke’s heart rate and the other to measure contractions. It was strange. Strange just to sit there and wait for things to get moving, but we did. Brian rolled around the room on the doctor’s stool; I watched and laughed. We played Uno, watched baseball and talked all as I had “easy” contractions. We tried to do what we would have at home. Gradually the pitocin was increased.
That night, after not much progress with the pitocin and contractions, they agreed to turn it off until the morning. Our doula came over and brought Brian dinner and was able to get the nurses to let us go walk the halls and go up and down the stairs in the hospital. And up and down the stairs we went. MANY times. (Now I realize that that’s probably why Luke has always loved falling asleep to us hiking up and down the stairs!)
It was starting to get late, and my doula went home and Brian and I settled back into the labor and delivery room to spend the night. It was so strange to do so and the nurses encouraged me to go ahead and take a shower. (In hindsight I wish I had!) We brushed our teeth and I climbed into that hospital bed and we tried to rest. We watched some of Mrs. Doubtfire because neither of us could sleep (the hospital never sleeps). Finally, in the wee hours of the morning I drifted off to sleep.
At 6 a.m. on September 14, the nurse came in and said it was time to get started again. They had already talked to our midwife who said that we were going to up the pitocin at a much faster rate today to get things moving. The nurse said to me, with a smile, that the goal was to have this baby by the time she got back at 7 p.m. for her overnight shift again. The other midwife showed up at 9 a.m. and decided to break my water to get things moving. While I didn’t want that to happen (because it would put us on a timetable and it was yet another unwanted intervention), I agreed. And after my water broke the contractions REALLY got started. The pitocin was strong and so were the contractions and by lunchtime I was telling the nurses to turn it off because my contractions were piggybacking so much—I would have three or four in a row without a break.
At around 1 p.m., the nurses agreed to turn off the pitocin and let my body take over on its own. My contractions slowed a bit and then picked right back up. Brian and the doula said I handled it well and even our midwife said I was stoic, but I did not feel that way at all. It was a journey to ride each wave of the contractions, able to only focus on each one and nothing else, just remembering to breathe. Once the pitocin was off, the nurse agreed to let me labor in the shower, which was IMMENSELY helpful. I felt like a new person to be able to have that water on my back as I leaned over on the birth ball riding each contraction wave.
Around dinnertime, I was hoping it would soon be time to push. I was feeling so ready to meet this baby and hold him and smell his new baby smell.
Close to 8 p.m., our midwife came in, checked me, and said we could get ready to start pushing. She wanted me to lay on my side for about 20-30 minutes and those contractions were some of the absolute worst that I had and were so intense. And then she wanted me to turn to my other side and do the same. I was certain that I was going to throw up. Finally, after 9 p.m., I was on my back again and ready to push.  And, all of a sudden, all the lights came on (we had dimmed them for laboring) and there were triple the amount of people in the room.
It brings back such feelings of vulnerability (though at the time I didn’t care because I was so focused on pushing out a baby) and insensitivity that I felt from those in the room just watching. There was even a debate among a nurse and our doula that her phone was being used to record photos not videos. For real? I’M FREAKING BIRTHING A BABY HERE! It’s like it wasn’t anything to be held sacred because they see babies born every day. In hindsight, I wish I had been more explicit with what I wanted. And I wasn’t wearing anything, because clothes didn’t matter at that point either.
I started to push with each contraction and was again certain that I would throw up at any minute. My doula was a lifesaver with the use of peppermint essential oil on a paper towel that she would wave near me to help with the extreme nausea. It was and still is a very comforting smell. I was most frustrated that it took over an hour and a half to push him out. One push in particular, I was certain he was almost out but then my midwife told me to stop pushing! Of course I stopped, but again in hindsight wish I had just kept going and pushed him out. When we neared the 2-hour mark since the pushing started, my midwife decided to do an episiotomy (which was again something I didn’t want but agreed to anyway). She hesitated and mentioned something like she had “never done this before” and through my teeth I gritted, “Just do it!” Maybe one to two pushes after that I could feel Luke slip out.
