Monday, May 4, 2009

Where Babies Come From, Part Three

Continued from here.

That night, and the early part of the next day, is fuzzy to me, and probably for good reason. I was on drugs. I understand the appeal to those people who get addicted: you feel sort of disconnected, and though I was summoned regularly to check my blood sugar or give myself a couple of units of insulin throughout the next 18 or so hours, I did so with a sort of detachment. One of my clearest memories is injecting insulin into my upper thigh, a spot I typically avoided because it's painful to give shots there. I couldn't feel my upper thigh at the time. It's a weird thing: when you're looking at your own hand gripping your own leg, and your hand can feel your leg, your brain doesn't necessarily get the message that your leg can't feel your hand. It felt like someone else's leg in my hand--I remember feeling surprised that it felt a little cold, but I'd complained since I arrived of how hot it was in my room, and they kept ratcheting up the air conditioning. My flesh felt a little like how I'd imagine a dead fish would feel.

They were giving me increasing amounts of pitocin, and as they'd turn up the amount I was getting, the contractions would start to hurt and I'd ask for more medication. I was relishing the feeling of being comfortable, after nine months of heartburn and backache and insomnia and various other complaints. I liked being reclined at 45 degrees, my feet slightly elevated, having ice chips brought to me. It was a little like being on vacation in a nice hotel except for the medical interventions, none of which phased me.

It was now June 21, 2005, and by noon, I'd officially been in labor for 20 hours. June 21 is the summer solstice, and believe me when I say that giving birth on that day brings new meaning to the words "longest day of the year." I kept waiting and waiting to feel different somehow, but with medication managing any pain I might have otherwise been feeling, I just didn't. I remember settling back after checking my blood sugar once with my blood sugar meter still balanced at the apex of my belly just as a contraction started, and watching the it on the monitor I was hooked to and the meter balanced on my belly, both rising exponentially as the contraction that I couldn't feel at all built and built and then falling as it receeded. I watched it with a sort of detached fascination, sort of a "Whoa, that was completely weird."

I don't like to throw up, not at all. I am one of those thoroughly perverse people who would prefer to sit miserably curled over myself for hours, sweating buckets of cold sweat, than throw up, feel better, and drive on. I was warned while I was still pregnant, that all women in labor throw up; it was a veteran L&D nurse who warned me, so I believed her. I threw up once shortly after I arrived at the hospital--just the remains of the leftover barbecue that I'd had for lunch that day, and then again in the early afternoon--that time it was just water, since all they'd let me have was ice chips.

That second throwing-up seemed to trigger an extra flurry of activity in my room. At that point, I had two nurses: a long-time L&D nurse who was training a student. "We need to check your cervix," she told me after I threw up. "You might be in transition."

They had been avoiding doing pelvic exams as much as possible. Since I'd come in with my water already broken, they wanted to avoid forcing any bacteria or anything else any closer to my cervix, and they were treating me with antibiotics, since now I'd been in labor so long. The veteran nurse gave directions to the student nurse on how to check for dilation. "You're eight centimeters, easy, maybe eight and a half," she told me. She snapped off the rubber glove and patted me on the leg. "Not long now."

It was right around this time that I began to feel a pain that was centered on my left hip that I didn't think should be there. Wasn't I supposed to be numb in that whole area? Why could I feel nothing but that one pain? Why did it coincide with every contraction I had? Why was I the only one who seemed concerned by it? And who the hell was making that awful wailing noise every time I had a contraction?

It was me, of course, who was wailing. Maybe the wailing was all in my head; I don't remember it bothering anyone else in the room, including my husband or my mother. Dan said I mentioned a pain in my hip sort of offhandedly; it was why he wasn't aware that anything had happened to me. I also remember it going on for hours and hours, when in reality, it was evidently just a few minutes. Dan tells me, still, though, that I didn't complain, although I began asking for more medication than they were willing to give me at that point. They did put more medication into my epidural line at one point, and it didn't help significantly. "This isn't working," I told them over and over again. "It only hurts in my hip." And it hurt a lot. It hurt like a knife stabbing me in the meaty part of my left hip. Apparently, though, I never complained.

