The axe forgets, the tree remembers...

This past Saturday night was really, really awesome.

A local group that supports quality maternity care and informed choices spread the word about these important issues by performing the play Birth. I volunteered to read a major role almost 3 months ago. I was a pretty huge drama "nerd" in high school, so I was excited to be able to "return to the stage" after more than 10 years. No late night rehearsals, no memorization...we read our monologues from binders with very minimal prop usage and scenery.

 

The role I chose mirrored my birth experience in many ways. A naive first time expectant woman, a woman wanting to "follow the rules" and not act out of line, a woman who gave birth in a room full of cold, impersonal doctors and staff. It haven't spoken much about W's birth story, but now seems like the time to let some of it out and move on...

In many ways, my pregnancy was beautiful. I spent 9 months daydreaming, journaling, napping, and counting down the days until we would finally meet our little boy. Jay was incredibly supportive and reflective along with me. My love for him grew so intensely during this time in our life together...we were going to be a family. I felt fantastic. I kept my job at the gym and worked out daily. I even continued to coach gymnastics up until the last 3 weeks of my pregnancy. I had a smile for everyone, and the date "August 1st" rolled off of my tongue so nicely to every passerby who wished me well and wondered "what's your due date?"

The only instances I felt any discomfort were during my prenatal appointments. Like many others in this country, I had no medical insurance when I discovered we were expecting. I panicked. Both of my jobs offered no health benefits, and I never really stopped to think about setting a plan up for myself once I was off of my father's plan when I turned 25. I received information about applying for medical assistance, and found out that I qualified. Each and every expense would be covered, right down to my prenatal vitamins. This really was a blessing, but it came with its own costs.

The OBGYN that accepted my insurance in our city was a womens clinic in a not-so-great section of town. Relieved to be receiving care, I walked into my first appointment, only to wait for an entire hour before being seen. All was forgotten after our first sonogram, where I saw baby W's heart beating for the first time. A little twinkle; a glimmer....a flickering light full of promise and strength. I pinned the photos to the sun visor in my car and glanced up at them the whole ride home.

Each subsequent prenatal appointment left me feeling uncomfortable and barely cared for. I found blood on the floor in the bathroom. I waited in line, on my feet, for 25 minutes each time just to check in. The waiting room smelled badly and from behind the pages of my magazines, I observed pregnant women cursing, fighting on their cell phones, eating junk food and leaving their garbage. Towards the end of my pregnancy, every time a doctor (a different one each time) would check me, a medical student would, too. According to a 20-week sonogram, measurements of fluid in W's brain were looking not quite right. We ended up seeing a maternal fetal medicine specialist, which only led to more sonograms and a lot of worrying and tears. The very small and minimally furnished room they lead you to when they tell you "there's a chance your baby may have Down's Syndrome"  is a frightening place to be. We opted out of any and all invasive procedures. Everyone, everyone told me "it's going to be ok", but those weren't the words I wanted to hear. I spent much of my third trimester obsessed with sonogram photos....looking for bone disfigurations in his fingers, toes, nose. Our blood tests were normal. Doctors told me "not to worry." I listened to "Songbird" by Fleetwood Mac constantly and sang through my sobs.

All the while, I longed for more personal care and some kind of support; even another friend who was pregnant. I wanted to know my doctor. I wanted a natural birth; no drugs, no medication...a vaginal birth. Maybe even in water! I wanted specific music. I wanted to use a birthing ball; I wanted to walk and be upright. I did not want to be induced. A homebirth sounded fantastic, but I didn't know of anyone who had experienced one, and I definitely didn't know of any local midwives. I was sure they wouldn't take my insurance, and we couldn't afford to pay for the services out of pocket. I wrote a birth plan and packed our hospital bag a month early. The days were passing, but not quickly enough for us! We were the most excited expectant parents you'd ever see. We were trusting. We were trying to remain positive.

Our due date came and went. My prenatal appointments were now every other day, and I was checked very frequently. A resident asked for my permission to rupture my membranes. I didn't want him to, and felt very much bullied by him and his condescending tone. "Oh, you want the natural birth, right?" He sat me down to talk to me about induction. I started crying and trying to explain that I vehemently did not want to be induced.  "Why not? Most women feel great about knowing that their baby is coming with our help!" I knew the baby was coming ....but in his own time, and with good reason. Documents were put before me, and the only thing I clearly remember is seeing the word Cytotec and "administered vaginally". I knew that this was a dangerous drug, not at all intended for pregnant women. I quietly questioned this, and he assured me that I had nothing to worry about. I signed the papers to be induced in 3 days, and went directly to the bathroom down the hall.

The stall I locked myself in reminded me of my high school...dirty yellow painted doors, a bit of grafitti, no toilet paper. I cried and cried. I started to feel like maybe I was behaving a bit overly dramatic and pulled myself together to receive my check out papers.

