Hank was born four weeks early at just five pounds, and we called him “Teeny McTiny” for the first six months of his life (until he experienced a massive growth spurt and shot from the bottom 10th-percentile on the pediatric growth charts to the top 15th-percentile). His little brother (whom we shall call Ollie here, to protect his privacy), arrived two weeks early, already weighing eight and a half pounds. He’s a big boy, yet one forgets how small and helpless all newborns are (even the big ones), and so we’re calling him “Bubba McTiny” for now.
Thankfully, the pregnancy induced hypertension (PIH) for which I was being so closely monitored for the last month of my pregnancy never developed, though I continued to have proteinuria until the end. I submitted to weekly blood tests, urine tests, ultrasounds, doctor’s visits, and twice weekly non stress tests at the childbirth center until my water broke, unexpectedly, the morning of March 10, when I was exactly 38 weeks pregnant. I was giving Hank a bath, squatting beside the tub, and when I got up to get his towel I noticed I’d left a small, pink puddle on the bathroom floor. (My mother also went into labor with my little sister while giving 4-year-old me a bath, so maybe there’s something to squatting by the tub as a labor trigger, at least in our family. My sister and sister-in-law have taken note.)
I called Dr. Dalton while Penelope helped Hank out of the tub, got him ready for the day, and told Grammy (who lives with us and who would watch Hank while we were in the hospital) what was happening. Dr. Dalton was already at the birth center with another patient, so she had us meet her there. They quickly confirmed that my water had indeed broken, but I wasn’t yet having contractions. Dr. Dalton didn’t want to send me home because she was still concerned about PIH, so we spent much of the day walking around the hospital and its grounds (it was a lovely, sunny, unseasonably warm day), trying to get things started. Penelope also had a IEP (Individualized Education Plan) to write for work, so she did that on her laptop while I did yoga in our birthing suite.
Unfortunately, I never had more than a few painless contractions all day, and once water breaks, there is increased risk of infection if labor doesn’t start reasonably quickly, so at 6:00 PM, we started to induce labor with pitocin. The first problem with pitocin is that it is delivered by IV and requires constant fetal monitoring, so even though they let me wear the wireless monitors, I couldn’t walk beyond the very small birthing ward, and I had to tote the IV around with me. The second problem with pitocin is that it creates very strong, very fast contractions in a short amount of time, before one’s body has a chance to acclimate. (At least for me: my sister also had a pitocin induced labor, and she says she contracted every two minutes for three hours before she felt any pain. I, on the other hand, was getting pretty uncomfortable by 9:00 PM, when my contractions were still more than three minutes apart and I had not dilated more than a fingertip.)
Around 10:00, I was miserable enough to request pain meds (a decision we’d left for “Game Day”), and we started with the IV narcotic Stadol. This made me dizzy, disoriented, and pretty loopy, but only provided pain relief for about an hour. My contractions increased in frequency, strength, and duration, and I began to shake and vomit, which made me hopeful I was progressing… but an exam at about 1:00 AM revealed I was still only dilated to 2 cm. That was a crushing blow to my morale and motivation, as I was already in serious, unremitting pain from back labor (with almost no break between contractions). I got another dose of Stadol, but this time the pain relieving effects wore off within about fifteen minutes.
At 2:30 AM, when I was begging for Penelope to make it stop and let me go home, I asked for an epidural. I wasn’t philosophically opposed to an epidural, but I was afraid it was too early to get one and that it would slow the already interminable labor process, but the nurses suggested it might give me relief enough to rest and let my body do the work while I got some sleep. That sounded good to me. They had to call in the anesthesiologist, who didn’t arrive for another hour (probably the longest hour of my life to date), but a little after 3:30 I got the epidural. Penelope got light headed (having not eaten in about eight hours) while trying to hold me up while the epidural was inserted, so she had to sit and I held on to the nurse instead. I remember apologizing, embarrassed because I wrapped my legs around her hips during a contraction, a very intimate thing to do to a total stranger!
