Jackson's Birth Story
by Sarah Harbin on Wednesday, September 14, 2011 at 11:44am
Tuesday, July 19, I was 39 weeks and 2 days pregnant. Walt and I went to dinner on Folly at a friend's rented beach house. They were serving gumbo, and we joked about the spicy food starting labor. I hadn't told anyone, but Jackson's movements felt different. Braxton Hicks had been going on for weeks, but now I was taking deep breaths during some of them. And I felt different; more in tune with my body and less with the outside world. I had a definite feeling that labor was imminent.
About midnight, I woke up during a contraction. It felt like tough menstrual cramps, the kind that curl your toes and bring nausea with them. It lasted about 30 seconds and faded away. I went back to sleep, waking up several more times during the night. I began timing with a phone app just to see how regular they were. 20 min apart, about 30 seconds long, with long breaks that probably meant I was sleeping through some. I felt amazing, excited but not jittery. I had prepared for this, and now I mostly just felt a lot of peace and a sense of being ready to do the work.
The only thing that worried me was how strong it was getting in my back. Jackson had turned from OA position to OP (with his back to mine) at 37.5 weeks, and I was worried about back labor. About 3 am, part of the mucous plug passed. I wanted to share the excitement with Walt, but we had been instructed to let each other sleep as much as possible in the early stages of labor. Around 4:30, he woke up when I came back in from the bathroom. He asked me if I was ok, and I finally got to say it out loud: "I'm starting to have some little contractions."
Wednesday morning, Walt stayed home for the first part of the morning to make sure things weren't going to progress quickly. We rested and added last minute items to our bags. Nothing was changing, so he went into work. I worked from home, did my prenatal yoga and went to the store. It's amazing how early contractions just become a part of your day. You have been expecting them for so long that their arrival is almost comforting, like a long-awaited house guest.
Liz was scheduled to do some last minute maternity photos of me, so we went out to Alhambra Hall and the Sullivan's Island beachfront . I'm so glad we got it in before the pregnancy I adored came to an end. Liz got a beautiful shot of me mid-contraction. And it was so amazing to be in the ocean, where the power and sound and smell consumed the discomfort and left only the wash of oxytocin and strength that rushed in on the tail end of each one. I drove us home, asking Liz if her driver being in labor made her nervous.
Things picked up Wednesday evening, but I still didn't feel we'd be rushing yet. The night was more restless, with contractions 10 minutes apart and 45 seconds long and harder to sleep through. I got up to shower before Walt left in the morning. We had decided that he shouldn't use up a vacation day if nothing was going to happen, but I was sad he had to leave. I had a prenatal appointment that morning, and we had called Hannah to drive me. Yesterday's drive through the Old Village seemed like a long time ago. I kissed Walt goodbye at the door in a bathrobe, and felt a contraction coming. The bathrobe and towel on my head felt incredibly heavy, and I told him to shut the door. I dropped it all and stood there breathing through the contraction. I heard Walt say quietly, "You're beautiful."
At the birth center, Laurie (one of the midwives) asked how I was. I couldn't resist messing with her a little. "I'm in labor," I said. Then I explained it was still pretty early. She put me on the monitor and examined me. We were 100% effaced but not dilated yet. A little frustrated that 33 hours of early labor hadn't made more progress, I tried to remain optimistic. Effacement is still progress, and people overlook that. She told me to call when I reached the five minute mark or if my water broke.
I spent the rest of the day in bed, watching junk tv so I could mute it when I needed. The rest of the mucous plug passed, beautiful like a tiny red octopus. The back pain was stronger, and my sense of peace was slipping a little to frustration and nerves. My instinct whispered to me that something might be off. But I knew that we would handle what came along, and tried not to focus on it.
During one contraction, I knew I was having trouble staying on top of it because I thought, "Augh. Forget this. Just go get a c-section and get it over with." I was just frustrated; giving natural birth in water was so important to me. I had wondered for a long time if I would recognize the paper tigers that pounced during difficult moments. I saw it right away and began taking deep breaths and revisiting all of the amazing stories and encouragement I'd read. Feeling better, I went back to breathing through it all. I texted Christie, who sent back encouraging words.