His umbilical cord was short so when I scooted back to see him I was told to stop (again, WHY??). This part brings tears to my eyes. All I wanted to do was see my baby and hold him, but because of the light meconium in the amniotic fluid, the nurse had to take him immediately to the NICU respiratory team who was waiting in the room to suction him out to make sure he didn’t breath in any of it. I could hear him crying and my heart was crying too; I just wanted to hold him! I remember asking Brian if he was still a boy because everything happened so fast that I couldn’t see.
cpagliabirthbhotos-080Finally, after the minutes that felt like hours, my baby was placed in my arms. He was so warm and cozy and I loved him immediately.  I held him close and just looked at him while I was being stitched up. I just kept saying, “I know, I know,” which seems like an odd thing to say. I hadn’t really thought about what I would say to him for the first time. But, he calmed soon after he heard my voice and settled into resting on my chest.
Soon the people started to filter out and it was just the doctor, nurses and midwife. I was bleeding more than is typical and feeling shaky as well as light headed, but they cleaned me up and left as they each finished their jobs. My parents and sister and brother had been in the waiting room—the nurse had been keeping my mom updated (another thing in hindsight, I wish I had had my mom be there in the room when Luke was born, too). And they all came in to meet Luke for the first time.
After they left I remember feeling so exhausted and physically spent.  My face was swollen from the fluids and even in the pictures I thought I was smiling, but my face looks expressionless. We rested our eyes while Brian called his parents. The blood pressure machine kept going off but I was ignoring it as I drifted in and out of consciousness because it had been acting up earlier in the day.
All of a sudden, all of the lights came on and the nurses flooded into the room. The head nurse told me that I had to go into the operating room immediately because they had to stop the bleeding. It was all so confusing to me and I was still feeling light headed, shaky, and having trouble focusing. I had to have all of these things explained to me, sign my name on multiple pieces of paper and hand my precious new baby over to Brian so that they could get me into the operating room as soon as possible. It was so shocking and disturbing at the same time and I worried that I was not going to be there for Brian and Luke.
Before I could even say a solid “see you later” to Brian and kiss them both, I was wheeled out of the room faster that I thought possible. The nurses were moving so fast that the bed ran into the door frame as they were trying to get me into the Operating Room. It was after midnight.
It was just down the hall, the room I hadn’t planned on visiting. The nurses had to move me to the operating table and used the sheets to help roll me onto the table. I felt so helpless. I kept apologizing for not being able to help them. All of the muscles in my body were so exhausted. They weren’t working like I needed them to.
Very quickly, the anesthesiologist gave me an epidural (another thing I never thought I would have, and ironic that I got one AFTER the baby was born) and I soon felt the warm tingling sensation trickle down my legs. I remember trying to wiggle my toes to no avail. The anesthesiologist sat near my head and talked to me as he did paperwork. I could hear the OB frantically talking to the nurses, demanding suction, more pressure, etc. as he tried to stop the bleeding.  And periodically he would ask if I was ok, since he was placing SO much pressure on my belly. Of course, I couldn’t feel much of anything.
I kept telling the anesthesiologist how tired I was and how I just wanted to go to sleep. There were times that my eyes drifted closed, but then they would wake me again. I have never been more physically and emotionally spent in my life.
Around 1:30 or 2 a.m., they were done. I was wheeled into recovery and waited there as they pumped warm air into my bed. Brian came in without Luke to see how I was doing. I wanted to see my baby, but they wanted me to wait until we were back in the Labor and Delivery room.
It had to have been close to 2:30 or 3 a.m. before they wheeled me back into the Labor and Delivery room. Luke was sleeping in the bassinet on the other side of the room. And then they started the blood transfusion. I needed two pints of blood to make up for what was lost. As the transfusion started, I began to feel more stable and less like I was going to faint. I rested my eyes for a moment, fading in and out of consciousness.
