The First Photo
Note: This post is really, really long. You may want to get a snack. The level of detail is high because I am afraid that I will forget all of this and I want to remember.
Throughout my pregnancy, things had gone rather smoothly. Most of the appointments lasted just minutes, as I was found to be measuring perfectly and things were moving along as they should be. Other than my doctor’s (unfounded) paranoia that I was going to get pre-eclampsia due to my “white coat syndrome” induced higher blood pressure (it was always fine at the end of the appointment when I was more calm and less anxious) and a scare that had me on bed rest during week 13, there were no worries.
I had an ultrasound at 32 weeks to check on the baby’s growth and at that point she was estimated to be five pounds and in the 57th percentile. At that appointment, I also learned that she was breech (head up). In fact, she had been breech at every ultrasound I had, except for the one at 20 weeks. I was not worried, because there was plenty of time for her to turn. At the next appointment, I mentioned it to the doctor and was told that if she did not turn around by 37 weeks, we could try something called an external cephalic version. Basically it involves giving the mother pain medication and medication to make her uterus more relaxed and manually turning the baby from the outside. The procedure has risks, so much so that it has to be done in the labor/deliver wing of the hospital in case an emergency c-section becomes necessary due to stress on the baby, a cord incident, or a drop in heart rate.
For the next couple of weeks, I tried to do a few things that would supposedly cause a baby to turn on its own, but I continued to feel her head/shoulders pressed firmly into my ribcage. At the next doctor appointment, at 36 weeks, I saw the midwife and she felt the baby and said that she thought she was head down. The last time someone tried to determine that from the outside, I was given that same diagnosis, only to have it be proven wrong by the ultrasound, so I did not believe it to be true. For some reason the doctor was not there, even though that day was designated for me to get an ultrasound and talk more about the ECV. I had to come back in the afternoon to see the doctor. At that appointment, I asked more questions about the ECV and the ultrasound was done to double check that she was still breech (she was).
The doctor also measured my amniotic fluid level and said that it was on the lower side, at 8.8. Normal range was 5-20. He said that the lower fluid was a negative for having the ECV done, as was the fact that this was my first pregnancy, but he still thought it could work. I struggled with whether this was something that I should do. If I did not, and the baby did not turn on her own, I would have to have a c-section. Neither option was really pleasant, but something in my gut kept telling me not to do the ECV. I felt like the decision not to have it done was the first parental decision that I had to make and I just had to rely on my instincts. I called the doctor’s office the following Monday and told them that I did not want to schedule an ECV. I was told that at my next appointment (that Thursday) they would schedule me for a c-section, for sometime in my 39th week.
That Thursday, October 27th, I went to my appointment, expecting to be in and out fairly quickly. I had my second non-stress test, where I was hooked up to a machine to monitor the baby, as well as any contractions (I had zero). I also had to push a button every time I felt the baby move. Toward the end of the 15 minutes, she got the hiccups, so I was constantly pressing the button and trying not to laugh, as it could upset the machine. The nurse practitioner came in and said that the baby looked great on the non-stress test and was about to send me home, when I asked about scheduling the c-section. She said that there was still time for her to turn on her own, but I told her I would like to schedule the surgery just in case, so that we could let our employers know when we would be gone. She said that the first possible date would be Friday the 11th, although that would be at the other hospital because the doctor did her scheduled surgeries there on Fridays. I was adamant about not wanting to have my baby at that hospital, for two main reasons: it was 25 minutes away, whereas the hospital I wanted is a two minute walk from my house and the other hospital had the possibility of having to share a room with another woman, her baby, and her husband. The idea of having to share a bathroom and living space with strangers (and their visitors), while trying to bond with my newborn and recover from a c-section was something that I was just not going to put up with.
The nurse practitioner said she would check with the doctor about possibly having it done at the hospital I wanted. She came back a moment later and said that the doctor wanted to do another ultrasound just to confirm the breech position before scheduling the c-section. We went into the ultrasound room and right away the doctor had a troubled look on her face (she has a bad poker face) and switched off the lights in the room to get a better view. She then said that she was not seeing any fluid around the baby. She asked if I had been leaking fluid and I said that I had not, aside from the normal discharge and occasional pee drip that pregnant women are accustomed to. For some reason I was not freaked out or scared or upset by what was happening and I really cannot explain why. I was very calm, even though the nurse practitioner looked worried as she said, “It’s nothing bad,” even as I was being ushered out of the room and the doctor was hurriedly calling down to the Maternal Fetal Medicine department to get me seen by a second doctor to confirm the fluid issue. The doctor told me that if I had not been 36 weeks, 6 days (one day short of the magic 37 weeks where babies were considered term), she would be sending me to labor and delivery to prep for surgery right away. Because I was one day shy, however, she needed a second doctor to confirm the diagnosis. (I always disagreed with her about my due date and always considered it to be a day earlier than what she did, because I based it on my cycle length, which had been on the shorter side, but we had to go by her date).
I headed down to get the ultrasound, calling E on the way, letting him know that he should be on stand-by. Part of me still thought that the second doctor would say all was okay and I would be going home. I had to wait awhile at the registration and later in the waiting area before getting the ultrasound and the fact that no one was rushing me in anywhere also calmed me and prevented me from freaking out that this was a really serious issue. After I was taken back for the second ultrasound, the tech started the scan and the doctor came in a few minutes later. The doctor was able to confirm that the fluid level was only 2.2 and that I would be having the baby that day. He told me that one of the risks of the lack of fluid was that the baby could be tangled in her own umbilical cord. He had the tech do extensive measuring to see if the baby was very small or if there were any other issues to be concerned about. He noted that the placenta looked aged far beyond 36 weeks and asked if anyone in my home smoked. Of course they do not, so he could not explain the condition of the placenta. The fact that it was wearing down already, however, was a sure sign that this baby was ready to be born. At the end of the ultrasound, the doctor confidently predicted that the baby would be around six pounds, ten ounces.
