Sunday, May 8, 2011

Birthing Day

In honor of Ayden's birthday and Mother's Day, I thought I would repost my birth story with Ayden.  You could also, if you are a sucker for repetition, read a slightly altered version of the story here, on Mothers of Change.

I became pregnant with Ayden on our honeymoon. We had planned on waiting two or three years before having children, so you can imagine our surprise when two very clear lines appeared on the pregnancy test!! My doctor laughed at our faces when she said, "So that pregnancy test is positive, eh?" Fortunately, nature gives us nine months to get accustomed to the idea of a baby before he pops out!
My job requires that I stop work and begin maternity leave six weeks before my due date. I fudged my due date to my employer to be able to work an extra two weeks, because I needed to work as much as possible to qualify for Maternity Benefits through EI (Canadian maternity leave is funded by the government), and because I felt very guilty for being three months pregnant when my boss hired me, and not disclosing this for fear of not being hired. Though illegal, it is difficult to prove. At any rate, I didn't tell him, and he about blew a gasket when he found out (two months later), so I felt responsible to stick around as long as possible. It seems dumb now that I even cared, but I did. My boss was a ridiculous jerk.
Two weeks before my last day of work, I was sitting leaning back in my chair at a paramedic course, when I felt like there was an enormous earthquake movement in my uterus, enough to make me slam my chair down and gasp (which of course made all my coworkers freak out--the pregnant lady just gasped!!). I had been enduring months of extremely active kicking and shoving from within, and this was the most violent movement yet.
On my very last shift in the distant town that I commuted to work in, in the morning as I got dressed to leave for my 2.5 hour drive home, I noticed some bleeding. It was four weeks before my due date, and I didn't know what on earth it could be from. I went over to the hospital to be checked out by the local doctor, who I of course knew quite well. He palpated my belly and did a full exam, kind and professional (always embarrassing having people you work with see your private parts). He reassured me that the small amount of bleeding I had was likely a minor irritation, nothing to worry about. But he did point out that I had more amniotic fluid than normal, and that my baby was in the breech position. All from palpation. The hospital was in a very small town with only very low tech stuff available.
I drove home, and the next day mentioned what he had found to my doctor in my regular prenatal appointment. She referred me for an ultrasound to confirm the baby's position at 38 weeks. At the time I wondered why she ordered the test so late, but I have since read that it is fairly standard to wait until 38 weeks before intervening with breech positioned babies, because attempts to turn them earlier can often result in a return to the breech position. In my case, 36 weeks would have been wiser, but we didn't know that at the time. At the ultrasound I watched the screen and thought I was astute enough to determine that the baby was a girl (despite not wanting to know one way or the other). Ha, ha. Once my doctor confirmed the baby was breech, she referred me to an obstetrician. I LOVED my obstetrician. She was very soft spoken and gentle mannered, intelligent and empathetic. She and another obstetrician, whom I didn't like nearly as much, attempted an external version in the hospital the following day. The baby was already measuring around 4000 grams (9lbs) and had a rather large head, and despite repeated attempts to get him to turn, he persisted. He was too big to turn. My uterus only put up with so much manhandling, and eventually they had to stop. I was surprised at how intensely such uterine manhandling affects a woman--I almost fainted later as we were driving home, and I felt nauseous and weak. I think I slept for a few hours after we got home (I remember that on the drive home from the attempted EV, Brent insisted on stopping at the mall to buy some object or other...I was frustrated that he didn't seem to GET how horrible I felt and how badly I wanted to go straight home!! I stayed in the car while he went into the mall). Since the EV failed, my obstetrician recommended a cesarean. I said, "Oh. Okay." And I remember being surprised when my OB looked visibly relieved and said, "Oh, good. Because a large research study published last year in Canada shows that it is safer to deliver breech babies by cesarean. It really is the safer choice." It was the first time I realized that I actually had a choice in the matter and didn't HAVE to follow my doctor's orders. Not that I disagreed with her, but that was the first time I realized that I could.
