Delivery Day

Friday, June 18, 2010.

Ray got up early to get to work and get as much done as he could. They've had HUGE projects going on, more scheduled than they can really handle, and he feels immense responsibility leaving his co-workers to deal with it all while he is gone. I get up early to eat my last meal for a while. Making a pregnant woman eat/drink nothing for 8-12 hours is just mean! Not to mention, I think to myself as I'm downing a big glass of ice water. It's going to be hard for them to get an IV in me after I haven't been drinking! (The orders, by the way, are no food or drink for 12 hours before surgery. The doc tells me to get up early, eat a big breakfast and then nothing more for the rest of the day, being about 8 hours for nothing-by-mouth. Still hard when you're a hungry, thirsty preggo!)

By the time I finish my breakfast of eggs and toast, Maia is up and wanting to play with me. We cuddle and play for a while, then I get ready and head into work as well. I figure if I get a couple hours in, I won't have to count this day as the first day of my maternity leave, and therefore I won't have to go back to work on a Friday. I can save myself $100 in daycare costs.

I get home around 11:30 and Ray arrives around noon. Our "call time" is 1:30, so we try to get a few last things done for us, for Maia, etc. Ray neglects to eat lunch. We say goodbye to Maia and tell her we'll see her tomorrow. Ray's folks tell her we're going to the hospital to get June Bug. She is a little sad, but waves to us out the garage door, and we're able to get some giggles as we go. We arrive at admitting (with our 500 bags: suitcase, laptop, camera, etc!) Admissions is running slow, one staffer with several people waiting. We are given a light pager thing similar to those given at restaurants while you wait for your table.

When it's our turn, we meet with the admissions staff member, who takes one look at me in my vastly pregnant state... ... and says "Honey, you can just go right on up to Labor & Delivery!" No, we assure her, we're here for scheduled procedures. She asks the usual questions... Is this your first? and she gets the brief overview of why we are getting procedures instead of being at labor & delivery. Oh, she tells me, you'll really rather have the vaginal delivery!

Thanks. Yeah, I'm definitely learning an interesting lesson about people's ideas and perceptions when it comes to birth. Believe me, I am a Woman With An Opinion when it comes to this stuff. Hopefully I am now a more sensitive one having now been forced to make the Tough Choice. Anyway. So on up to the center tower we go.

Firstly, I am struck by how odd this is. I'm walking into labor and delivery, and I'm NOT in labor. We are put into this birthing suite, which I believe is actually bigger and nicer than the one we had Maia in. I'm given my gown to change into, and I notice (not without sadness) that this suite has a jacuzzi tub in it. I had hoped to try laboring in the tub this time around.

So we advise of the plan that we will not do the ECV if the baby has not turned significantly, which it hadn't as of yesterday, and I have not felt any great flips. They will do a quick ultrasound to double check, and then start prepping me for the c-section.

Here's the similarity to my last birthing experience: The nurse cannot find a good vein for the IV. Twice she thinks she found one... twice it turns out she missed it. Both on the left side. The nurse is very dear, and says her turns are up, she will get someone else to find one. She ends up getting the GVSU nursing instructor (a former employee) to do it. She does manage to get one on the first try, but (just like with Maia) it is in an awkward, inconvenient place on my right wrist, and it needs to be taped down excessively so that it doesn't get pulled out.

So it's once... twice... three times an IV...

So, the ultrasound machine arrives, accompanied by an OB resident. The resident confirms: still frank breech. We will move forward with surgery. And here's where you'll start seeing a theme that also differs greatly from our experience with Maia.

With Maia: we had 1 triage nurse who transferred us to 1 L&D nurse, who left at pushing time because of shift change, so we got a 2nd nurse. There was a lab tech and a separate nurse to attend the baby after delivery. And Dr L. That's it. Our whole team.

This time? We had a GVSU nursing student named Ashley who is doing her OB rotation. This was her first opportunity to witness a c-section, so she was handed off to the nurses assigned to us, so she could follow us all the way through. So she started with the nurse who couldn't do my IV (who was very dear), but who got my cord blood donation kit started. She hung out for the GVSU nursing instructor who DID get my IV, and then was transferred on to the OR nurse. Then a lab tech showed, and ended up having to stick me again for more blood work. Then Dr. L comes in with a student as well (I've never seen him with a student, but it's clear he loves teaching. In fact, we found out later that student was on his way out, and Dr L called him back to witness and participate in this surgery).

So far: 3 nurses and a student, 2 doctors and a student, and a lab tech.

So here we are, getting ready to go. Ray is extremely excited about the scrubs, and tells the staff that he's planning on watching the surgery. Really.

With my IV in... finally!

Me in my "party hat" as the nurse called it.

Last Belly Pic

I spend some time with the nurse anesthetist, who goes through my medical history as it relates particularly to issues of pain, pain relief, and neurological issues (yes, three occular migraines during this pregnancy - never had occular migraines before, and had been headache and migraine free for about 20 months prior to this pregnancy). She walks me through the process and answers my questions (I have lots... because I'm that kind of girl). I am walked down to the OR, while Ray heads to the surgical waiting room - where my folks and his are waiting too. The staff will get him when it is time for surgery to begin. The OR is small, bright, full and freezing! I am introduced to anesthesiologist Dr P, the only one who doesn't have a student! I am asked to sit on this narrow black board, which apparently is the operating table. The nurse anesthetist faces me and helps me through the process of getting the spinal block. My mind is really struggling to make sense of all this. It seems so surreal.

