Category Archives: big fat pregnant fall

ramona & her mother, part ten

(this is essentially ramona’s birth story, but because her birth was so crazy, there’s a lot going into it. this is part ten of ten, & all are tagged “birth story,” in order to help you the reader navigate from one part of the story to the next.)

we’re taking off in a little while to visit her again for her week birthday. we’re bringing her some swaddling blankets from home & a knit hat. she’s off the jaundice lights as of today & we’ll be able to hold her as much as we want. she’s also off her cannula so we’ll be able to see her little face for the first time since she was born, with no masks or tubes or helmets. she has also started having baths, just once every few nights, & we’re going to make the effort to get involved with that. we attended a NICU-sponsored infant massage class that specialized in premature infants, & we went to the NICU discharge class last night. that’s a required class that parents enroll in “during the month that their babies are coming home”. no one will even hazard a guess at a date when ramona might come home, but we are cautiously optimistic that it will happen before the end of the month, in light of the head NICU nurse enrolling us in this class within a week of her birth. it’s basically an infant care & safety class with a special emphasis on premature/sick babies.

during the class, they talked a lot about how our babies will be “fortified milk” when they come home–either special premature/sick baby formula or breast milk fortified with premature baby formula. the nurse was all, “the formula powder is really helpful, it provides extra nutrition for baby’s bones!” jared & i were beyond confused about this. i know for a fact that ramona is just on straight breast milk right now. they specifically said that they were not fortifying it (although i guess they do fortify a lot of breast milk in the NICU). i don’t understand how i’m supposed to fortify at home. keep pumping exclusively & give her fortified breast milk in a bottle? that seems crazy & counter-intuitive. i don’t have the money to keep renting my hospital-grade pump forever, & pumping is such a pain in the ass compared to just sticking the boob directly into the kid’s mouth. we also don’t understand why formula powder would be in any way better for ramona’s bones than just regular breast milk. i thought “breast was best”? why wouldn’t she thrive on it? it’s worth noting that ramona didn’t gain weight when she was getting premature infant formula (back when i was only pumping like 1ml at a time). she started packing on the ounces when they switched to just breast milk. clearly it’s doing good things for her. why not just continue?

jared hypothesized that it’s a way to be respectful of women with supply issues. you know, tell them that everyone is fortifying & that it’s NICU protocol & it takes the pressure off of them to increase their output. because a lot of NICU moms did have cesareans, & premature babies, & were sick, & are dealing with the stress & anxiety of being away from their babies, & are trying to build their supply with a pump. this is a lot to deal with & it can take its toll on what mom is able to produce. if she feels pressure to make enough, especially because so many women are already so anxious about making enough (SO MANY women decide not to breastfeed before their babies are even born because “women in my family always have supply issues” or “i’m just not confident i’ll be able to provide enough nutrition on my own” or whatever), it just ratchets up the anxiety. i don’t know. we will definitely be asking about it before ramona comes home though.

one thing that has helped my supply a lot has been watching a video of ramona every time i pump. seeing her, & especially seeing her move & hearing her make noises, helps trigger the letdown. this was jared’s idea, because he is fucking awesome. this video was made when she was only two days old & has been my go-to until now. we’re planning to make a new video tonight since we’ll be able to see her face & everything now.

the only other thing i have that could really pass as advice right now pertains to FOOD. obviously, our situation is different from than of the average new parent. most people get to have their babies at home with them right away. but food is still an issue for us. usually by the time we get home from a NICU visit, it’s late & we are really tired. especially me because i have not had an uninterrupted night’s sleep in nearly two weeks, & will not have one again until ramona is weaned, at the very least. we don’t have much energy for cooking at that point. everyone says, “make some freezer meals you can heat up after baby comes,” or, “try to organize your friends into a food delivery system, have them drop off casseroles or whatever so you don’t have to fuss with cooking.” these are both good tips, but what about people like us who a) had their baby too soon to stock the freezer, & b) don’t really have any friends that are dropping off casseroles? (i don’t know if we just are not close enough with people for them to feel that they can do this, or if they don’t realize we could use this since we are not actually at home with baby yet, or what.) i really wish it would have occurred to me to register for some gift cards to local restaurants that deliver as part of the baby registry. a nanny friend bought us a gift card to a local pizza place & it was such a stroke of genius. this is what we really need, more than yet another onesie or receiving blanket.

i had therapy this morning & shared the whole story of being hospitalized & giving birth & having the baby in the NICU, etc etc. my therapist actually said, “um…how are you alive?! like, how is it possible that all of this happened & you walked here to tell me about it? this is ridiculous!” i told jared that i am so sleep-deprived that i am forgetting what i am saying even as i say it. he replied, “this birth story is going to be off the hook!” he also rather accurately observed that sleep deprivation makes me simultaneously incredibly laid-back & extremely assertive. it’s like i just don’t have the energy to get really neurotic about anything, nor do i have the energy to wait around while other people make crappy decisions.