Upon arriving home, I called the hospital. I told them that I had signed the papers, but I really wasn't comfortable at all with being induced. Surprisingly enough, they moved the induction date 2 days later. "But once you're here, you're not leaving without a baby, one way or another." Nice.

That night, at 11:00, I woke up to my water breaking. I climbed out of bed, woke Jay up, and called the hospital. I was joyous and so very excited. As we stopped at the grocery store on the way to the hospital (to pick up my final meal...raspberries and a peanut butter protein bar!) I could feel contractions getting stronger. This was it! The world seemed so asleep; no traffic, stores darkened, signs turned off....but I was very much awake, alive, and changing by the minute!!

When we arrived in triage, I was put on pitocin almost immediately. As the nurse hooked up my IV, I watched a print out from the monitor strapped around my belly. She explained to me that the jumping lines meant a contraction....and looking back at the papers, even my untrained eye could see that they were progressing and becoming bigger. But still, I was put on pitocin because my water had already broken.

Even if you know only a tiny bit about labor and delivery standard practice, you'd probably be aware that pitocin contractions are unnatural and extremely painful. No woman goes without an epidural if she's receiving pitocin. I managed 4 hours and an incredibly painful and invasive foley ball (a "balloon" placed in your cervix and syringed with water to manually dilate a woman quicker) before I requested pain medication. The foley ball is a dreadful memory and certainly the most pain I have ever been in. What's most painful is my recollection of the student doctors who administered it to me. They looked so uncomfortable as I shrieked so loudly in pain, that when they were done, they left the room without saying a word to me. They came back a few hours later with a stack of papers for me to sign. I finally got the epidural.

Because I didn't have private medical insurance, I was a sort of test subject, and I am not kidding. This had been later confirmed to me by a midwife and several other reputable birth professionals. I was asked to read and sign thick packets of papers, detailing tests and studies, at 4am, while in active labor. I signed. I wanted to speak up, but I didn't want to be more of a disturbance. I didn't want to be treated badly. I saw how I was abandoned after showing signs of discomfort and "acting up." They tinkered with medication levels, they used internal fetal monitors, which looking back, just made me so incredibly sad. They told me when I was having a contraction. I was checked more and more frequently, until I finally ran a fever, a sign of infection. I was shaking. I wanted water so, so badly. I tried  some visualization while listening to my headphones, but it didn't work. Every time I opened my eyes again, I was still in this cold and unfamiliar place, unable to find peace. I couldn't listen to my body. I had nothing to do with my body at this point. The attending nurse told me, "You'll have to calm down. I'm turning off the lights. I'll be back in 15 minutes." She was downright cold to me, and it only got worse. Among other things, I kept thinking, "Why don't you like me? What did I do? I'm in labor!"

While she was gone, I had a very real urge to push. My bottom hurt so badly from laying propped up in the hospital bed all day long. The internal monitors stuck out from inside of me like fishing poles. Fishing poles, that's all I kept thinking. When she returned, she went towards the bottom of the bed and started putting thick socks on my feet. "You're going to have to start thinking about the very real possibility of a C-section. Your water has been broken for almost 24 hours. I know you wanted a natural birth, but you can try again next time." She removed my necklace, a baby ring that was my grandmother's on a gold chain from my mother, and put it in a urine sample cup and instructed me to write my name on it. I was being prepped for surgery as I felt the strong urge to push and stand up.

I spoke up, "I need to push or something is going to burst inside of me!!!!!!" Reluctantly, and I could very much see and sense the reluctance, she allowed me to push as she sat next to the bed. She called for someone, and they came in and started breaking down the bed. I felt a surge of positivity and energy. This was happening. I kept pushing. Doctors suited up and prepared a warming station for the baby. Oddly colored green medical "paper" was all around me and I felt like I was surrounded by weird people in masks, googles, and splash guards, like I was something unclean and dangerous. What did they think was going to happen? I felt like a specimen being observed by 2 doctors and 6 medical students. There I was, legs wide open, on my back, attempting to push my baby out. The attending nurse kept yelling for me to clasp my hands behind my knees. I couldn't do it, and I consider myself pretty flexible and conditioned. That's all she kept insisting. "Hook your elbows behind your knees!" I stared up at the ceiling tiles. The lighting was bright and flourescent. I thought to myself, "Here you are. This is happening." I never really had the urge to scream, but I was out of breath, mostly from having to hold it during pushing. This seemed very counter inuitive (I later discovered that this is called "purple faced pushing" and is not recommended.) "You can curse if you want to!", said the nurse. Why would I want to curse during the birth of my son?? I was getting angry. In fact, I was downright pissed. Gone were the hopes of a gentle birth, dim lighting, smiles, elation....The doctor kept moving the internal monitors to the side (they were still inside of me, those fishing poles...) and using his hand to quickly sweep back and forth inside of me, kind of in a "U" shape. I felt like throwing up. "I need to give you an episiotomy, Rebecca." No sooner were the words out of his mouth that I was cut. And I screamed. I became more angry and felt afraid, but the intense feeling of understanding that I was birthing my son any minute was pulling me through and keeping me somewhat positive.