So, a cesarean was scheduled for a week later. I felt like a failure. I wouldn't even get to go into labour. But part of why I went along with the idea of a cesarean so calmly was that I knew that vaginal birth after cesareans are possible, so I figured that next time I could try again. At my post operative visit with my OB she indeed told me that "There is no reason why you can't have a vaginal birth next time." I'm glad she encouraged me, though I would have pursued a vaginal birth anyways. It was significant to me that normal birth was something she valued and encouraged me to have with my next pregnancy. It has also been determined more recently that the Term Breech Trial my obstetrician referred to had some major flaws, and the Society of Obstetricians and Gynecologists of Canada is no longer recommending automatic cesareans for breech babies.  But we didn't know that in 2003.
On May 8th, 2003, I went to the hospital at 8 a.m., after fasting all night. I was scheduled for surgery at 11:00 a.m. We got a room on the maternity ward and settled in. We joked around and took pictures. My mom was there, and my cousin, and my friend Keli. I don't remember Brent's parents being there but I know they must have been, because they were there immediately afterwards. My general physician was running behind, so my surgery got repeatedly pushed back because she was assisting my OB for the operation. I got crankier and cranker, because I was STARVING, and because I was so, so afraid of the surgery itself. Eventually they wheeled me to a waiting area outside the O.R., and I remember feeling very helpless and small, watching the ceiling tiles go by above me and anticipating surgery. I was afraid they would forget to get Brent before they started the surgery. I was afraid of the spinal anaesthesia. I was afraid to become a parent.
But eventually my doctor rushed in, and they prepped me, and although I threw my arms around the scrub nurse with all my strength in anticipation, making her yelp in surprise, the spinal anaesthesia didn't hurt that much, and wasn't that bad after all. I laid down, they put a catheter in (which I felt, but numbly), and soon after they pinched me with tweezers on my belly. As they were doing this, Brent walked in. I was flooded with relief, because I knew that as long as he was there with me, I would be okay. "Can you feel this?" someone asked me. "Yes." I could feel pinching. "What does it feel like?" "It feels like someone is taking tweezers and pinching my skin, lifting it up, and twisting it." The anaesthesiologist tilted the table so my head was lower than my body, to encourage the medication to travel higher up my spinal cord and numb me properly. This happened fairly quickly, and they started the surgery. As they cut, I asked Brent to look at me in the eyes and tell me all the things we would do with the new baby, and how wonderful it would be. As long as he was looking me in the eyes and talking, I felt calm. As soon as he slowed down or looked away, I panicked. When they pulled him out it felt like an enormous animal was gutting me alive. My whole body rocked back and forth, and I could feel my insides being pulled out. It took my breath away. The doctor asked Brent if he wanted to see whether the baby was a girl or a boy, and he looked over the curtain. He didn't say anything, and he looked back at me. "SO?!?!" I said. "Uhhhh...." and he looked back over the curtain. "It's a boy!.....And what a boy!" This was intended to be a joke, which fell absolutely flat in the operating room in awkward silence. I was so irritated, but only for an instant. "A boy? Really?!" I was shocked, having convinced myself we were having a girl. I remember someone asked what his name was, and we told them it was Ayden. Then I heard a baby cry, and I remember thinking "Someone's baby is crying. That's weird, that I can hear it from in the operating room." And suddenly a few minutes later it dawned on me that it was MY baby that was crying! Brent left to go to the baby warmer and cut the remaining cord, which they had left long, take some pictures, and meet the baby. I remember he looked at me just before he left, to make sure I was okay, but I felt far less anxious, and I told him to go with the baby. A few minutes later they brought him to me and placed him on my chest, bundled in blankets. He was quiet, blinking his eyes and looking around, his face all squished up fat by the blankets. Well, his face was chubby anyways, but the blankets squashed them even more. I held him for what felt like a very long time, and stroked his cheek, and tried to shield his eyes from the bright lights. Then they took him and put him in an incubator and he and Brent left while my obstetrician finished my surgery.
I was wheeled to the recovery room and told I could go upstairs and see my baby after I could move my legs, which takes about an hour. At first I felt no urgency, just tired and relieved that the surgery was finished. But within about fifteen minutes I was DYING to see my baby. I felt a sense of loss and eagerness, and could hardly wait until I could see Ayden again. I tried every few minutes, and finally after 45 minutes in the recovery room, I could move my legs. I called the recovery room nurse over and showed her, so she called for a porter to take me back upstairs. No porter came, and no porter came, and finally she took pity on me and wheeled me up herself one hour post operative.