so, that’s the story! it took me like three days to write this. hopefully you found it entertaining, relevant yet whimsical, with an underlying revisionist conceit that belied my attachment to the subject matter.

ramona & her mother, part eight

(this is essentially ramona’s birth story, but because her birth was so crazy, there’s a lot going into it. this is part eight of ten, & all are tagged “birth story,” in order to help you the reader navigate from one part of the story to the next.)

i was in desperate need of a nap, so jared visited the NICU by himself again later & did some more kangaroo care. i never would have foreseen dapper-if-perhaps-overly-modest jared, he of the omnipresent undershirt, the man who probably wears clothes just to shower, being so into whipping off his shirt & holding a baby on his chest, but he LOVES IT. & ramona loves it too. she’ll be a-fussin’ & a -feudin’, but the second she hits daddy’s chest, all she does is snuggle. i kind of expected to feel jealous when jared was holding her because it’s just more time when i am not holding her myself, but i LOVE watching them together. jared has all these goofy little tricks that he uses to calm her down, like palming her little noggin, or breathing deeply & audibly so she can try to match her breathing to his & relax. & it seems like it has all just come to him intuitively. obviously i wouldn’t have had a baby with him if i didn’t anticipate that he would be a pretty decent father, but he is off-the-charts-amazing with her. he talks to her & asks how she’s feeling & tells her how he is feeling. i have actually teared up a bit seeing them together because there is already such a love bond between them.

the next day, the nurse asked if i felt like i was ready to be released yet. i was able to get out of bed & walk around a little bit, though i still had jared wheel me upstairs to the NICU in a wheelchair every time. i didn’t feel quite ready to get all the way to the elevators & down the hall under my own power, & i didn’t want to risk having to be on my feet too much in ramona’s room. i hemmed & hawed a bit because being in the hospital meant that i was at least close to ramona, even if it also meant i was being constantly poked & prodded & medicated & interrupted. it was a moot point anyway because the obstetrician wanted to keep me at least one more day to monitor my blood pressure. i felt pretty good though, so we spent a lot of time with ramona that day.

it was also the first weekday since she had born, so we had a lot of bureaucratic crap to handle. jared called his insurance company to make sure ramona would be covered under his plan. i called medicare to see what kind of reimbursement they offered on breast pumps. it’s always a hilarious conversation to try to get someone to cover something pregnancy-related under medicare. people are like, “medicaid?” & i have to explain, no, medicare is for disabled people too, of childbearing age, not just oldsters enjoying their great-great-grandchildren. even medicare seems to be caught wrong-footed sometimes by the needs of its clientele, as indicated by their complete lack of a breast pump-specific policy. i wound up renting one from lawrence memorial hospital for a pretty decent price. we had to have stefanie pick it up & bring it in to us, but that also gave her a chance to see ramona for the first time. she confirmed my feeling that ramona looks exactly like jared. same nose, same chin, same mouth. she has my uncommonly deep upper lip divot, & she is long-limbed & short-torsoed like i am (“doomed to a lifetime of unflattering sweaters,” i told jared), but mostly she looks like daddy.

jared went out & bought a calzone for us to split for dinner & then we went upstairs to see ramona again. we were really excited to find that she had been taken off CPAP, which meant that the little helmet/tube thing she had to wear over her nose had been removed. she was wiggling around in her isolette with just a nasal cannula, & without all the gear pressing down on her little skull, she was opening her eyes & looking around! i came as close as i could physically come to RUNNING over to her bassinet to bask in her gaze. she must have heard & recognized her voices because she turned her head toward us & looked right into our faces.

ramona is peeping at us!
ramona is peeping at us!

i got to try my hand at taking her temperature & changing her diaper. if i had ever changed a diaper before, i have no recollection of it, & it’s not so easy to do when you are limited by the armholes in the side of an isolette & you also have to fold the diaper down so it doesn’t rub on her belly button or any of her monitor wires, & you have to avoid closing any wires or tubes into the diaper. but the nurse observed that i instinctively closed the diaper up nice & tight & that made me feel good. it was tough to leave her when her eyes were open–she obviously just wanted to look at us & we wanted to look at her. she was clearly fighting sleep so she could stare at us. but we had to get back downstairs to pump & sleep ourselves.

the obstetrician finally signed off on my release the next day. i was SO STOKED to get out of the hospital, i almost didn’t even think about the fact that ramona wouldn’t be coming home with us. it was a busy day on labor & delivery–every room was full & three other laboring women were waiting for rooms, so my doctor kept being called away for deliveries & didn’t process my discharge paperwork for six hours. that gave us lots of time to spend with ramona though.