I'm talked through needing to ignore my body's impulses to pull away, and to actually push into the needle. I'm encouraged to slouch as much as possible to open up the spaces between each vertebrae. Of course... slouching is a challenge with this watermelon in my lap. I am concentrating and breathing, while feeling rather nervous and shivering from the cold. I lean into the nurse and try to connect with her as Dr. P inserts the block, which causes a volt to shoot from my spine to the tip of my pelvis on the right side. Dr P pulls out the block and starts again. Same result. Again. Similar result, but straight through instead of down. I'm really leaning into the nurse at this point and needing to focus on her guidance. Dr. L is also giving me suggestions and encouragement. Finally, the block is in and warmth and numbness is spreading down my legs.

Then everything jumps into high speed and I no longer have any control over 90% of my body. This is the utmost in vulnerability, helplessness and surrealism. Suddenly it's like I'm on an amusement park ride in the dark.... the ride is twisting and turning in front of me, but I can't see any of it coming. I can't brace for it or prepare myself mentally for it.

Ray is brought into the room around this part, and tells them he wants to watch. For me, the paper barrier is just inches from my face and my arms are spread out to either side of me.

Dr L announces himself to the surgical team, and introduces me as the patient, and asks each member of the surgical team to identify themselves. Then... they're right to it. I can feel my body being pushed and shaken, but cannot feel pain or identify specifics. I am listening to Dr L teach his student.

At the beginning of surgery. Left to Right:

The student doc, the instrument nurse, the GVSU student nurse, Dr L.

Ray is standing near my head watching, and thinks he is doing fine, when all of a sudden, he experiences a completely visceral reaction, and he is sweating. Dr P and the baby's nurse get Ray down to the floor, and get him some orange juice, and I stop listening to Dr L and start worrying about Ray.

Ray, on the other hand, is feeling Not Good, and now he's on the floor where he is instead seeing other byproducts of delivery.

Moments later, Dr L announces: We have a baby butt! .... We have baby balls! ... Whoa, you have a linebacker in here! He's huge!

And I hear the most wonderful sound as my child takes a breath and begins to cry. So I do too. And he's peeing! someone laughs.

I see that they've moved him into the isolette to work on him while the surgery continues. However, the isolette is on the far side of the paper curtain and I can't see him at all!

Can I see him? I ask. No one hears me, so I say I want to see him please! and they move the isolette toward the head side of the curtain. Ray tells me later this was rather inconvenient for them, but alas... I'm okay with that! My first impression as I see him lying there, naked and screaming, is that he looks like a boy version of Maia. And wow, he has the same color hair (although a bit more of it than Maia did at birth). By this time, Ray was feeling better and was able to move around and greet our son. I'm told that they did place him on my tummy after delivering him, but I couldn't feel that. After that, it was a waiting game until my turn to touch him.

Sorry. These pics aren't helpful to see the hair color or amount.

Little Feet

Mad

Calm

So I watch him scream while they examine him. 9 lbs. 10 oz. 21" long. Apgars of 8 and 9. He's pinking up nicely, and his skin looks really good. Then finally... FINALLY, they bring him over to me. However my arms aren't really available to me, so I still can't really hold him. So this is what I get instead. He's screaming his head off, so I'm talking to him, kissing him, nuzzling his little red face. And he calms down again (he calms quickly in Ray's arms as well, which is pretty cool).

While all this work is going on with our baby boy, the surgical team is continuing to work on me. Dr L asks me if I want him to do the double layer suture that I'd asked about in the office. (Having read in a recent NIH study that it's safer for VBACs. He said it didn't make a difference to him, he's done both ways and would be happy to accommodate my request). I say "Yes, please" So he announces to the team that he'll be doing a double layer stitch at my request and I hear him walking the student through the process. Before long, it's all done and I finally get to hold my baby boy before the wheel me back to recovery.

Dr. L, Parker, Mommy and Daddy
 As one of my friends commented: Three smiling faces and one sweet boy screaming after eviction.

Parker David Ashley 06/18/10 4:20 pm 9 lbs, 10 oz 21 inches long 38 1/2 cm head circumference

After this, the surreal roller coaster ride begins again, as I am wheeled into recovery and they are constantly checking my vitals. I'm in a tiny curtained cove with the nurse from surgery and the GVSU student taking care of me, and another nurse taking care of the baby. The nurse helps me roll to my side and brings Parker to me so he can nurse for the first time. I still have limited use of my arms, not because they're numb, but because I have lots of tubes and wires connected. The pulse ox is the most frustrating. For someone who has spent a fair amount of time breastfeeding, it's odd to need this kind of help.

Anyway. Parker does a good job with his first nursing session, opens up, latches well. I enjoy every minute of nuzzling his soft skin and kissing his sweet cheeks. And after a little while, Ray leaves my side so that our parents can all come in and greet me and Parker (one at a time). Parker eventually gets a bath, during which he poops, gets cleaned up, poops again, gets cleaned up, and then starts with the pee fountain. He gave the nurse a run for her money!

While Parker gets his bath, I am given mine, which continues to be an odd sensation, as I know I am being moved, but I cannot feel where my body is in space, and it's quite disconcerting. Before long, I am being moved to our room. Up the elevator we go and suddenly, I am burping. We stop so I can vomit up the "stomach neutralizing" beverage they gave me prior to surgery. After getting rid of that, I feel fine. Another transfer, and I'm settled in. And we can all gather around to enjoy our sweet new bundle.