"You're ready to push," the nurse told me. I felt like I'd been in terrible pain for hours, and I had no intention of pushing until I had more drugs. I was afraid pushing would make the pain worse, if that was possible; worse pain seemed inconceivable to me at this point. "What if you tried just one push?" she asked. "You're dilated to ten, this baby is coming." I hadn't felt any irresistable urge to push like I'd heard other women describe; I was focused on the pain in my hip and getting from one break between contractions to the next and just surviving the pain in between. There was beginning to be a lot more activity in the room, NICU nurses were coming in and setting up the table and scales across the room in the little nook that was reserved for the baby; other people were coming and going. Some of them looked vaguely familiar to me; most of them I'd never seen before. It seemed like a strange time and place for me to feel so exposed, although I wasn't really: I was wearing a hospital gown, and had blankets and pillows. I only felt like an obscene, crazed spectacle. I was still watching things with a sort of detached fascination; I don't know if it was an effect of all the drugs I'd taken or if I really was just much calmer than I remember feeling at the time. I had a short chat with a NICU nurse who'd seen me just after I'd gotten the first hit of narcotics; she poked a little good-natured fun at me for having not much of a head for the drugs.

The nurse finally convinced me to push. "Did you take a childbirth class?" she asked. We hadn't; everyone who I'd ever talked to said that they were a waste of time and money and they never used anything they'd learned in them. I shook my head no. "You'll want to push down with the same muscles you use to poop," she said. "When you have a contraction, you'll bring your knees up and tuck your chin into your chest and push from your middle, not from your head. Take a couple of big deep breaths, then push out the last breath."

Knees? Chin? Middle? Poop? What the hell? I was thinking. "I can't pull my knees up," I said. My legs and any muscular control I'd once had over them had left the building.

"We'll do it for you," she said. She grabbed one and the student nurse grabbed the other, my mother was standing down by my left foot. The end of the bed detached and rolled away; most of the parts of my anatomy I have never been eager to display publicly were now public domain in the middle of the room. There were bright lights focused on it and lots of people seemed to be gathering around it and I found myself wishing my mother would stand somewhere else, although I didn't say anything at the time because I was hoping she wouldn't notice it and I would prefer not to call attention to it. I can't fathom what I was thinking.

A contraction started and the nurse instructed Dan how to count backward from ten slowly for me, staying close to me so I'd focus on his face. He drew a chair close to the right side of my bed and put his chin on the rail of the bed, reached for my hand. One of the things I've always loved about Dan has been his ability to convey whatever he was thinking with a touch. I instantly felt better and more confident and secure; his faith in me came through as soon as I grabbed for him. I gamely followed all the directions they'd given me. "Good, good, good," the nurses were all saying. The pain in my hip was gone as soon as they'd flexed my knees back towards me and it felt exhilarating to be doing something, finally, after lying there for so long waiting for something besides the drugs wearing off to happen. I pushed maybe three times before they released my knees and put my feet in the stirrups that were at the end of the bed. "The doctor's not in here yet," the nurse told me. "I can do it without her, but I don't want to. So don't push."

Don't push? Whattayoumean, don't push? Pushing was doing something, I wanted to do something. I flicked on the television to distract myself while I waited and talked myself through the contractions. "Don't push," I hummed to myself. It felt like there was a grapefruit stuck in my butt; I wanted to push but I didn't dare.