& uteruses across the land collectively developed acute baby rabies.
& uteruses across the land collectively developed acute baby rabies.

we had hoped to go to boarding, which is something my insurance covers for three days. it allows the baby’s parents to stay in the hospital, in a hospital room, but without any hospital services (nursing, food service, housekeeping, etc). it’s just so they can be on the spot to visit baby as much as they want. we requested a room but with all the laboring women, there was nothing available. we were pretty bummed at first, but during our last visit before we left for the day, we learned that ramona had jaundice, which is why her skin was so red. her doctor has ordered light therapy for her & she had to stay in her isolette for 23 hours a day. we would be permitted to hold her for one hour a day (which we immediately decided to split into two half-hour holds so we’d each get a chance with her). so boarding at that point would have been kind of a waste. we decided to save our free days for after her jaundice is resolved & we could hold her as much as we like, or maybe even after they let us start experimenting with breastfeeding, so i can be there as often as possible. lawrence isn’t too far from overland park–only about 35 minutes. but it’s kind of a trek when you’re making it every single day, & we just don’t really have the time or the gas money to do it numerous times per day.

that doesn’t mean it was at all easy to leave though. i cried for a good chunk of the drive home. it just felt unnatural to leave the hospital without her! we had no sooner gotten into the elevator than i started missing her so much, it was almost physical.

ramona & her mother, part seven

(this is essentially ramona’s birth story, but because her birth was so crazy, there’s a lot going into it. this is part seven of ten, & all are tagged “birth story,” in order to help you the reader navigate from one part of the story to the next.)

jared turned up again, all packed & ready to stay with me for the next several days. we put stefanie on the job of feeding charlotte, since she lives right across the street from us (an unexpected but incredibly helpful aspect of hiring her as our doula!). at 11:30pm, i was taken off the mag. i convinced the nurse to give me a fioricet to stave off another headache. i stuck with my pumping schedule & walked jared through the procedure. he wound up being incredibly helpful. he was right there next to me every time i pumped, helping to turn the machine on (hard to do when each hand is occupied holding a pump to a breast), giving me sips of water, cuing up videos of ramona for me to watch on my laptop, etc. because i still had the catheter in, i still wasn’t allowed to get up on my own, so he took the pump parts apart after every use & washed them, & then put them together for me again when it was time to pump later. he also helped me stay on top of my pumping log. the lactation consultant recommended it, but i probably wouldn’t have done it without jared there to encourage me. i thought what every new mom thinks: i don’t need to write it down, i’ll remember. but i’m glad jared was on my case to write it down because of course i couldn’t remember everything, & i was happy i had a record a few days later when i wanted to see how my output had changed from pump to pump. jared is also the one who figured out that if you make a seal around the breast shield with your hands & blow, you can blow an extra few drops down into the syringe. this matters more for when you are just starting to pump & your output is literally tenths of a milliliter. this little trick helped boost us from no output at all to .5ml several times, & that really helped keep my spirits up. even though i know it’s normal for a mom to only get a few drops during a 15-minute pumping session when she is just starting, it’s still a little discouraging. thanks to jared, i didn’t have to experience that quite as often. maybe we contaminated that milk with our gross mouth germs, but ramona is still alive & kicking several days later, so i guess it worked out okay.

i finally felt strong enough to go upstairs & see her after my 2am pump session. the doctor was dubious because i was still on oxygen, but i guess he realized that it’s uncool to keep a new mom away from her baby for more than 24 hours, so he let me go as long as i stayed on the oxygen tank & was in a wheelchair. as if i could have walked anyway. it took me literally like twenty minutes just to transition from the bed to the wheelchair. i could barely move due to incision pain.

but all was forgotten the minute i laid eyes on that little baby. her face was obscured by the CPAP hood, but she was wiggling around in her isolette, opening & closing her hands, kicking her legs. she cried when the nurse changed her diaper. even though she was making sad noises, i just couldn’t get over how precious they were & how good it felt to hear the little baby that i only knew as the bumpy creature that lived in my body. they were about to do a feed, which involved dripping formula into her belly though a very slim tube wound down her throat. they hadn’t started her on colostrum yet because they were still making sure she tolerated food okay before they wasted any of the good stuff. they offered to let me hold her during the feed, but i demurred because i was still really weak & shaky. just being wheeled upstairs had almost made me fall asleep; i didn’t trust myself to hold a baby yet, & i was still in so much pain, i knew i wouldn’t be able to do it for long & they said they prefer for holds to last at least half an hour. when i declined, they said they usually prefer for moms to get the first hold, so they would just wait until i was ready. i was like, “no way! there’s nothing wrong with jared, i am happy to relinquish ownership of the first hold to him.” they asked if he wanted a swaddle hold or skin to skin. i told him that babies love skin to skin, especially preemie babies. he seemed to feel embarrassed about being shirtless in front of the nurses but he was game. i stuck around while they situated ramona on his chest (she was not yet being clothed because of temperature regulation issues & all the various tubes & monitors–they had her under heat in nothing but a diaper & sometimes a hat) & snapped a quick photo & then went back to my room & fell asleep.