Wesley was born at 10:42 PM on August 7, 2009, after only 25 minutes of pushing. The nurse brought over his purple little body to the side of my bed and displayed him to me. I noticed the sweet cleft in his chin. He was taken away, and it would be another 90 minutes before I saw him again. Nurse began kneading my stomach, and it felt like someone was punching me. I had this dreadful feeling, "it's not over." I delivered the placenta a few moments later and it was discarded, probably to be incinerated as hazardous waste. Waste. My baby's first home, his safe cocoon full of nutrients and miracles.

A student doctor began repairing my episiotomy cut with the superivsion of the doctor. They spoke no words to me, but conversed in their medical terminology. After the stitches were in place, a doctor informed me that they were missing 3 sponges. As standard procedure, they needed to check if they were still inside of me. So up went the hands of yet another stranger, after receiving 7 stitches to the most sensitive spaces in my body, which didn't even feel like my own anymore. A clean up crew came in and disposed of linens, medical paper, and full trash cans. I asked the nurse for water, which I had been craving for almost 26 hours. (as someone who needs a water bottle everywhere I go...in the car, on a walk, by the bed....this was really killing me.) "You'll have to ask the doctor." Thankfully, he said "yes", and the nurse returned with 2 plastic applesauce-looking cups with a foil top. She shoved the straw into them and wheeled a tray up to my bed. It was cafeteria apple juice.

I was beginning to get feeling back in the lower half of my body. I felt the urge to urinate, and I expressed this to the nurse. She handed me a bed pan. She actually kind of threw it onto the bed. What was I supposed to do with this? I couldn't lift my hips! "I can't go", I said. "Well, I'll have to cath you...", as she inserted another catheter into me. That was it. I shrieked again in pain as she flipped some kind of plastic switch and I saw urine flowing into a clear tube. This woman. I will never forget her. Her name is Jan. She's an older woman with a stern face and curly hair. She treated me with no kindness or respect for the milestone in my life that she was in attendance for. I certainly didn't invite her. Many times I have considered writing a letter to the hospitals L&D department. But what would be done? Would it be read? The more I revisit this, the more I think that I may just show up there one day...that would take some major guts on my part.

Wesley was taken to the Pedatric Intermediate care unit immediately after he was born for observation and to be administered medication through an IV. As a precaution, he was being treated for the possible infection and fever I ran during the last hour of my labor. (probably brought on by the epidural, also known as "epidural fever") It had been 2 hours since I had delivered him. Still lying in bed, I was wheeled upstairs into the dimly lit room where I saw him laying under a warmer and crying; his little pink arms flailing. Jay had been there the entire time, thankfully, as the student nurse attempted 3 times to find the correct space for his IV, gave him formula, a pacifier, and his very first bath, all against my wishes and what had been clearly outlined in our birth plan. He (the nurse) was laughing and joking around, acting very non chalantley as he told me how my baby "screamed for the first half hour non stop." I was placed next to the warmer, and I glanced at my reflection in the large window next to me. It was 2 am, and the world was dark. I clearly watched myself holding my son, with a little splint on his arm to support the IV.  I sang to him for the first time as I coaxed him to latch onto my breast. I felt my hair in the most humongous tangles it had ever been in. I was exhausted.
  As I was wheeled downstairs to the Mother and Baby recovery floor, I remarked to the nurse in my new room, "Those people are awful up there." She agreed with me. She was a young girl with kind eyes who brought me ice packs for my very, very sore bottom. She admitted that she wasn't yet a mother as she tried to help me get Wesley to latch again..."Come on, friend" she would say...
  A few minutes later, I was informed that I would need to urinate before the hour was over, or I would need to have another catheter. That frightened me, and I felt desperate to pee. How ironic! I spend my entire pregnancy peeing every 20 minutes...now I physically couldn't. I hobble to the bathroom as the nurse told me, "It sometimes helps if you hear the water running." She turned on the water in the sink. She turned off all the lights. And she left.
   The next 2 days were a whirlwind  of too many well meaning visitors, unappetizing food, pouring rain, major discomfort with every move I made, and...a successful start to breastfeeding. I never let W leave our room without us. I stood outside the room and watched through the window as they gave him a hearing test. I refused all help from the nurses; I never even gave any of them a chance. A lactation consultant came to do a routine visit and told me I was the only breastfeeding mother on the entire floor. She congratulated meand gave me information about local La Leche League meetings.
    So many of the hospital rules seemed so odd to me...no walking out side of the room with your baby, unless he or she was lying in the "plastic bin" baby crib, lined with the blankets that were used so many times, bleached, and then given to newborns. No leaving the designated mother/baby wing, whether you were with your child or not. I wanted to return home so badly. I was tired of my food arriving on a wheeled cart; I wanted real nourishment. I wanted our bed, our things, I wanted the smell of our home and windows that open.
   We were discharged early. The staff didn't administer Wesley's last 2 doses of medication through his IV. They dismissed it as if it never really mattered in the first place. The final thing they said to us as we were leaving..."Just so you know, we can't help you with the carseat."

