Friday, October 9, 2015

Meeting Maddie

On the eve of a fortnight since my newest and smallest child was born, I find myself finally sitting before this once-(more) familiar screen again. In small part, trying to fill the profound space and quiet left behind in the absence of my two oldest- who are on their way to reunite with me after a second successful trip to New Jersey- and my husband, who has returned to work and left me to figure this whole parenting solo during work hours thing out all over again.* Much more so, however, I am driven to continue trying to fulfill what seems a futile promise to myself, to get my brain working and my fingers dancing again; to put my head in a space where I can find appreciation for the beauty in the chaos around me and translate it to written form.

As always, it has been harder than anticipated. The lack of sleep, the desire to hold on to cherished moments with my husband, even if they consist of nothing more than sitting beside one another, devoid of conversation, the long commitments to holding a tiny, brand-new human being on my chest and soaking up the wonder of her- all of these things have pulled me in every direction but behind a lonely, glowing screen. And beneath it all, I wonder if I am ready for the finality of it- of putting into words a birth story that most likely will be the last I ever write. And doing so in a mental place I hoped I wouldn't be, still in the midst of a seemingly eternal longing that will perhaps never be quenched. Bringing a new life in the world has only made me remember more clearly why I started on the journey to help create another in the first place.

As for that journey, it was a difficult one; the most difficult of the four I carried all the way to birth. I hardly know where to start speaking of its ending, as the drawn-out nature of it was the most agonizing aspect of all. I suppose I could start at 24 weeks, when the overly-active contractions began, or perhaps 28 weeks, when I first dilated to one cm unexpectedly. But there would only be pain and frustration to speak of from those points, long weeks of feeling anxious, helpless, and out-of-control of my life.

Ultimately, there were no real changes in that time, either. No further dilation, no effacement, no issues with baby, and just the usual issues with me. No, the real changes made their appearance about a week or two later than the point at which some amount of excitement occurred with my second and third: 37 weeks. Perhaps there was something to that date, which urged my body into action. Perhaps it was the wedding that I took a chance on traveling a bit for, because it was a precious chance to reconnect to an old but somewhat estranged friend who still holds a piece of my heart, and always will.

In any case, when I noted along with my usual list of complaints some terrible back pain and a bit of spotting that looked suspiciously like bloody show at 37 weeks and one day, I finally decided to take a (likely) brief but worrisome run of five-minute spaced contractions seriously enough to make a visit to labor and delivery triage. It's always a tough call to make. I had already spent a long six hours there in the deep of night a couple of weeks before, and it was every bit as miserable as I had expected it to be, and ultimately it seemed that with or without the turbutaline I eventually received, it was likely unnecessary.

Upon arrival at the hospital, I expected another unpleasant stay with the inevitable outcome of being sent home. This time, at least, (being now beyond 37 weeks) I knew that no one would try to stop my labor, but I was fairly certain that it had not actually begun. Imagine my surprise, then, to find that I was suddenly at 2.5-3cm. It was a notable change, but not a big enough one to indicate active labor. I was encouraged to "ambulate," or walk around, for two hours. Despite it being a little early in the pregnancy, I jumped at the chance to get things possibly moving. I had to believe that despite whatever disadvantages may come with my daughter being born so early, it had to be better for her than being continually being barraged with all of the stress hormones I was likely producing in the extreme.

I tried to hold my hope in check, however. It's not as though I hadn't been this far dilated at this point in time before, and still carried my older two to term. However, the suddenness of the change and the frequency of contractions made it impossible not to hope just a little, and that I did for the two exhausting hours of walking that I forced myself to endure.

The walking perhaps pushed me a half centimeter into definite three centimeter territory. Perhaps not. Especially with a different doctor on shift by this time I often wonder how much the differing numbers I've gotten regarding the state of my cervix simply come down to personal perspective on the checker's part. However, three centimeters does not active labor indicate, and so I was sent home despite continuing contractions. Those contractions went on without stopping or changing in degree for another two hours before I called again to find out what I should do.

The answer was to come in again, which Tom and I did, only to find that the contractions had caused no physical changes. This news sent me into near-instant hysteria, delivered as it was in the presence of contractions so frequent that they were reason enough to be at the hospital in the first place. What was I to do, then, if they went on like this? Come and go all night? The doctor saw my plight clearly and, given my obvious level of stress, felt it was a reasonable call to admit me for observation overnight despite the unlikelihood of any immediate developments.

Thus began a miserable night of non-sleep in a terribly uncomfortable delivery "bed," accentuated by ringing alarms, blaring announcements, and the frustrated movements of a baby irritated by the monitor straps encircling the womb in which she still resided. The stadol that I was offered to "help me sleep" turned out to be a pain medication that only made me not care for awhile that I was not sleeping, and then left me feeling terribly hung over the next day, which dawned nearly free of contractions and otherwise without incident.

I was sent home to worry unendingly about what would happen if I went into labor the next day, Tuesday, the very last one for which Tom was scheduled to go into work. I feared that if things happened quickly, he would miss the birth trying to commute back to me. As it happened, labor was not in the cards for me on Tuesday, but all of the stress I was feeling about Tom's absence got a few contractions going and earned me my husband's early arrival home. Though they died down for a bit, they continued to pick up in strength and frequency through the late afternoon, and despite my fear of being disappointed again, I decided it was worth another visit to one of my least favorite places to find out if we were finally on our way to some significant development.