Close to 4 a.m., Luke woke and I woke Brian and asked him bring Luke to me. I held Luke as close as I could with IVs in both my hands. We snuggled as best as we could. I was still feeling the effects of the epidural and could not move my legs or turn on my side.
At 6 a.m., after we had just settled to sleep, two nurses came in to move us to the postpartum wing. There was no rest for the weary.
I remember being so embarrassed that I could hardly move on my own. My hair was a rat’s nest and the IVs still in my hands had prevented me from fixing it. Brian tried to help, being the awesome husband he is, but he doesn’t have much experience with doing girls hair coming from a family with four of six children being boys. I had to have help from the nurse to get into the wheelchair and sit on a pillow so I could be awkwardly wheeled, IV poles and all, to the postpartum unit. Luke and Brian had gone ahead and the other nurse loaded a cart with all of our stuff.
At one point, after struggling to get up out of the bed to take a desperately needed shower, I looked in the mirror and hardly recognized myself. I smelled awful, my hair was a disaster and my face and chest were splotchy with burst blood vessels from all of the pushing. After a tedious shower, I felt a little better, but still not close to normal.
We stayed in the postpartum unit longer than I was hoping. Finally, after a total of four nights and five days at the hospital, we were released to go home. I was elated but still completely spent. We drove home under the speed limit, wanting to be as cautious as possible with our precious cargo.
When just three days after we got home, I became very sick, very fast. I spent an entire day with a very high fever (102+), aches, chills, loss of appetite, exhaustion and general malaise. I only woke during the day to feed Luke who was sleeping happily beside me. We finally called our midwife that evening and she quickly deemed that I had mastitis and needed to be on strong antibiotics pronto. This was without an exam or much discussion about my symptoms. She made it clear that I needed to be exact about following the instructions with the antibiotics, because, as she said, things could turn south very quickly.
So, I did and I got better, or so I thought. At my six-week post partum appointment I was still bleeding, which I thought was normal. I was also unable to stand for long periods of time before feeling light headed, which I also thought was normal. In addition, I was feeling pain … still. Which I thought was normal.
After another “ring around the rosy” appointment and an ultrasound, it was determined that I had to have surgery to remove an additional fragment of placenta. That “fragment” turned out to be a solid three centimeters. I am certain now that my sickness when we had just returned home from the hospital was related to this—my body was trying to say that something was wrong. I am also certain that my midwife making a hasty decision and pulling out my placenta before it was ready to come out caused pieces to be left behind.
I was hysterical again at the prospect of having to leave my baby at just six weeks old, return to the hospital, be placed under general anesthesia in the main OR. You know, the big one. It was unreal. Having only 24 hours notice, I pumped as much breast milk as I could. And I pumped more while at the hospital before my surgery. I knew I would have to pump and dump after the surgery because of the anesthesia. Once that surgery was over and I was cleared at yet another appointment, I made sure that I would never go to that practice again. I discovered later that the midwife who had made so many careless decisions had since left the country and returned to South Africa.
It’s cathartic to write this all down, but it’s also painful. There are moments just reading through it that my eyes brim with tears and others where my blood pressure surges in frustration and anger. I spent much of Luke’s first months wanting to hold him close—and he loved being held close. I could not leave him, even for a short time, until he was at least 9 months old. I am also certain that I suffered from strong post partum anxiety.
In hindsight, I should have known from the moment my midwife changed my due date from Sept. 9 to Sept. 2 (because she said “he measured big”) that she would be pushing for him to be born sooner than he was ready. I should have known that pulling out a placenta before it’s ready to come out means that complications are far more likely and that it does not prevent infection, but instead can cause infection. I should have known that I could have said no to any of the interventions I had and take a stand for myself.
In hindsight, the joy and love that I have been given through the life of my son has made it all, every bit of it, worth it. And he has been a gift that I will keep close to my heart.
But I do know now. I know that I can birth a baby (even with so many interventions). I know that I can choose to be with a more supportive practice. I know that a due date is just a guess, and that 40-41 weeks plus is not so uncommon. In hindsight, I now know that I can, and I will.
May-2010_1216

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