Dr. Bushrod strode efficiently into the room wearing scrubs, shedding her white coat and exchanging it for a long-sleeved, cuffed blue cover-up sort of thing, donning gloves and a big plastic faceshield. "Do you want a mirror?" one of the nurses asked me. A mirror? I thought. Is my hair really awful? She must be thinking about pictures That's not what she was thinking of. She was thinking of a mirror so I could see what was happening. And, no. I very much didn't want a mirror. As much as I didn't want all my parts on display to the whole world, I didn't want to see them myself. Dr. Bushrod pulled up a stool, positioning it between my feet. The first thing I noticed was that the mirror would have been totally unnecessary; the plastic faceshield she was wearing was conspiring with the bright lights to become totally reflective; anything I didn't want to see I could now see as clearly as I could see Dr. Phil and his big stupid moustache still on the TV across the room. I had lost the remote control and frankly, I realized, I didn't care. I'd rather look at Dr. Phil than a reflection of my own gory genitals, especially after Dr. Bushrod picked up a tiny pair of scissors--no kidding, little scissors--and snipped an episiotomy.

A word about the episiotomy: yeah, I didn't really care. A lot of women take it as some kind of a personal affront; I just didn't care. Either I was going to tear or I wasn't, and I'd been hearing for weeks about how enormous Max's head was on ultrasound. I was picturing the Hamburgler in there; I didn't really care that much about how he came out. I guess I don't understand the women who are so horrified by their episiotomy; I picked good doctors that I was comfortable with and got educated and didn't let all of my control issues totally take over my head in the moment. I trusted them to do the right thing, and they did. It was fine.

"Here we go," said Dr. Bushrod.

It all happened fast after that. I was prepared to be pushing for hours; but all that time that I'd spent having to be coerced into pushing by the nurses seemed to have paid off. Dr. Bushrod gave good directions with each contraction: push just a tiny bit, push as hard as you can; push at 50%. I remember seeing Dan's face next to me and the wooshing of the oxygen mask they slipped over my face; I also remember my mother turning vaguely purple every time I pushed; she was pushing too.

Suddenly, I felt the baby slither free. It was a huge relief: seconds before I'd been pregnant, now I was most decidedly not. The difference was night and day and I remember heaving a huge sigh of relief. Dr. Bushrod held Max up for me to see him for a split second before passing him off to the NICU nurse who was waiting with a towel spread over her arms to receive him. He had fuzzy tufts of blondish hair that was full of bits of blood and other gore; he and I exchanged what I can only imagine was an astonished look of holy fuck! and he was whisked off to the other side of the room. I could hear him bleating noisily in protest at whatever was happening over there but I didn't mind; the activity on that side of the room was efficient, but not frantic; if he was crying he was breathing and I'd seen him; he'd been squirming and clearly a healthy newborn, even if he looked a lot like Dan's older brother in squashed-old-man form.

The doctor sewed up the episiotomy with a few quick stitches and positioned a basin under my butt to catch the placenta. I had to push more for the placenta than I had for Max. The heartburn I'd been suffering from for months finally paid off; I'd had a cough caused by reflux for weeks and finally by coughing in conjunction with the enormous pitocin contractions I was still having, the placenta dropped into the basin with a graphic-sounding squish. I never looked at it; I'm not squeamish per se, but there's some stuff I can live a long time without seeing.

They brought Max back to me, tightly swaddled in one of those ugly flannel receiving blankets with a hat squished down over his face. The first thing I did was strip all of that off of him so I could see him. He was totally normal looking: he looked just like a baby. He had giant hands and cute little feet and I thought he looked a lot like Dan. He did need to be monitored more closely in the NICU, though; low blood sugar is a major concern for babies of diabetics because they get excess insulin from the injections. He did have a couple of episodes of low blood sugar that first night, but I was, to be honest, a whole lot more concerned with what was happening to me at that point.

To be Continued...


Treen said...

Ughhh, the E word. I am one of those women. An episiotomy is the numero uno main reason why I live in fear of ever having children. It just sounds horrifying. I would rather they cut me in half and completely removed my top half from my bottom half to deliver a baby than have an episiotomy. I once had a dream that they delivered a baby through my calves somehow and when I turned around to look it was sewed up loosely with yarn. Fuzzy yarn. I'd prefer that to any pair or teeny scissors near my taint.

Anonymous said...

Eagerly awaiting part 4!