Despite another two hours of hopeless ambulating after checking in, once again, at three centimeters, it was not to be on that Tuesday evening either. Thankfully, I had a previously scheduled follow-up appointment with my OB-GYN for Wednesday morning to look forward to. I consoled myself on the tearful third drive home from the hospital with the knowledge that at least I didn't have to worry too much about not catching any developments that might occur over the next several hours, as they would be revealed by late the next morning.

Wednesday morning's NST didn't seem to be revealing much at all beyond some irregularly spaced and unpredictable-in-strength contractions. However, somehow, someway, my cervix had continued to dilate overnight, as was revealed by my doctor's check at the end of the appointment. I was now four-to-five centimeters, and in some new and different territory which allowed for some level of augmentation. Despite the fact that I was still in latent/prodromal labor which could potentially have gone on for hours or days more, we were cleared to go, and would not even have to stop in triage on the way.

Pushing down some measure of guilt over the knowledge that I was making a decision to budge my baby from her resting place a little earlier than she might have wanted, I focused on the elation that the long and troubling ordeal would finally be over soon, and that I would finally get to hold and name my eagerly-awaited newest daughter, my rainbow baby after a dark year of loss. It also occurred to me that I was hungry, but between my eagerness to get things started and my worry that I might be stuck on a pitocin drip right away that could cause me to lose my lunch, I elected to skip it.

That decision came back to bite me rather quickly as I found I would need to wait over three hours to even talk to the doctor on call and formulate a plan. In the meantime, as in the doctor's office, not much of consequence was happening in my uterus, since the contractions were all over the place. Though I was hoping for a quick ending, I still wanted to try the least-invasive route first. A membrane sweep had worked wonders for starting Michael's labor, so I asked to do that first.

Waiting on the doctor before incessant hunger set in. Not much happening, except not-sure-what going on with my hair...
Unpleasant as it was, it bought me nothing. The doctor was supposed to check in after an hour but was keeping fairly busy and could not swing by for over two more, at which point there was a shift change that caused even more delays. By perhaps three hours later I had decided to try one more thing before moving on to pitocin (the prospect of which terrified me): the breaking of my water. However, even as I moved forward with this plan I was doubting myself. I was hungry beyond belief and my energy was waning. Though we agreed as the crochet hook tool began its work to check back in two hours later, I wasn't sure I wanted to give the process that long, especially given that each return of a doctor seemed to be fraught with delays.

I made sure Tom got lunch at the hospital as soon as possible, but once admitted I was sadly not allowed much of anything.
Though I generally became more uncomfortable after my water was broken in that the sensation of every movement within was magnified, the contractions themselves were not becoming reliably stronger or more frequent. Even thirty minutes after the procedure this seemed to be the case, and it wasn't too much longer after that that I threw my hands in the air and decided to not only go for the pitocin, but to throw in an epidural as well. I was a long way away from the mindset I'd had as a first-time new mom that valued a natural, non-invasive birth over all else, though to be fair even going in to my firstborns birth with that attitude did not stop me from giving in to the offer of an epidural once the pain and exhaustion had swiftly managed to overwhelm me. This time it was not pain that swayed me, but the fear of it- of having to handle it when I already felt so spent- and the fear of any further source of anxiety when I was maxed out on stress to begin with.

Same view- same room, even- as that first night in the hospital, but this time with real hope that my daughter would come and be placed there very soon in the joyful moments following her birth.
 Thankfully, from the moment of that decision, everything went more quickly. The anesthesiologist showed up within 20 minutes or so, the pitocin drip was started almost immediately after the epidural was administered. All seemed to be going fairly smoothly except the way I felt, which was rather sick to my stomach and loopy in an unpleasant way. I began to find new things to worry about, like how I would know when it was "time," and whether I would find myself sick to my stomach even after the precautions I thought I had taken earlier.

However, once the pitocin got going, it was only two hours before my time came, and amazingly I did know when that was. I couldn't feel much, but I could feel that familiar pressure, and my nurse confirmed it and got the ball rolling shortly after 10 pm. It had been an impossibly long day, but now it was almost over, and it was still Wednesday, the same weekday chosen by the three siblings that came before.

I watched in fascination as my doctor returned for the last time with a back up team and more gear in hand than I'd ever remembered seeing before, including various layers of draped plastic and full coverage headgear. I tried not to panic too much about how much, for the first time in my childbearing experience (and despite the epidural) I was feeling an urge to push which I wanted badly to be able to give in to and focused instead on the organized speed with which my birth team was working. In no time, they were ready, and perhaps four pushes in I was led forward to help my baby the last bit of the way into the world and onto my chest, where she promptly peed all over me before gazing into my eyes for the first time.

Cranky Miss Maddie, who has mostly been anything but since coming home.
Though neither of us could commit to it until we saw her in person, Tom and I really only had one name in mind: Madeleine. However, the middle name was a surprise even to me, as I gave Tom the honor of choosing it himself, a revelation that he kept to himself until her birth. And there she was, a little early and a lot reluctant, but finally in our arms- healthy, beautiful, and perfect.

Welcome to the Wednesday Club, Miss Madeleine! You're in good company here.

Seven pounds, seven ounces, and 20 exquisite inches long; our tiniest one (and earliest) by quite a bit!

*As you may have discerned, despite my best intentions it took multiple days to finish writing this post, so while I may have started on the eve of a fortnight, I am ending two days beyond. The kids are all home, I am thus far surviving Tom's return to work, and we are settling in as a family of six as though we always were one.