my first visit with ramona.
my first visit with ramona.
ramona's first hold! kangaroo care.
ramona’s first hold! kangaroo care.

the next day was sunday. everything is kind of a blur. i don’t remember too many details. i was up every three hours to pump & jared usually got up with me because i was still catheterized & couldn’t get up on my own to put together the pump. i know the doctors were still concerned about my oxygen saturation levels, which were hovering at around 90% (according to the machine, which is of course fallible). i was allowed to start eating & drinking freely. at some point, they removed the catheter. i hoped they would take out my heplock too, because trust me, having an IV in your hand for a week straight is no party. but they wouldn’t, lest my condition deteriorate & i need IV fluids or medication suddenly. we visited ramona again some time in the morning or early afternoon & i was able to hold her for the first time!

mama's first hold! i chose a swaddle hold so i could see her little face.
mama’s first hold! i chose a swaddle hold so i could see her little face.

she was still on CPAP, but they had reduced the flow a little. we were just enchanted with her. we couldn’t stop gushing over how cute she was & how adorable all of her activities were, whether she was yawning or wiggling her legs or pooping the second her diaper was removed. yeah, we magically transformed into parents the second she was born. it’s crazy how that happens. suddenly poop is cute. no one can explain it.

she had slimmed down from her birth weight of four pounds, eleven ounces, to four pounds, six ounces, but holding her for an hour was still murder on my incision. i was walking a bit by this point (i had to after they removed the catheter because i had to get myself to the bathroom), but it was still slow going. meaning i generally did not actually lift my feet. i told jared that if a grizzly bear suddenly entered the room, i would not be able to run away from it. he was like, “um, if a grizzly bear suddenly comes strolling into your hospital room, running away from it is probably the least of your concerns.”

ramona & her mother, part six

(this is essentially ramona’s birth story, but because her birth was so crazy, there’s a lot going into it. this is part six of ten, & all are tagged “birth story,” in order to help you the reader navigate from one part of the story to the next.)

they wheeled me into the OR & rolled me on to the operating table. jared & the anesthesiologist helped me sit up & i was allowed to lean on jared’s shoulder while they did the spinal block. i was in so much pain at that point from the headache, & i was so muddled by the magnesium that i barely remember a thing. i remember that the drugs took effect right away & a nurse had to lift my legs back on to the table. i was not strapped down above the waist at all. i remember just feeling a lot of pressure & pulling while they cut me open & moved everything around trying to get a handle on the baby. i remember i threw up at some point in there, & jared tried to catch it but i still wound up with puke down the side of my face & in my hair. & then we heard a baby crying. A LOT. & then some gloved hands held a screaming baby over the top of the drape. i remember there were blood splatters on the drape but all i could really focus on was the baby–a girl that we named ramona. both jared & i were laughing & crying. a nurse grabbed jared & whisked him over to where baby was being assessed & i was left alone while they stitched me back up. this seemed to take a really long time, during which point i threw up again. a nurse wiped my face down with a washcloth. i started shaking uncontrollably. jared says i was crying too, but i don’t remember this. i just could not control the shaking. a nurse showed me the baby again before they took her to the NICU. she was wearing a pink & blue striped hat & they let me kiss her head.

happy birthday!
happy birthday!
angry baby!
angry baby!

after this, i pretty much remember nothing until well into the next day. i guess i was wheeled back my labor & delivery room for a few hours of recovery. i was put back on the mag. i couldn’t stop shaking, though i don’t really remember being cold. i don’t remember if jared was there or if he was with the baby. stefanie was there & she rubbed my feet. at some point i was transferred to the mother/baby unit. jared stayed with me on the fold-out. i remember literally nothing about the next morning or afternoon. i know i was still catheterized & therefore not allowed to get up. i was on oxygen. i basically couldn’t move because my incision site was pure agony. i had shaken off most of the effects of the spinal & was able to wiggle my legs. they started me on percocet to control the incision pain. i was still on a lot of other meds too. i wasn’t allowed to eat or drink until i reported being able to fart. who says having a baby isn’t glamorous, huh? i kept dozing off.