I called E again and told him that I was going to labor and delivery and he needed to come as soon as possible. The surgery was not going to be for several hours, as they wanted me to have an empty stomach and I had eaten breakfast that morning. He stayed at work long enough to complete a half day and then headed home to get our bags, which I had thankfully already packed. I had even repacked them the prior weekend to allow for a longer hospital stay because a c-section seemed so likely at that point. While I waited for him to arrive, I was given an IV and had to answer some questions. A monitor on my belly allowed me to hear the constant heartbeat of the baby, which was reassuring.
E arrived and we watched the People’s Court, expecting the surgery would be at 2pm. It got pushed back until 3pm because of another surgery that was more urgent that mine. I think that watching countless episodes of A Baby Story and other similar shows really prepared me well because I knew what to expect at each step of the process. I had to drink something to keep me from puking, E had to put on scrubs, and we both donned hairnets. I knew that I would be headed into the surgery room by myself and that E would come in later after the first incision. Knowing all this made me calmer. Had I not known this (it was not explained that day), I might have freaked out that he was going to miss it. Once I was in the surgery room, I was given the spinal, which did not hurt at all, and laid down on the table. I felt the numbing immediately, followed by a wave of nausea. I told the anesthesiologist that I felt nauseated and he told me that he had already started giving me medicine for that, as he noticed my blood pressure had gone down. It kicked in and I felt fine.
During this time, I heard two women counting equipment, like the number of scissors, etc. It was only when I heard them counting again at the end of the surgery that I realized that they were ensuring that the doctor did not leave any instruments in my body. For some reason that made me laugh.
The doctor said that she was starting the incision (I could not see anything, of course, as they put a large drape in front of me), and then I heard E come in the room and be directed to sit next to me. He held my hand and then what seems like immediately Miss M was born, at 3:34pm. She cried and was taken over immediately to be checked and warmed. E said, “already?” because it happened so fast. When the doctor had told us prior to surgery that it was going to take 20 minutes, he thought that meant until she was born, not the whole surgery. E was able to go over and take some pictures of her as the nurses did their checks on her. Someone remarked that she had a large head, something I had been hearing since the 32 week ultrasound. At 3:46pm, she was brought over to me and I had the chance to kiss her, rub her head, and let her know that I was her mama. I surprised myself by not crying at all, which was funny, because in the weeks leading up to her birth, I cried just thinking about the moment when we would meet.
E and the baby then went across the hall to the recovery room while I was getting stitched back up. The whole thing happened so fast and before I knew it my doctor was heading out the door. I thought it odd she didn’t say anything to me as she left, but she has never really been one for warmth or sentiment. I asked one of the nurses how much the baby weighed, but she did not know. I was then taken over to recovery and was in a bed next to Miss M, who was in a bassinet under the warming lights. Her breathing was a bit of a struggle, as it sounded like she was grunting as she breathed. The nurse kept monitoring her and checking her breathing with a stethoscope. I asked a nurse if she knew how much the baby weighed, not realizing it was the same nurse I had asked in the delivery room, who still did not know. Eventually we were told that she weighed 5 pounds, 11 ounces, a far cry from the 6 pounds, 10 ounces the doctor had estimated that morning.
Finally at 4:17pm, I finally got to hold my baby. She felt so small to me, as the previously smallest baby I had ever held was my niece at four days old, who had been 7 pounds when she was born. I did skin to skin contact with her, trying to help her feel better and regulate her breathing. Unfortunately it did not work any magic and when it was time for me to go to my room, Miss M had to go to the special care nursery for further monitoring. She stayed there until 9:00am the next morning (when she received a clean bill of health), except when they brought her in our room for feedings. I started pumping about three hours after her birth and was able to feed her the colostrum that I pumped. Unfortunately she also had to have formula the first two days, but I was so proud of the fact that by Saturday morning I was producing enough milk to be able to just feed her that via bottles.
When my doctor stopped by to check on me on Saturday, she said “it was fortunate you had your appointment when you did,” and her tone of voice made it pretty clear that we were beyond lucky that I had an ultrasound that day. I try not to dwell on what might have happened had the low fluid gone undetected and just count my lucky stars that I brought up scheduling the c-section that day (and complained about not wanting it done at the other hospital) or the ultrasound would not have happened until the following week, when it may well have been too late.
There is a lot that I could write about our hospital stay, but then this post would never end. Things I do want to remember: the fact that the nurses kept trying to convince me to take narcotic pain medication post-op when the Motrin was enough for me. One actually told me “don’t be a martyr,” as though I would willingly endure pain (I cannot imagine the terrible things they must say to women who are trying to labor without pain meds); the nurses were wildly inconsistent with the things they told us regarding baby care, hospital policies, and the like and we were presumed to know the hospital procedures, even though no one told us, which was very frustrating. Most of the nurses were perfectly nice, except for the one (who was not my assigned nurse, but the one that responded when I pressed my button), who made me cry at 3:00am (less than 12 hours after surgery, when I hadn’t slept and was stressed out by the fact that my baby was not with me and having breathing issues) by scolding me that I needed to put my colostrum in a different kind of bottle and couldn’t I really just take it to the nursery myself to be refrigerated? I informed her that I COULDN’T WALK YET, before bursting into tears. When she came back with the right bottle, she said nothing about my tears, even though I was still sobbing.
By Sunday we were more than ready to go home and thankfully we were both discharged and able to head home. We are still adjusting to being a family of seven, although the four feline members of the family are getting more and more accustomed to the tiny human.