I was practicing a visualization exercise I had almost zero faith in where you imagine your body opening like a lotus, and I suddenly felt a distant pop. Immediately after that came a small gush, like marsh water in your shoes. I was lying on expensive new sheets, so I shot off the bed. Yay! This was a welcome change. My excitement faded when I saw the fluid. It was murky and textured. I thought it was supposed to be clear? I made a handful of phone calls, first to Laurie. "I think my water just broke, but I'm afraid if that's what it is, it isn't clear." She reserved judgment but told me to come in. Then to Walt, both Moms, my sister, and his sister Sara. Neither of the Moms nor Sara had seen their amniotic fluid before, so they could not reassure me that it wasn't what I feared.
Walt was on his way home from work and headed for the birth center. His Mom picked me up and we headed that way in what had been one of my most dreaded scenarios...5:00 rush hour. I am not patient in traffic, and I despise rush hour in Charleston. To top it off, there was an accident at 526 and I-26. We sat in traffic for a long time, with me pleading to escape it during contractions and apologizing while chowing down an apple and banana between them.
At the birth center, my family was excited but I was all business, waiting for my examination. Lesley took me back, but when she saw the fluid, she didn't need to examine me. "Yep, that is meconium. Get dressed," she said, "and we are going to talk about what is next." I wasn't sure, but I couldn't see how they could let me in their birthing tub with meconium flowing all around us. In her office, she explained that there was an infection risk and that we would be transferring to Trident Hospital. I couldn't help but cry. We had protected our birth plan like a fragile egg through an in-utero diagnosis of hydronephrosis, positive test for the digestive bacteria Group B strep, and severe edema that had my blood pressure creeping upward. Lesley reminded me of all of this, and said, "We have never transferred a birth that didn't end with us saying there was a reason, that we are so glad this one was delivered in a hospital setting. Trust me, this will all make sense in the end."
We diverted the rest of the family to the hospital, and I arrived angry and frustrated. "In ten minutes, I will be a happy laboring pregnant lady. But right now the birth I pictured is out the window and I want to be a royal bitch." No one argued with me.
My mom and I took over my L&D room, putting up a poster I'd made with facts, reminders, and encouragements from the books I read and our notes from birth class. Lesley had an electric oil diffuser, and I had brought lavender oil. We dimmed the lights and unpacked the picture of my mom and dad, the "God Bless This Child" plaque that hung over my crib, and the quilt Loretta had made. I changed into clothes I could work in, and they ran my IV. We met our L&D nurse, who was wonderful and believed in the value of natural birth.
They had to start me on a little Pitocin to get me dilated, but I asked them to keep it at the absolute minimum. The fetal heart monitor had to stay on, which restricted my movement further. I tried to set things up to make the best of it, sipped on protein drinks, and Walt and I got down to work.
By this time, it was 10pm Thursday. I had been at this for 46 hours, and though I was well practiced I was also tired. Back labor makes it difficult to sit down, so the birthing ball and rocking chair weren't going to work. I labored standing or leaned over the bed with Walt or my sister applying pressure to my back as long as I could, but eventually I was just too tired. I lay on my side with my Boppy pregnancy pillow, Julia at my back and Walt facing me to breathe through the contractions, both Moms in the background encouraging me.
I sent them out when I had to pee, which was often due to the IV, since getting to the bathroom with all the wires was frustrating and sitting down on the toilet was uncomfortable. Eventually Walt just brought me a cup and slipped out until I was relieved. At some point I became aware that I had given Walt's mom my phone and that she was still timing the contractions. I was having trouble staying on top of the pain, and falling asleep between them and waking up with too little time to prepare myself before the next one. Falling asleep between contractions is a blessing when you're relaxed, but I had worked myself into a stress ball and was only sleeping out of exhaustion. And exhaustion is your biggest enemy in labor.
Hilarity visited our tense little room when Walt, sitting by the bed on the birth ball, fell asleep. He rolled backwards on the ball, and his mom stuck out her foot to catch him. He switched to a chair and eventually, his hormones flowed in tune with mine and he would wake up instinctively seconds before I did, ready to coax me through another contraction.