jared rushed back to lawrence to pack himself a bag so he could stay in the hospital with me for as long as possible. no one could tell me when i might be released. they said that they released the average cesarean patient after three or four nights, depending on her pain level, but i was not the average cesarean patient due to my pre-eclampsia. they wanted to make sure my blood pressure was being reasonably controlled before they let me leave. because i wasn’t allowed out of bed, i wasn’t allowed to visit the baby. maybe they would have taken me up in my hospital bed if i’d made a big enough stink, but i was so out of it, it didn’t really occur to me to ask. jared visited her though & came back down with a ton of photos & videos of her laying in her little isolette. she had mask on her head with an elephant trunk-looking tube on her nose (this was called CPAP). she had all kinds of wires sticking out of her. NICU called down to my room to tell me they wanted to thread a central line into her belly button to give her medicine & be able to draw blood as needed without sticking her foot over & over.

a lactation consultant showed up at some point while i was alone in my room, about fifteen hours after the birth. she had a fancy electric pump with her & i felt simultaneously excited that they hadn’t forgotten about me & that maybe i could start doing something for ramona even though i was stuck in bed, & also terrified that the moment of truth was here. i would discover whether or not i was able to start making milk for my baby. you just hear SO MANY stories about women who grapple with milk supply issues & end up giving up on breastfeeding or supplementing pretty liberally with formula–& these are women who had vaginal deliveries with full-term infants ready to go to the breast! i knew i was working against a lot of complications, between the late pregnancy bed rest, the prematurity, the cesarean, the medications & the fact that i was sick, & the fact that any milk i produced would have to be expressed because ramona is too tiny to have a developed sucking reflex or the skills to take food by mouth.

the lactation consultant just dove right in & was all, “take down your gown & massage your breasts!” then she manhandled them a bit herself & immediately produced a few drops of colostrum via hand expression. she was like, “this is great! you are ready to go! & you have perfect breasts for breastfeeding! when your little baby is ready, she’s going to love these things!” i didn’t ask for clarification about what makes a breast “perfect” for breastfeeding. i just kind of reveled in being able to do SOMETHING baby-related right, since apparently i totally suck at being pregnant without having a toxic reaction.

she got me hooked up to the machine & there i sat for fifteen minutes watching little drops of liquid gold collect in the teeny syringe. i managed to produce 1.75ml that first time & the lactation consultant was all, “wow! you could feed twins with production like this!” that really cheered me up a lot. she told me to pump for fifteen minutes every three hours, even during the night, in order to establish supply. i was happy to give it a whirl because i wanted to feel like i was doing SOMETHING to help care for ramona. & i know so many breastfeeding advocates talk about how it’s especially crucial for premature babies to get all the colostrum they can because it is basically like medicine to them. there are so many nutrients & antibodies that they really need because they shouldn’t be outside of the womb yet.

ramona & her mother, part five

(this is essentially ramona’s birth story, but because her birth was so crazy, there’s a lot going into it. this is part five of ten, & all are tagged “birth story,” in order to help you the reader navigate from one part of the story to the next.)

jared came in for dinner on thursday. he brought us leftover lasagna & pie from thanksgiving. we laid in my hospital bed together & watched “project runway”. some scary stuff happened while he was visiting. i started spiking some pretty high blood pressures, like 170/110. even though i was just laying in bed, doing nothing. i even felt downright relaxed because i was with jared. then i started having sharp chest pains & a lot of pressure in my chest. they ordered an echocardiogram, which was perfect; an EEG, which was perfect; & a lung x-ray, which was perfect. i chalked it up to some kind of unresolved anxiety about hospital bed rest. in the absence of obvious diagnostics, the doctors chalked it up to heartburn (or so i thought) & added a heartburn medication to my chart. i also started having sudden & severe swelling in my hands, but it went away when we elevated them on pillows. i figured maybe i was just having weird fluid retention from being on bed rest. they gave me a diuretic to help me get rid of the extra water. jared left pretty late after making a plan to come in for dinner the next night, since that had been a pretty relaxed time for us to see each other.

i woke up bright & early on friday planning to do my best to have a productive day before jared showed up. i was going to finish reading a library book that was almost due, & maybe do a little writing about the hospital stay, & organize all my hospital paperwork. i had toured the NICU the day before & wanted to write up a list of questions to have answered before the baby was born & wound up there (assuming i couldn’t hold it in long enough to avoid the NICU altogether). i started by ordering a nice breakfast.

just as i was polishing off my morning coffee, yet another perinatologist stopped by. i should have known it wasn’t good news when he actually pulled a chair up to my bedside. he said that he didn’t like the looks of the blood pressures from the night before, nor my tales of chest pain & swelling. he said he was inducing me ASAP. i was stunned & started crying. again. i know how ridiculous that sounds. this was like my sixth day in the hospital, knowing that i’m not being released until i have a probably-premature infant, & yet i start crying every time someone hints that i might have to have the baby. like it’s some big shock all over again. i asked how the baby would be coming & he said he wanted to induce labor because i’d been pretty stable in the last few days & he wanted to give my body a chance to have the baby on its own. he thought that was less risky than the risks associated with cesarean. he said he’d order all the paperwork & they’d move me down to labor & delivery lickety split.

as soon as he left, i called jared, who was still asleep, & said, “they’re making me have the baby today!” through sobs.