In the meantime, Ayden was in the nursery with Brent. My mom had encouraged me to ask that no one hold him before I came back from the operating room and had a chance to bond with him, so she and Brent's parents crowded around and took pictures, but no one except Brent held him until after I came back. The pediatrician talked about possibly giving him a bottle because he was so big and might need feeding before I returned, but fortunately he didn't make good on that. Brent says he would not have allowed that to happen because he knew how strongly I felt about wanting to only breastfeed.
When I returned, Ayden was placed on my chest, skin to skin. And I finally felt I could relax. I was surprised by the strength of my feelings, and by my desire to simply LOOK at Ayden, for hours and hours on end. A bustling nurse asked me if I had fed him yet, and I said, "I don't know how." She said, "What do you mean you don't know how? There's nothing to it! You just put the baby on your breast!" And she bustled over and helped me. She had a kind look in her eyes when she said that, so I didn't mind. Ayden was a hoover vacuum cleaner. SUCK, SUCK, SUCK!
My family flooded into the room, all excited and chattering, and I was proud to show Ayden off. I was still starving, since I hadn't eaten since the night before and it was now dinnertime! So I convinced someone to give me some of their subway sandwich and lemonade, despite not having shown signs of return of bowel function (translation: I hadn't farted yet). I didn't care, I was SO HUNGRY! And then I promptly threw up. All over myself, the bed, and the baby. Nice. Everyone cleared out, and the nurse changed me and my bed with me in it. Brent was mad at me for eating before I was supposed to :)
Later that night, as the anaesthetic wore off my face and chest were incredibly, maddeningly itchy. My mom got me a wet washcloth and rubbing it on my face was very very helpful. I held Ayden skin to skin on my chest for hours.
The next day I was able to get up and walk, the catheter was removed, and I got to have a shower. I was still weak and sore, but mobile. I spent most of the day in bed with Ayden, feeding him often. That night, I developed a headache that was incapacitating. It was the type of headache that feels heavy on your head, and whose pain is so loud it is difficult to think. Every time I would sit up to feed Ayden, it would crush me. When I laid down, it disappeared. I was diagnosed with a spinal headache, which is a complication of spinal anaesthesia. A small amount of spinal fluid leaks out the hole the catheter was threaded through to reach the spinal meninges, causing a change in pressure that causes a headache when upright. My surgeon kept recommending a spinal patch, where blood is taken from the veins and injected into the spinal fluid, compensating for the pressure change and curing the headache. She would visit separately from the anaesthesiologist, who kept visiting and recommending a hands off approach, since my headache seemed to be improving. In the end, no patch was done, and the headache lasted two weeks, and I had residual vertigo for four months afterwards.
My milk came in that night, two days after his birth. One day earlier than normal for a cesarean birth, which my mom attributed to the near constant skin to skin cuddling. I remember that Ayden was always hungry, hungry, hungry before my milk came in, and then that first feed with milk he seemed to relax, and acted drunk when he came off the breast. He spit up a tiny bit and the spit up was WHITE! And I felt like the most AMAZING MOM IN THE UNIVERSE! LOOK AT ME MAKE MILK AND FEED MY BABY!!! Breastfeeding empowered me. At last, I was successful at something in this whole birthing/mothering thing. Which of course is not entirely contingent upon breastfeeding, because some women are unsuccessful at this but still amazing moms. But breastfeeding was really what redeemed the experience of Ayden's birth for me and set me off away from the attitude which I had had during the entire pregnancy and birth, that this was something that was happening TO me, and towards the attitude of active responsibility for my baby. I persisted, despite the spinal headache that required me to learn to breastfeed lying down (reportedly the most difficult position to nurse in, though because I learned it so early it has always been one of my favourite positions. Also, the large breasts are unwieldy for tiny newborns, and the bed helps support the excess breast tissue.
We went home from the hospital on the Sunday after he was born. Three days after his birth, and on my very first Mother's Day as a mom. Brent got me a card and put a photo of Ayden in a little frame that says "Mommy's Little Angel," which still sits on my bedside table. I cried. It was amazing and overwhelming to watch myself fall rapidly in love with this hungry, cranky little creature with big blue eyes and no hair and the most peaceful sleeping face imaginable.
And that is the birth story of Ayden Leonard Smith Vose, born May 8th, 2003 by cesarean section at 4:39 in the afternoon.


melissa joanne said...

Oh, I love birth stories and this one was no exception. Happy Birthday to your boy!

Anonymous said...

This story makes me cry every time...and I was even there. Thanks for being such an amazing mom to such an amazing kid.