I needed to get back in it, so at 2am Lesley and I decided to use sterile water ampules. These are injected in the small of your back and serve to block the nerves that deliver back labor pain. They feel like someone putting cigarettes out on you when they go in, but the relief is instantaneous and amazing. Immediately after getting them, I could think clearly enough to realize we were doing a few things wrong. Why did I have so many people in the room at once? Who ever needed to time contractions like a monitored lab rat? How could I be ready for the next contraction if all I was doing was surviving the current one? I asked our moms and Julia to go to the waiting room, and Walt and I started practicing labor breathing. We took deep, heavy breaths in unison, and when the contractions came on I just breathed deeper and held on tighter. I told myself that I had been through plenty by this point and that this one would pass into history just like the rest had. For two hours, we enjoyed real, manageable labor. This was how it was supposed to be, and probably would have been if not for the complications. We worked hard, staring into each other's eyes, and I fell in love with him, with the process, and with my body all over again. It was amazing, and it will be the thing that helps me choose natural labor again. I felt refreshed, high from the heavy oxygen intake, and at the same peace as while sitting in the ocean on Wednesday afternoon.
When the ampules wore off, I asked Lesley to do them again. Same injection burning, same relief. But this time I had a ton of oxygen in my bloodstream, and I metabolized them in under 45 minutes. When the back pain returned, I knew I couldn't handle the injections again for such short relief. It was 6am, and my exhaustion wasn't a paper tiger. After 54 hours, I needed an epidural.
Amazingly, I wasn't dilated enough yet for the epidural, so I made the only decision I am unsure about in retrospect. I had narcotics put in my IV. They dulled the discomfort slightly, but they made me loopy and emotional during contractions. It wasn't really worth it. However, I was in a difficult position and maybe I'd do the same if I had it to do all over again.
The epidural was night and day, and I understand now how for women who don't handle pain well, it is a lifesaver. I learned when I destroyed my ankle in 2006 that I handle pain better than I handle medication. My hours of unmedicated labor showed me how strong I am and made me appreciate my body so much. I would not want an epidural unless I had to have one again, but it served its purpose well when the time came. You could see huge contractions on the monitor, but I felt nothing. It was sad to be taken out of the game, but I needed the rest. Numb from my chest down, catheterized, Pitocin cranked up and unable to move, I slept most of the morning. At 10am, I was 8 cm dilated. Laurie came in to take over for Lesley.
By noon Friday, I had slept so much that I had not kept amping up the anesthesia as I should have, and it was wearing off. The only strong pain I noticed was severe stomach cramps. I hadn't had a real meal in 24 hours and a lot had happened. Laurie said Jackson's heart rate had dropped slightly, and that though I was 9.5 cm, he hadn't dropped. She could feel his head molded by my uterus pushing him down, but the rest of him hadn't followed. I started to understand why we had meconium in our fluid. And since he was OP before my water broke, he was probably still in this position, making his trip down more difficult. By all estimations, I probably needed to give birth by Cesarean. I tried pushing once, but was unable to move him. Laurie had another mom coming into the birth center in labor, but would send Lesley in to see us through.
I sent everyone but Walt out of the room and asked him to put on "Blackbird" from our birth playlist. Tears rolled down my face and I thought back to that frustrated contraction, a million years ago, in bed at home. Was all of this a waste of energy? Should I have thrown in the towel then? "This is my worst nightmare," I said.
Walt held my hand and said, "No, your worst nightmare was being bullied into a medically unnecessary procedure. You have done everything, you have made the best decisions you could have made. If you do this, it will be because you need to."
Lesley explained that I could take two hours if I wanted to push, but if nothing happened, I would need the surgery to protect myself and Jackson. This would mean I could not deliver at the birth center by VBAC later, I would have to be in the hospital. I was more exhausted than I could have imagined possible, and my stomach pains were overwhelming. I decided to just go with the C-section. My mom and sister, exhausted as well, came in to comfort me before surgery.
My anxieties got the better of me briefly as we transitioned into the operating room, and for a little while there under the bright lights, I was a pretty bad patient. But the anesthesia started to work, and when Walt came in his presence comforted me. I recalled our birth class where Cynthia walked us through a C-section as we squirmed in our seats. First would be the numbing, then the cut, then the pressure, then the sweep of the placenta. It all came back to me. Our birth playlist tinkled in the background, playing Rufus Wainwright's version of "Hallelujah," Chris Thomas' "Brian Petit," and Allison Kraus' "Down in the River to Pray." The doctor and Lesley talked to each other, the nurses and the anesthesiologists talked to each other, machines beeped, and I shot nervous questions over the blue divider while Walt comforted me and we exchanged I love yous.
And suddenly, over all of that noise in the tiny room, a baby cried.