“oh my god,” he said, “i’ll be right there.” he called stefanie back in & i laid there & cried while i was hooked back up to the fetal monitors, the magnesium IV, general IV fluids, etc etc. i again convinced them not to do a catheter unless they thought it was absolutely necessary. i was loaded into a wheelchair & pushed over to labor & delivery, where i was then loaded into a new hospital bed. jared & stefanie showed up & i was given a cup full of ice chips. the nurse explained that they would be inducing with cytotec, a vaginal suppository. i’d get a fresh dose every three hours until i either went into real labor independently or for 24 hours. if i still wasn’t in labor within 24 hours, they would start me on pitocin. i decided to make it my mission in life to get contractions going just with the cytotec because i was terrified of pitocin. i’ve just heard too many stories about pitocin making contractions unbearably long & powerful & ultimately traumatic, leading to either epidurals or fetal distress signifiers & cesareans.

i started contracting within about two hours. they were pretty minor at first, & maybe seven minutes apart, but as we continued with the cytotec, they gradually got stronger & closer together. my cervix, which started high & closed up super-tight, had started to thin a little by the tenth hour or so. but by that point, i was starting to develop another migraine. within an hour, it had progressed to a full-on migraine accompanied by vomiting every time i moved. & i started spiking major blood pressures again, even on the mag drip. i think the highest was something like 180/130. from the beginning, i was confused about why they were allowing me to do a trial of labor on friday when the perinatologist three days before had ordered a cesarean because he thought i was a seizure risk. by the time i really started to lose it, i’d been on cytotec for twelve hours & contractions were coming every minute or two. i am pretty foggy on what happened at this point. i guess the obstetric surgeon came in & we had a consult. stefanie was involved as well. they wanted to do a therapeutic cesarean to prevent me from seizing (even stefanie recommended it) & i agreed. the next thing i knew, the incision area was being shaved & jared was putting on OR scrubs.

i have no recollection of this photo being taken.
i have no recollection of this photo being taken.

sometimes when i am by myself, like when i am waiting at the hospital entrance for jared to pull the car around so we can go home from visiting the baby, i wonder if maybe i gave up. if maybe i could have done a vaginal birth if i’d just tried harder. maybe i could have asked for my fioricet to power through the headache (though they were again reluctant to medicate it away lest it be a symptom of high blood pressure–which it almost certainly was), i could have laid on my side to bring down the blood pressures a little, & i could have done it. the contractions were strong & pretty close together, but they really weren’t hurting much at all. they just felt like extreme pressure. undoubtedly they would have gotten worse, but i was handling them like a champ even while i was puking. i asked jared about all of this because i remember so little about it. i don’t even remember that meeting with the obstetric surgeon. i didn’t realize she had performed the surgery until several days later when jared told me. he also told me there were about fifteen doctors & nurses in the OR. i only remember like two or three. he told me that both the doctor & stefanie were afraid i was going to start seizing any second, & that my blood pressure was a little higher every time they took it. he told me about how scary it was for him to see me like that & that trying for a vaginal birth at that point would have been against all medical advice, all doula advice, & every instinct in his body. so. yeah.

ramona & her mother, part four

(this is essentially ramona’s birth story, but because her birth was so crazy, there’s a lot going into it. this is part four of ten, & all are tagged “birth story,” in order to help you the reader navigate from one part of the story to the next.)

i woke up feeling reasonably refreshed (which is to say, not like my head was about to explode) bright & early the next day when the blood folks came around to do more labs. then i kicked back & waited for the perinatologist to tell me that everything looked stable & i could have breakfast. the head nurse came in to fill me in on some of the details: my diagnosis was severe pre-eclampsia. they hadn’t wanted to drug away my headache the night before because they thought it might be related to high blood pressure, even though my blood pressure had come down quite a bit & stabilized since i was admitted. before i was hospitalized, it had been hovering around 150/100. by tuesday morning, it was more like 120/80–a huge improvement. but these things can change at the drop of a hat, & i may or may not be symptomatic when it happens, so they were going to keep me until i had the baby regardless of anything else that happened. when i asked when that might be, just to give myself some feeling that i still had a little bit of autonomy over the situation, she said, “no one knows. it could happen today, but it seems more likely that you will get to 37 weeks.” i got pretty upset & pointed out that 37 weeks was still over a month away. not that i wanted the baby to come sooner than that, but i couldn’t believe they would keep me in the hospital for over a month if i was asymptomatic & my bed rest blood pressures were so (relatively) low. i mean, couldn’t i just do bed rest at home?

this line of questioning was interrupted by a preinatalogist that i dubbed “dr. hysterical”. he blustered in, scrubs a-flapping, & said, “we are getting this baby out TODAY, okay, mom? we have someone on the schedule for noon but you’ll be next at 2pm.”

