Please excuse my long absence. I know so many of you are patiently waiting for the details of Bean’s arrival. Here they are.
On Tuesday morning I skipped work to tie up a few loose ends, just in case the biophysical profile indicated a problem that required intervention. I tidied the house, fed the cat some extra food, scooped the myriad litter boxes, put a few lamps on timers — just in case. I picked up the car seat, and said a silent prayer that we wouldn’t leave the hospital without a baby in it. I had this weird sense of foreboding that I kept pushing further and further down my throat.
We arrived at the doctor’s office and “Mercedes” (Favorite Dr. M’s best sonographer) was quiet while she performed the exam. She didn’t smile at our little coos over the baby’s movements and features. She didn’t smile at all, actually. She said Bean’s amniotic fluid levels were low enough to be concerned about her oxygenation in utero at that point, and she prepared us to hear that favorite Dr. M (henceforth – JM) would want to induce. We sat nervously in the exam room waiting on JM. The nurse said the doctor would be right in, “she’s just finishing with a patient.” R and I said we’d expected to see JM, not LM (his wife). We were nervous that LM wouldn’t know our history as well, and wouldn’t be as cautious as JM. We were wrong.
LM came in and said “You’re done. It’s go time. This baby needs to come out.” She said we could get some food and fresh air, but we wouldn’t be able to go home that night. She explained the plan very clearly. R was not dilated at all, and her cervix would need to be “ripened” for labor before the doctors could induce her. She’d get cervidil in the early evening, get a good night’s rest, and have the medicine removed in early morning. She’d have 30 minutes to shower and prepare for induction, and then around 6 am the doctors would start a pitocin drip to induce labor. I was relieved to get an overview of the plan, and felt good about it.
R wanted to get a little bit of food. I wanted to go straight to admissions. We compromised by getting ice cream sundaes and taking a short walk around the hospital (which seemed interminable to me).
Around 4 pm we checked in to our amazing labor suite. To say it was luxurious would be to understate the facts. I present the evidence.
We turned over all our legal paperwork to ensure that I could make decisions for Bean and R, in case of an emergency. We made sure people understood we were both the moms and were to be treated as such, and really, that explanation wasn’t needed. Everyone treated us with so much warmth and respect.
Around 5 pm, R’s nurse, Andrea, inserted cervidil to start ripening R’s cervix before inducing labor. She was not dilated at all. Andrea encouraged R to rest up for the big day ahead, and warned us that a typical course of cervidil-pitocin for first time moms would result in a delivery about 30 hours after the start of cervidil. We were ready to settle in for some rest and relaxation.
Around 11, R became increasingly uncomfortable. She shook uncontrollably and was writhing in pain. All the crap we learned in childbirth class was difficult to access and none of our planned comfort measures provided any comfort. I felt so helpless. It was miserable to watch my wife suffer so much, and to know it was expected to drag on for 24 more hours. By 1 am Wednesday, R was sweating and sick with pain. I called the night nurse, Traci, who offered some Tylenol for pain. I asked if the staff would check R again for dilation, and Traci said, “No, not unless you get to the point where you think you just can’t take the pain anymore. Then we’d check you to see if you made any progress.” R looked a little deflated. She was terrified that she’d get to the 5:00 am check only to find she’d made no progress at all. She continued to push through her pain without any meds.
By 3 am, I couldn’t take it anymore and asked Traci to help us figure out a new pain management plan. She said that R could try a little morphine and see if that would take the edge off until morning. I asked if she could check for any progress, and she discovered R was at least 4 cm. R really wanted to get to active labor before starting an epidural, so we debated the pain control options. Finally I suggested we go with the epidural.
By the time the epidural was in, R was already 7 cm. She’d only been in active labor for 2 hours. The baby’s heart rate was decelerating at regular intervals, and she appeared stressed. The nurses had prepared us a little bit for this possibility; many small babies have some trouble during delivery. Traci enlisted a few more nurses to help out, and two of them never left our side. One watched the monitor while the other turned R from side to side to try to relieve the stress on Bean. They started oxygen and IV fluids, and repositioned R repeatedly. I saw Traci come in and out, talking quietly to the other nurses. Soon the emergency on call physician was in the room, sitting quietly in a corner watching. Two other nurses came in, and readied the delivery trays and added equipment to the infant warmer. Our physician was on her way, but apparently had been in a deep sleep when she was paged. Traci told her R was almost ready to push, and Dr. K said “I already delivered that baby!” Apparently Dr. K dreamt she’d delivered Bean during the night. When she arrived, she still had pillow marks on her cheek and couldn’t stop yawning. I nervously asked how the dream delivery had gone. She smiled.
Dr. K suited up and soon R was pushing. I looked up and realized there were about 7 people in the room. I asked if there was always such a crowd for a delivery, or if we were just special. The nurse asked me if I really wanted to hear the answer. I said I guessed I did not want to know.
Around 4:15 am, R pushed through 5 sets of contractions and Bean emerged. It was the most amazing, awe-inspiring few minutes of my life. My love for R and pride in her swelled. I thought I would throw up from excitement and nerves. Dr. K handed Bean to R. The first thing I noticed was the meconium staining Bean’s bottom and her legs. And then I noticed the silence.
