i am getting ready o start writing “ella funt” #2, which will cover all the excitement of being diagnosed with pre-eclampsia, being put on hospital bed rest, being induced, having a premature baby in the NICU, etc. it’s making me think a lot about all the stuff i wish i would have known before all that stuff happened. despite having gone to midwifery school & read like every book about pregnancy EVER, there was a lot of stuff i simply didn’t know. i had never even been in a hospital labor & delivery ward. i had a tour/pre-registration appointment scheduled…but ramona was born too early. when i called to cancel, they were like, “okay, do you need to reschedule?” & i was like, “um, no, my baby is already born.”
#1: i wish i had known that not every hospital can handle any degree of prematurity. obviously i didn’t even think about this when i was pregnant because i wasn’t planning to have a premature baby. especially not one that was so premature, she required advanced neonatal care. i had hoped to give birth at lawrence memorial hospital, five minutes from my house, with all kinds of amenities like birth tubs. my biggest concern was that LMH partners with this weird disney-owned company that tries to sell new parents expensive newborn portrait packages. but it turns out, their NICU can’t handle babies born before 34 weeks, & ramona was born at 32 weeks (technically–see #2). so i had to give birth at overland park regional medical center in suburban kansas city–40 minutes away.
#2: only completed weeks count toward gestational age. to be precise, ramona’s gestational age when she was born was 32 weeks, 6 days, 23 hours, & 37 minutes. surely we could fudge that 23 minutes, right? & say she was born at 33 weeks? especially because she was probably conceived a few days earlier than what’s typical? (they counted her conception as 14 days after my last period, but i know for a fact that she was conceived at 11 or 12 days after because i was obsessively tracking ovulation.) but no: because i hadn’t technically completed that last week, she was marked as a 32-week-old preemie. & when it comes to premature babies, a single week makes a big difference. i know someone who gave birth to premature twins two weeks before ramona was born…but she was 35 weeks pregnant when they were born. they were in the NICU for less than a week. ramona, on the other hand, was in the NICU for 24 days–& she was super-healthy from the get-go. her apgars were 8 & 9. she was only one a ventilator for one day, & she never had any spells of low oxygen saturation or bradycardia. doesn’t matter. she was a 32-week preemie.
#3: if you are diagnosed with pre-eclampsia at 28 weeks, prepare yourself. you will almost certainly be having a premature baby. i was completely in denial about this. i kept hearing stories about women with pre-e giving birth at 37 weeks, 38 weeks, even 41 weeks! nice healthy full-term numbers with nice healthy full-term babies. i clung to those stories, not accounting for the fact that those women were diagnosed with pre-e at like 36 weeks…37 weeks…40 weeks. they didn’t get sick until their babies were already mostly cooked. i got sick kind of way early by pre-eclampsia standards. i never had a prayer of making it to term, but ramona was several months old before i finally accepted that fact.
#4: a cesarean scar will continue to twinge for months. i had no clue about this. obviously i knew that a cesarean was major surgery, & i was in no hurry to have one. but induction was taking forever & i couldn’t do it with my magnesium headache (see #5). i thought i would be in a lot of pain for a while & eventually it would go away & i would have a scar, the end. but this is some harry potter shit. whoever heard of a scar that hurts? & maybe i’m crazy, but i feel like it’s extra twinge-y when i am anxious or sad. or when voldemort is near me. apparently this is all normal though.
#5: magnesium is the worst stuff in the world. i had never even heard of a magnesium drip before i was put on one. it’s not a normal part of the birth experience. it’s reserved for those of us lucky enough to be pre-eclamptic (because it helps prevent stroke) &/or giving birth to premature babies (because it can help prevent the baby from having a brain bleed).
a lot of moms i’ve talked to have never even heard of this. one openly scoffed at me when i mentioned the horrors of the magnesium drip. the nurses warned me, “sometimes the magnesium can cause a headache,” but i was in no way prepared. it caused the worst headache i have ever had in my life. & i was fortunate enough to be put on magnesium THREE SEPARATE TIMES. once on the night i was transferred, because they though i was going to give birth that night & they wanted to prevent a brain bleed, especially because i hadn’t had time to process he steroid shots yet. once two days later, when they actually scheduled the OR for a cesarean because my labs looked so bad. & then once again when they finally induced me. & the best part is that they wouldn’t give me anything for the headache when i was in labor because “we don’t know if it’s the magnesium causing he headache or the high blood pressure & we don’t want to mask symptoms that could be signs of stroke.” it wasn’t until i was crying & vomiting from pain (headache pain only–labor was like being licked by kittens in comparison, i’m not even kidding) that they gave me a fioricet, but by that point, it was too late & i was literally begging for a cesarean. ugh.
#6: a pink baby is a good thing, but a hot pink baby might have jaundice. i didn’t know! i thought jaundice turned the baby’s skin sallow. in retrospect, ramona was literally as red as a lobster fresh out of the pot, & i was like, “oh, she’s so pink & healthy!” yeah, because she had jaundice. luckily, she only needed phototherapy for three days. she recovered much more quickly than they had anticipated.
#7: when you’re first starting out making milk, even a few drops is a huge achievement. people freak out because they aren’t gushing like geysers an hour after giving birth. at five days post-partum, i delivered a vial containing ten milliliters of milk to the NICU & all the lactation consultants lost their shit. “you’re making enough milk to feed triplets!” they said. & i have indeed gone on to pump about fifty ounces of milk a day–about twice as much as ramona needs. there’s a woman just outside kansas city that has been taking all my extra milk, so i actually am feeding more than one baby. from humble beginnings…i didn’t know what to expect with milk production. if someone had asked, i probably would have said hat i expected to be able to pump at least an ounce (thirty milliliters) within 24 hours of giving birth. had the lactation consultants not set me straight with their effusive praise, i probably would have been really concerned & anxious, which actually could have affected my supply.
#8: newborns are noisy. all their grunting & snuffling doesn’t necessarily mean anything. they’ll cry when they need you. granted, i figured this one out fairly quickly, but it would have been nice to know in advance.
#9: just because a baby LIKES a pacifier doesn’t mean it NEEDS a pacifier. & not letting it have a pacifier means you don’t have to wean it off the paci later. ’nuff said. i stopped giving ramona a pacifier pretty quickly (they started her on it in the NICU without consulting us, & i didn’t think to object) because she had poor mouth strength (like all newborns) & it was more trouble than it was worth stuffing the thing back in every time it fell out. now she simply has no interest. she’d rather chew on her burp cloth, which is fine with me!
#10: all those post-birth painkillers they give you can really fuck you up. i remember almost nothing about ramona’s first few weeks because i was stoned out of my gourd on morphine & percocet. i mean, it was kind of cool, but i also really fucked with my emotional equilibrium. one of the worst parts about it was that i didn’t really have the energy to speak at a normal volume, so i just went around muttering all the time, & people would be like, “what? i didn’t hear you,” & i never had the energy to repeat myself.