“next for what?” i asked.

“cesarean. i already booked the OR.” he turned to the nurse. “get her back on mag, & has it been 24 hours since that last steroid? no? …oh well, the NICU can handle it. let her nurse know to start prepping her.”

by this point, i was pretty hysterical myself, as you might imagine. i had just been entertaining visions of home bed rest not twenty seconds earlier (as unlikely as they were to come to fruition). the doctor explained that my morning labs had showed continued elevation in liver enzymes (though platelets remained stable & normal), & while the nurse had said that the elevation still seemed within the realm of tolerable, especially given how young the baby was gestationally, the perinatologist, who is the person with the actual decision-making power, thought the toxic effect of the pregnancy on my body had gone far enough & he wanted that baby out pronto. he also didn’t think that my body could withstand a trial of labor, hence the cesarean. he was afraid that trying to induce, especially at only 32 weeks & three days, when my body was not going to want to help go into labor on its own, could push me over the edge into seizures.

obviously i called jared, who called our doula. both dropped everything & rushed to overland park. the perinatologist ordered one more set of labs & told me that i’d be getting the cesarean if my liver enzymes were any worse or the same. he turned to the nurse & said, “i wouldn’t be surprised if they’re over 100 this time.” i don’t totally know what that means. i don’t know what the liver enzymes are supposed to be or what mine were at this point. i know they said that i was at a seven when i went in for “further testing” at lawrence memorial two days earlier.

jared & stefanie arrived & we all just kind of sat around waiting for the lab results. my nurse came in to start prepping me, but i managed to convince her not to put the catheter in until we were on our way to the OR. the magnesium made me feel really shitty, but i didn’t get dizzy & lightheaded like a lot of women, so i was still able to make it to the bathroom on my own. stefanie encouraged the nurse to walk us through the cesarean procedure after ascertaining that i really had no idea how any of it worked or what to expect at all. i mean, i knew i didn’t want to have a cesarean, & so i guess i just never paid any attention to exactly what it involved. although i heard nothing especially reassuring, it was good to be informed & i was really grateful that stefanie helped us facilitate it because i think jared & i were just both in shock & never would have thought to ask some of the questions stefanie came up with. & i KNOW she asked those questions for our benefit because she has attended her fair share of cesarean births.

the nurse popped back in at 12:30pm with crazy news: my liver enzymes had actually DROPPED a little, back toward normal levels. they were still high, obviously, but i was stabilizing. the cesarean was canceled. stefanie took off shortly thereafter, but jared stayed until i started falling asleep. they took me off mag right away & i started getting another migraine, but i was more successful this time in asking for treatment sooner rather than later. i was also given permission to eat & drink. jared made a plan to come back to the hospital early the next morning so he could be there when the doctor went on rounds & avoid the stress of another emergency “they’re making me have a c-section!” phone call. i spent the evening trying to mentally prepare for myself for being on hospital bed rest for god knows how many more weeks.

on hospital bed rest, just chilling out & waiting for daddy's little 2012 tax break.
on hospital bed rest, just chilling out & waiting for daddy’s little 2012 tax break.

i was put back on food restriction again at midnight in case my labs looked worse in the morning & emergency surgery was scheduled again. jared showed up at around 8am & we just hung out & waited for the doctor to show up. but that didn’t happen until nearly 1pm. apparently my labs that day were stable & i was FINALLY given permission to eat & drink. by that point, you could have set me loose in a cornfield & i would have devoured the entire thing like a storm of locusts. the head nurse came in & told me that they were thinking of scaling my labs back to every other day since i seemed to have stabilized really well. she gave the order for me to be removed from the fetal monitor shortly after jared left for the day. that was amazing because then i could get up & use the bathroom any time i wanted without feeling bad about the movement jostling the monitors & forcing the nurses to come in & readjust the belts to get the baby back on the read again. i ordered myself a big dinner from the cafeteria & kicked back to watch TV. i still had to do an hour of fetal monitoring every four hours, plus vitals every six hours, plus medication twice a day, plus just the random interruptions from various doctors, nurses, social workers, financial advisers, etc, peeking in on me. but i was starting to accept that this is just the way life is on hospital bed rest.

