Unexpected

It's amazing how you can try to prepare for major events in your life, but then find yourself overwhelmed by the reality of them.  Kant talks about the sublime, awe and terror at something grand, usually in nature.  In one of my classes we discussed the fact that the idea of sublimity is fading because of our exposure to so many things through media and facilitated travel.  I made the argument that perhaps the thing we have left is the sublimity of experience.  I'm going to write this just for the catharsis of it, and to have it recorded somewhere.

Our third baby was due June 11.  Was being the operative word.  Early in the morning of April 30th I woke up for my normal pregnancy-induced nighttime routine of a drink of water, a handful of jellybeans, a walk around the apartment, and a trip to the bathroom.  By a happy accident (or some providential divine protection, take your pick) I turned on the light (I usually don't do this so as to not wake the other two kids) and realized that I was bleeding heavily.  I kicked into motion before I was really awake, and the adrenaline made me incapable of choosing the correct phone menu option for the midwife on call without hanging up the call.  I took a deep breath, found my bra, told a very asleep Ben I was bleeding but thought I was okay to drive, and called the midwife while I was on the road.  Once she confirmed that she needed to see me, I called Ben and asked "What if the baby dies?" It was a horrible thought.

I didn't think I was in labor, since the contractions did not feel like contractions to me based on my other two experiences.  Apparently with a placental abruption this is typical - you have all sorts of pain that confuse the labor pains.  I had no idea of any of that at the time, just that I was bleeding and that the pain was regular and intense, but fortunately in about 8-minute intervals.  I prayed all the way to the hospital - 45 minutes away in Cincinnati, the only hospital within 50 miles with a practice of midwives.  Turns out it was fortuitous that I didn't want to use the local hospital....thing would not have turned out nearly as well there as they did since we were at Good Samaritan.

I parked in the ER lot and walked to the desk.  I sat and talked to the night guard while they went for a wheelchair....he asked me about my T-shirt, and I looked down and realized I had on one of Dad's old highway patrol shirts.  I had come to the hospital in my pjs, without thinking a thing of it.  They took me back to triage where the staff had the attitude that seems to be my lot when I show up to the hospital in labor.  Since I don't look as though I'm in obvious pain, no one feels urgency about me.  After about 10 minutes I said, "Look, I really think you need to get me to a room.  I know I look together, but I'm bleeding badly and am really scared." They looked at each other and told me that they'd go ahead and get a urine sample "to get started on." I accommodated, and when they saw the blood clots they started moving a little more quickly.

The midwife was waiting for me in the room, she started an exam and said "I know this was not your plan, but it looks like the baby will be coming and that you'll need the residents here to take your case over.  If I go forward with the exam it's going to speed up your labor, and we don't want that, so I'm going to hold off and let the resident take over.  I'll stay if you want me to." (Let me point out, this is yet another reason to love midwives - she would get no payment for attending the birth, but didn't want me to be alone with a 12-person team, none of whom I had ever met.) I called Ben and explained what was going on, and that the baby was coming.  He didn't seem to register, I guess because he was asleep, but I was too focused on what was going on to worry much about him being there.

The resident arrived. She was very young and very capable, but not practiced enough to make things look effortless or be very reassuring.  I think I was a good patient for her to have, because I can recognize the difference between competent novices and incompetent practitioners, and could see she was the former.  She continued the exam and said (almost hopefully) that maybe it was old blood shedding for some reason.  Just then, another contraction that I recognized as a contraction happened, and a cover-the-table gush of bright red blood along with it.  The resident said "No, you're abrupting." They brought an ultrasound machine in within minutes, and verified that the placenta hadn't completely come away, which it had not.  Baby's life support was still intact, thankfully.