Walt and I stared at each other for a split second, and then both of us began to cry too. They lowered the divider and Lesley held him up, screaming and bloody, for me to see. He was beautiful, long and loud, and looked exactly like his 32 week ultrasound. Jackson Walter Markiewicz, born at 3:39 on July 22, weighing 7 lb 14 oz, 21 inches long and with the craziest molding on his head that you'll ever see. They bathed him and Walt ran over to take pictures. Then a nurse brought him over, swaddled and wearing a hat, and explained that he had pneumothoraces, or pressure from air around his lungs, and he was headed for the NICU. He blinked up at me, impervious to the words flying over him. I kissed his face over and over and wished I could hold him. But they needed to take him and I was shivering like I was lying in an ice floe, so I just kept asking the nurse when I could feed him and when I could lie skin to skin with him.
Lesley brought me apple juice for my stomach during recovery, and I discovered that I had taken my "God Bless This Child" plaque with me to the delivery room. I had forgotten that. They wheeled me down the hall, on my back under recurrent fluorescent lights like in the movies. I saw a man walking backwards out of a room, and then they wheeled me into that room. The man followed us in, and he turned out to be Jackson's neonatologist, Dr. Shepherd. He said Jackson was doing great, and that I could visit him in the NICU when I was able to get up. The nurses said that I would need to stay in bed overnight. I slowly realized that this meant I would not see Jackson until the next day. The only thing I could do was accept this. If I let the disappointment creep in, I would unravel completely.
Our family visited Jackson, and every time Walt went over I asked him to take pictures. I pumped little victorious golden drops of colostrum and tried not to have a breakdown. The next morning, I pushed the nurses to help me get the catheter out, then to the bathroom to prove I could walk and pee on my own, then the IV out, then in a wheelchair on my way to see my son.
About noon, Walt wheeled me across the hall. I was stunned to realize the NICU had been so close all this time. He helped me stand up at Jackson's cot in the NICU, where I could touch and kiss him. The same nurse I questioned in the operating room explained that Dr. Shepherd would have to examine him before he could have my milk, but that it would probably be by bottle. We helped her bathe him, and when the doctor came around he listened to his chest and said, "Would you like to nurse?" I almost fell back into my wheelchair. They set up a divider and while he was still only wearing a diaper, he latched on before I even had a chance to wonder how to do it. We lay skin to skin and nursed for the first time.
I had imagined a hospital stay being harsh and confrontational for our leftist hippie ways. But we felt like guests rather than patients at Trident. They backed us 100% on breastfeeding and baby bonding and did what they could to make us feel at home and comfortable.
The next day, while Walt was at Josh and Olena's wedding as a groomsman, they let Jackson room out with us and Mom and I surprised Walt when he came back in his tux with a baby in the room. The day after that, we came home. That was almost eight weeks ago, and it has been the longest and shortest eight weeks of my life. We watched our little baby get x-rayed for his hydronephrosis and accepted that in another era or culture, we would have both died from our labor complications. We stand in awe over him as he sleeps, unaware that our whole little world has revolved around him since the day I saw that second little pink line. Our friends and family, particularly my mom and Julia, have extended themselves greatly to assist us as we transitioned from two to three in all of the awkward, frustrating, amazing ways that you do.
I have been overjoyed and felt love to the point of sobbing, I have experienced a brief bit of PPD, and I have looked in the mirror and not known who was staring back at me. It has been a joy to get to know that person all over again, as well as my partner, and most of all, our son. As he lies here on my chest chirping at a pacifier that has slipped out of his mouth, I think about all the other moms in the world and history going through this too. Before I went into labor, our pastor said to me, "A million other women have done what you are about to do. But not you." Like falling in love, giving birth is comfortably universal, but also singularly your own.
I realize now that my whole labor, that anyone's whole labor, is a beautiful and incredible journey. Your experience is the sum of its parts, from start to finish, and that is the best reason that being present and being part of the process is so sweet. When I made the decisions I had to make, I hadn't given up or failed; I had been led slowly out into the deep end and made the best moves that kept my lungs full of air and delivered us both safely to the other side. Every one of my 64 hours of labor, from the first contraction through our surgery, was part of becoming a Mom, a little lesson I needed to learn to get there.
That's incredibly beautiful.
ReplyDeleteThank you, Sarah for sharing this with us!