ramona & her mother, part three

(this is essentially ramona’s birth story, but because her birth was so crazy, there’s a lot going into it. this is part three of ten, & all are tagged “birth story,” in order to help you the reader navigate from one part of the story to the next.)

when i got to overland park, they immediately started me on a magnesium IV into the heplock. i had vaguely heard moms talking about being on “mag,” as the vernacular goes, & how absolutely horrible it is, but i hadn’t paid much attention to the details. dude, let me tell you. IT’S THE DEVIL IN FLUID FORM. i immediately felt like i had caught on fire, i was so hot. apparently it makes a person foggy & dizzy, so i was forced to have a catheter inserted & was not allowed out of bed. the nurse who put in the catheter had kind of long fingernails & obviously i wasn’t on any painkillers yet, so it hurt & she kind of scratched my vagina a little with her fingernails. i felt free to vocalize my way through the pain (just saying, “ow, ow,” a lot), which caused her to say, “so…you think you might be getting the epidural with this baby?” i wanted to say, “that’s enough of your smart mouth, & maybe you should consider keeping your nails trimmed if you are a fucking labor & delivery nurse,” but i knew i was beholden to her to bring me water & be gentle while taking vitals & stuff, so i didn’t say anything.

a perinatalogist walked in & immediately started freaking out about my liver. he was all, “we are going to deliver this baby tonight!” i don’t know why he changed his mind, but ultimately they decided to get me through to at least 24 hours after the steroid shot to give the baby’s lungs a little more time to bake. in the meantime, i would be on strict hospital bed rest, continueous fetal monitoring, & magnesium. jared showed up with my stuff & was allowed to stay through the night on a pull-out right next to my bed. i started developing a magnesium headache, which is apparently a common side effect, but not something i was prepared for. i begged them to take me off the mag if they weren’t going to make me deliver that night, but they said it was a safety measure to prevent the baby from bleeding into its brain & developing cerebral palsy if they did deliver precipitously. i found out later that it is also used as an emergency blood pressure treatment & that they were afraid i was going to start seizing…or worse.

they gave me an ambien & i managed to doze intermittently, but i kept waking up & crying. jared stayed by my bed all night, holding my hand & trying to encourage me, saying stuff like, “you are so strong, you can get through this, i love you,” etc etc.

a different perinatologist rounded in the morning. they had done more bloodwork on me at 6am, & he said that it showed even higher liver enzymes, but things weren’t deteriorating as rapidly as they had anticipated the night before, & they were incredibly reluctant to take the baby out before i had an entire steroid course on board (two shots 24 hours apart, with each given 24 hours to absorb across the placenta & benefit the baby), & that ideally, they would leave it in until at least 34 weeks. they took me off magnesium but continued to take blood every six hours to make sure i wasn’t having a toxic reaction to it. they also removed the catheter. it hurt a lot more going in than coming out, i’ll say that much. i was given the all clear to eat & drink & get my own self to the bathroom, but i was still hooked up to the fetal monitor, so they wanted me to stay in bed as much as possible.

my relief at not being forced to have the baby that day, & being allowed to consume chicken sandwiches instead, was short-lived. before long, i was out with the mother of all migraines. i have plenty of experience with migraines & i’ve had some bad ones, but this was unspeakable. jared had called our doula the night before when it appeared that delivery might be imminent, & she came by the hospital just to visit me that afternoon. i couldn’t even bear to pull the washcloth off of my eyes & look at her. i’d had jared close the blinds & turn off all the lights so it was pitch black in there. i don’t even know what he was doing at this point. working on his computer, maybe? obviously he didn’t have light to read by or anything.

an out of town friend somehow figured out that i must have an in-room telephone if i’m in the hospital & she called me on it. she wanted to know how i was doing, how the baby was doing, how jared was holding up, whether they were going to let me go home soon, whether they were going to make me have the baby soon, etc etc etc. it was kind of hard to explain to her, “i barely know the answers to any of your questions, & i am also blind with pain right now so maybe now is not a great time for chatting.” i mean, i knew i was going to want to talk about everything & want people’s support at some point. i didn’t want to chase anyone off when, from their perspective, maybe i have nothing better to do than lie in bed being monitored & yack on the phone like a teenage girl.

i finally convinced the doctor to sign off on something stronger than tylenol for the headache at around 10pm. jared had gone home by this point because i was in no fit state for hanging out, but obviously i was stable & the baby was staying put for the moment. they gave me a fioricet & an ambien & i started feeling a lot better. my night nurse raided the nourishment room for me until i was put back on food/drink restriction at midnight. she was bringing me cokes, milk, pudding, soup, & crackers every ten minutes.