  If I could epitomize my entire birth into one single word....it would be counter intuitive. Counter intuitive, more so than traumatic, which I certainly feel it was. I never once thought my son's birth would go exactly how I wanted it to; I wasn't that naive. But I believed that I could do it. I believed that I needed no medication or intervention.
   I wasn't expecting first class treatment. I am just one person; one more mother to be cycled in then out of the system. But what still shocks me most is the real lack of warmth, empathy, and desire to help. Maybe they assumed that because I had government insurance that I was uneducated. That I didn't care. That I would go along with whatever was put in front of me, because I should be thankful to be receiving care at all.

  I've done much research on homebirth and America's maternity care system since the birth of Wesley. I have been active in several groups that stand for quality maternity care and the choices every woman has a right to make. I've worked in low income government nutrition programs; offering peer support to women who wish to breastfeed, even though the odds are stacked against them in the beginning. (i.e- unnecessary caesarean, extended time away from baby immediately following birth, babies routinely placed in a hospital nursery instead of with their mother, lack of support and guidance, hospitals routinely giving formula and pacifiers; even as "gifts", etc.) I was also slated to appear on a panel before doctors from the hospital I delivered at to discuss what Labor and Delivery nurses can do to make a mother more comfortable during birth and promote a strong start to breastfeeding. Unfortunately, funding for my position was cut and I never had the chance. But, I would have had a lot to suggest.
  I suppose you have guessed by now that we plan to have our next child at home, with a midwife. I feel confident in this decision, and I feel safe knowing that we live less than 2 miles from 2 major hospitals in our area. In my opinion, what a woman needs most during labor and pregnancy is support. Support from her care providers, from her friends, from her family. She needs to be heard and valued. The birth of a child, of any child, is an incredible and beautiful act of God to be respected and honored. People should act accordingly.
 I understand that interventions during labor are sometimes necessary. Sometimes they save lives! But what our maternity care system needs to address is the excess, and then cascade of interventions that leave a woman feeling detached from her body and sometimes, her baby. Her body, which is made to birth young....a body that knows what to do, and, in the case of a healthy woman and normal pregnancy, should be left to work its miracles. I wish I could have felt these sensations during the birth of my son...to feel your baby move through you as they enter the world. I felt alone and incredibly "out of my body." One of my favorite monologues from the play speaks about "a dog about to have her pups. You don't interfere, you don't poke or prod here. You let her be." You give her space. Many friends and family have expressed to me, "yes, but you have a healthy baby!" I am so glad, of course. But what about the mother? She is just as important.
 In the end, I do feel somewhat sorry for OBGYN's. They have hectic schedules and they're over worked. In a lovely world, an OB would attend high risk births, and midwives would assist healthy women with normal pregnancies; in the hospital or in the comfort of the home. Sadly, in my town, midwives no longer have the privilege to attend births in hospitals.
I want to apologize to my son for not being there for his first few hours. Thinking of the many hands he was placed in before mine is agonizing. There was a real disconnect, and I still mourn for those moments in so many ways. It's hard to put into words. Sometimes, when he cries in the night, I think of how lonely he must have been. I think of how lonely both Jay and I were. Nearly 22 months later, I look back on all of this and realize how much we've grown and changed. I have regrets, but I know that once that child was handed over to me, finally, I never let him go. My body felt strange for a long while after Wesley was born. Intimacy was, and still is, difficult for me. Up until a few weeks ago, I had a difficult time picturing anything other than the crowded room full of doctors and students and the OB's hands inside of me. We very much want another child, but getting there is physically challenging for me. It hurts.  I miss the closeness and pleasure Jay and I used to share. I know one day we will get it back. Our next birth will be beautiful. I'm not so much looking for the experience...I'm longing for the closeness, respect, and support. I'm looking for those first few seconds; that primal moment of the beginning of a bond that will last forever. I missed it with my little boy, but I know we have it. I know he was searching for me. And I was searching like hell for him, even though I couldn't get up to physically find him. I know we collided somehow, somewhere. I feel it over and over again as I lay with him at night and feel his body rise and fall against mine. I feel it when he reaches for me in the middle of the night, and I'm there.

Thank you so much for reading.