They took me up to a delivery room and the midwife explained that they would probably want to do an epidural.  I was glad, because I was not managing the pain the way I had with my other two....I don't know if it was the fear or the fact that I wasn't prepared (thinking I had six weeks still), or additional pain associated with the complication.  Either way,when she said my two options would likely be an epidural or the risk of needing to be rapidly put under for an emergency c-section in the event the baby's heart dropped, I was grateful for a pain-blocking technology that allowed me to stay awake to see the outcome of the delivery.  The thought that I might go to sleep and then wake up not knowing what happened to the baby was intolerable to me.

A nurse joined me and the midwife, and the anesthesiologist followed her.  They told me that the resident did want to have an epidural line in place, and I set myself up for that pain.

Once we were in the room, a whole mess of people joined us.  There was a medical fellow in neonatology that had henna on her hands.  She was a capable, practiced novice who made things look easy.  I liked her a lot.  She explained the lines of defense that they would try to use for baby, and what would be positive or negative indicators that I could recognize at birth. She had an additional four people on her team.

The resident came in again with her team (two other residents and an attending, it seemed to me).  There were also two nurses.  They waited for the epidural to take effect, did a check, and were pleasantly surprised to see I could start pushing, which meant that we would probably avoid a C-section.

I pushed once, in the horrible and awkward lie-on-your-back-and-pull-yourself-up-by-grabbing-your-legs way that I guess is normal with an epidural?  I had never, ever pushed like that, and if I can come to accept the idea of another pregnancy, I never want to do it again.  I didn't feel any progress, or any semblance of what a push should have felt like.  I started to panic a little, it was so different from natural birth...I looked up at the midwife, and she read my face, I guess.  She said "It's okay.  It is VERY different, and you will not feel in control the way you did with your other babies.  It will still work, you and your body will still get the hang of it."

And we did.  4 pushes later, baby was born.  They laid the baby up on my belly and did his initial assessment - surprisingly, his APGAR was an 8, and then a 9 at the subsequent one.  He breathed on his own and cried quickly....they rushed him over to the warm table to keep working on him and make sure he would keep breathing.  I asked "WAIT, is it a boy or a girl!?" The team didn't know that I hadn't found out the sex at the ultrasound.  The neonatology fellow said "OH!  No!  I mean, it's a boy!"  Everyone laughed.  I think we all needed a relief from the tension.

They wheeled baby away to the NICU, and kept me in the delivery room to monitor me and make sure that there wasn't an underlying issue that had caused the abruption.  Ben came in, having dropped the kids with Mom (who was coincidentally in town for Gran's 75th birthday....she had had no intention of meeting her newest grandson that trip!) at T's.

We settled in.  What came next was a 12-day NICU stay of shuffling schedules to try not to ever leave him alone for more than a few hours at a time, learning about pumping milk, praying that he would eat (the only lasting complication of his six-week-early arrival), and talk, talk, talking to process with the two BEST nurses in the world.  Ed and Holly are my favorites.

Now, almost four months later, I am finally allowing myself to call it trauma.  I initially felt that since we had such good outcomes, I wasn't entitled to that phrase.  Now, I recognize that it will be very important to process this through to help avoid fear and overprotectiveness.  I still don't know if I will ever get to the point where another pregnancy feels anything other than terrifying for me.

Fortunately, that's not a choice I have to make today.  For now, I get to enjoy my sweet baby and be so glad that the unexpected ended so well.

Uncertainty

We're waiting. Waiting for a contract to come through to be sure that this job is actually as good as they have promised me. Waiting to find a house. Waiting for a baby to be born in the next 8 weeks. Waiting to move our whole little family to a new state. Waiting to see if Ben's company will let him work remotely or if he'll get to be a for-real stay-at-home dad. Waiting to see if I can adjust to his way of getting the laundry done. Waiting to see if he can adjust to being the home-body. Lots of waiting. It's all very suspenseful and normally would cause my control-freak tendencies to work me into a frenzy. So far we're holding up okay. It seems like this is going to be a wonderful adventure.

You can't fix stupid

You can kindly explain. You can provide resources. You can ask them to analyze what they have said. You can yell and get indignant. You can patiently ask questions. And still, stupid. Just. Doesn't. Die.