The silence was deafening. Bean was blue and limp. She did not cry. Dr. K calmly instructed me to cut the cord. It took me three tries. I couldn’t stop staring at the baby and wondering why she wasn’t crying. I began to cry. The nurses calmly scooped up Bean, and took her to the warmer. There were at least 10 people in the room. I saw the code cart. I heard people talking. I saw my baby, limp, lifeless, and unresponsive to stimuli. The respiratory therapists, neonatologist, and neonatal intensive care unit (NICU) nurses took over. R asked if everything was okay. I don’t know if I answered. I begged the nurses not to let the baby die. They brought me to the warmer, and let me talk to Bean and hold her arms down while they tried to push air into her lungs. She never drew a good breath. She made little grunting noises, and pinked up a little bit but her heart rate and oxygenation were dangerously low so the team put a tiny breathing tube down her trachea and placed her on a ventilator to force air in and out of her lungs at a normal rate.
One of the NICU nurses hugged me tight and told me the baby would be okay, she was just a little stressed and needed extra help. I totally lost it, friends. Not a shred of composure. R was calm and collected. I like to think she was riding the high of maternal hormones. I, of course, had none. I was a helpless bystander, a little too informed (I am a nurse by training) and totally powerless. I was torn between comforting my wife, who just finished the most difficult physical task of her 36 years, and keeping vigil over my baby as a team of skilled providers attempted to rouse her to life. R told me to stay with Bean, and I did.
I tried to calm myself and talk to Bean, just like I did when she was in utero. I tried to cue up a soothing voice as I choked on my own tears. The doctors placed Bean in an isolette and wheeled her to R’s bedside so she could touch her before they rushed the baby to the NICU for further intervention. R reached her hand in, and then we pulled the isolette away. I walked out with the team, trailing a ventilator and an assortment of life-saving medical equipment.
On the way to the NICU I called R’s sister and my mother, and started to rally the troops that we’d held at bay hoping to have the first hour alone with Bean to initiate breastfeeding and bonding. How different that first hour was.
In the NICU I held the baby’s tiny legs while the nurses tried to get an IV in her. It took them six tries to get a line in our sweet girl. By then she was mad. One of the nurses stepped aside to fashion a pacifier that would fit underneath the baby’s breathing tube. I held it in Bean’s mouth – a pathetic attempt to provide what little maternal comfort I could in midst of several steady hands working on our baby.
My mother arrived by 8 am, and I just fell into her. I was so tired. I hadn’t slept for 27 hours. I left mom in charge of watching over Bean while R and I slept for just one hour. We woke up and walked down to the NICU to see the baby, and she’d already been extubated and removed from the ventilator. She was on oxygen, and had a nasogastric tube to drain her stomach. The doctor said she’d practically extubated herself.
The nurses gave Bean prophylactic IV antibiotics to ward off infection in case she inhaled any of her first stool during the birth. Her tiny arm was wrapped in a stiff cuff to hold her arm still. There was tape all over her face, and her limbs were bruised from all the attempts to get an IV line in her. She was dehydrated, and so small. She looked like a little old man! But she cried and fought with the nurses, who all noted her fighting spirit. I think it’s pretty clear she’s feisty.
By Thursday, Bean was ready to try breastfeeding, and she latched on like a champ. The lactation nurses helped us tremendously, and we felt so fortunate to have such wonderful support for breastfeeding our little girl. Through the weekend, the NICU nurses gently coached us through providing progressively more care for the baby. We started tentatively, overwhelmed by the tubes and the machines that blared every time we held the baby or moved her. Bean’s heart rate and oxygenation occasionally dropped precipitously, which made caring for her a bit frightening but eventually we learned to trust our girl to weather the stress of feeding and changing and she got stronger by the hour.
The nurses stood by as needed, and offered really helpful suggestions for keeping her soothed and peaceful despite the noisy environment. We were lucky to deliver at a wonderful hospital, where all NICU rooms are private and have a day bed for parents to sleep on, plus closets and storage space for clothing and personal items. The unit had a little craft room where we made decorations for the baby’s door, which provided some respite for us.
Over the course of several days we saw each of the docs from the OB/GYN office. All of them took the time to hug us and talk us through what happened during the delivery. They answered all our questions, and helped us process the trauma we experienced so unexpectedly. They could neither explain the reason for Bean’s slow growth in the last four weeks in utero, nor the reason for her distress at birth. The working hypothesis is that the labor was too rapid for the baby to prepare herself, or maybe her cord was repeatedly compressed during labor and that restricted blood flow and oxygen which caused her distress. In any case, it was helpful to work through the events of the labor and delivery so that we could move forward.
Bean continued to improve, and had fewer and fewer periods of low heart rate and decreased oxygen level. On Saturday morning the doctors asked us if we were ready to take her home. We were terrified. What would we do without the machines to reassure us that she was getting enough oxygen and her heart rate was stable??? The doctor told us we had to stop relying on the machines and start relying on the baby to tell us what we needed to know. We all agreed we’d give it one more day to be sure the baby didn’t have any more “episodes.”
We got to bring the baby home late yesterday afternoon. She’s still a little vulnerable because she’s underweight and she had a pretty stressful first few days. We have to limit the number of people who handle her, because she gets stressed when she’s transfered from person to person, and because she’s more vulnerable to infection than babies who had a more typical start. But seeing her home, surrounded by the things that friends and family so lovingly made or purchased for her, has really helped me set aside the events of the last few days. I’ll process them more, later. For now, I want to enjoy my sweet girl.
I told one of my dear friends the baby’s full name, and he said it was fit for a queen. He’s nicknamed her “Queenie.” He said like all great queens, she made a grand entrance.