The epidural worked quickly, and I did get to doze, fitfully, after that — but only for about an hour. Around 4:30 (I think, I was kind of out of it), the nurse came in and put an oxygen mask on me. She told me the baby was having late decelerations with each contraction, a sign of fetal distress, and they were putting me on oxygen to see if it would help. I think she also urged me to turn onto my left side, but I can’t remember. (Penelope slept through this, so she doesn’t remember, either.)
I continued in a confused, half-asleep, half-aware haze for another hour until Dr. Dalton came in and did another pelvic exam. I had dilated to 4 cm, which was finally some progress, but not enough: the baby was still having late decelerations, and I was not progressing fast enough to risk continuing with labor. Dr. Dalton recommended a caesarian section. (I think she’d already called in the surgical team, so I don’t know what would have happened if I’d disagreed — but I didn’t. I was ready to be done, one way or another.)
It took another forty-five minutes for the surgical team to arrive and set up, but that time moved quickly, filled with consent forms and other preparations. I remember the nurse handing me a consent form and showing me where to sign. I took the clipboard from her and said, “I’m a lawyer, I have to read it,” which made everyone laugh (except me). Dr. Dalton said, “As a lawyer, you probably know that they always tell us consent forms are unenforceable anyway,” and I retorted, “Well, yeah: how many drugs have you given me tonight? Do I look like I’m in my right frame of mind?” which made everyone laugh again (again, except me).
In the OR, they gave me a spinal and draped me for surgery. I cannot describe, and frankly don’t care to think much about, the actual c-section itself. Even with the spinal and a local anesthetic “gap” medication, I felt a lot more of the surgery than I expected to. The anesthesiologist kept asking if it hurt or was just uncomfortable, and I couldn’t answer her: of course it hurt, but it was also intensely uncomfortable. Penelope was sitting next to me, trying to talk me through it, but I can’t recall a thing she said.
The anesthesiologist told Penelope when they were lifting the baby out, and she looked over the drape (something I was afraid to do, being a blood fainter, when Hank was born). She says it wasn’t gory: it just looked like they lifted a baby out of a funny red hole in the drape. (“Red hole” = gory, to my lights.) I remember everyone talking about what a big baby he was, and then I was pretty distracted by pain/discomfort as they worked to remove the placenta.
Penelope went with the baby to watch as they cleaned him up and did his APGAR tests. (He scored a 7 first, and then a 9, which is about as well as c-section babies ever do.) She says the nurses were taking bets as to how big he was (8 pounds, 7 ounces). I could hear him yelling and yelling: he was soooo loud.
Penelope carried him over to me as they were still putting me back together. I didn’t know what to say, but knew I had to say something, so I started (in my narcotic haze) reciting “The Owl and the Pussycat.”
The Owl and the Pussycat went to sea in a beautiful pea green boat. They took some honey, and plenty of money, wrapped up in a five pound note…
They gave me another dose of something because I was in a lot of pain, and Penelope says I went into a narcotic nod for about 5-10 minutes. I don’t remember that. I remember them driving my gurney back to a recovery room, being greeted by the dayshift nurses (shifts changed during my surgery), and then promptly throwing up on myself and one of the nurses. After that, though, I felt much better.
They brought Ollie to me and laid him on my chest. Paula (one of the day nurses, who we remembered from our hospital stay when Penelope had Hank, and who I’d also become re-acquainted with during the many non stress tests over the last few weeks) encouraged me to try breastfeeding. Ollie latched on immediately and nursed for a long time, probably 45 minutes, despite the fact that I couldn’t yet sit up or really even hold him, being still quite numb from my chest to my feet.
I hated that total sense of helplessness and was glad when the spinal started to wear off. I didn’t need much for pain management: just Motrin. I got up on my feet about eight hours after surgery and walked back and forth across the small room. It was still very uncomfortable sitting up and standing, but I was glad to be able to move.
Hank and both of his grandmothers came to visit that evening. Hank is an excellent, proud, gentle big brother. “The baby person is finally out of Mumma’s belly!” he says.