We
arrived at St. Joe’s hospital at 7:15AM and were in the delivery room by
7:30. We met our first shift of
nurses and Tina had a ‘port’ installed to allow them to attach the oxytocin
later in the morning. At around
9:30, the doctor on duty stopped in to discuss the induction and answer any
questions we might have. By 10:30,
the oxytocin (labor inducing medication) was started at 1 milliunit per
minute. (I never did figure out
what the ‘unit’ was, but they did tell us that they were starting very low to
come as close as possible to simulate going into labor naturally.)
At
11AM there was a shift change and we met our second group of nurses and went
through another round of the exact same questions [no, we don’t know the gender
yet and don’t want to know until birth; yes, Wade wants to both announce the
gender and cut the cord (“Can I use my Swiss Army knife?” “No, but you can use the hospital
machete.” – actual conversation in the delivery room, but everyone was joking,
so don’t worry); yes, we’d like to have the baby directly in Tina’s arms if
possible; no, no known allergies to any medicines; and on and on]. At 11:15AM, they came in to let us know
that the baby’s heart rate had slowed and they were turning off the oxytocin
for the time being. By 12:20,
baby’s heart rate had returned to ‘normal’ and they started up the oxytocin
again.
Within
an hour, Tina was feeling what she described as the first possible non Braxton
Hicks contractions, but that she did not yet feel the need to ‘breathe through
them.’ The oxytocin was up to 4
milliunits per minute by this time, and the baby’s heartbeat was doing what
they wanted it to do. At 2:10, the
doctor came in again. Tina was
dilated between 3 and 4 cm; contractions, while not being intense, were coming
about every 4 minutes; the baby’s head had not yet descended; and oxytocin was
up to 5 mu/min.
At
2:35, with oxytocin up to 6 mu/min, Tina had to breathe through the first
‘real’ contraction. They were 3
minutes apart by this time. Labor,
from a medical standpoint, had begun.
After another examination at 4:40PM, the doctor broke Tina’s water. The baby’s heartbeat spiked for several
minutes, then returned to normal.
By
5:45, with oxytocin up to 7 mu/min, Tina’s labor seemed to be in full
swing. As sitting in bed was no
longer comfortable, Tina sat beside the bed on what they called The Egg. (Imagine one of those big inflatable
exercise balls with an elongated center.)
She
would rock and gently bounce on it between contractions, then have me massage
her lower back during each contraction.
Over the next hour, as the contractions became more and more intense,
Tina tried several different positions – beside the bed on the Egg, in bed with
a support bar to hold on to, in bed with the Egg there with her. (I will not go into detail about Tina’s
gradually increasing volume accompanying each contraction, but I will let you know
that Tina says, if she were to write a ten page paper about this
experience, at least eight pages of it would fit right here.)
Suffice it to say that Tina was getting tired and felt ready to deliver with each contraction. Which
made the 7PM shift change rather difficult to handle. I was vaguely able to handle introductions between
contractions, but Tina was barely able to respond, much less understand words
and grasp names. We were also
introduced to a new doctor – and by new I mean one we had never met
before. The medical group we had
been seeing over the preceding nine months had about 8-10 doctors, all of whom
we’d met at various exams and check-ups.
This was one who had been with the practice for years, but who had been
out of the country for a while, working in Africa. We had never met him, were in the height of labor, and were
now supposed to put full trust in him.
The first thing he told us was that, upon examination, Tina was only
dilated to 5 cm. (For those of you
who are unfamiliar, birth happens around 10 cm, so it meant we were only halfway
there! Completely demoralizing in
many respects.)
Intense
contractions are still coming every three minutes, Tina is increasingly unable
to process and think, there is a completely new team of people around us (again
going through those same questions that we’d already answered at least 3
times), and everyone is looking to Tina for her thoughts.
We
came into this experience hoping for a natural birth. Tina had delivered two kids before, the most recent of which
without any pain medication. She
knew it was possible and that she could do it, in theory. But facing the possibility of continued
hours of contractions wracking her frame every three minutes, she tuned
everyone else out and started talking to me. Looking back, I don’t even know that words were being
exchanged; I only know that we were communicating and coming to the same
conclusion. She seemed to want to
apologize for what she was about to ask, but I tried my best to communicate
that I supported her fully in every way I could and that no apology would be
accepted because none was needed.
At
7:15PM, she asked the doctor if an epidural was an option. There was no hesitation or
discussion. He simply said that it
was, and that they would start preparing for it. Paperwork materialized for Tina to sign (we had not signed
any paperwork for an epidural ahead of time, as we didn’t think that was going
to be necessary), and by 7:30, I was sitting in front of Tina, trying to calm
her and keep her immobile so the man with the epidural cart could access her
spine. As soon as one contraction
was subsiding, he started. The
prick of the local anesthesia made her jump, but she held completely still as
he hooked up the epidural, even as she started into the next contraction before
he was completely finished.
Within
three to four contractions, Tina was able to lie down on her side and start to
relax. She said she was still
fully aware of each contraction, but that they were not overpowering her or
causing her such intense pain any longer.
As our new nurse re-introduced herself to Tina and checked all of the
vital signs for Tina and the baby over the following half-hour, Tina’s
contractions eased off in frequency as well. At 8:15PM Tina told me she felt calm, peaceful, and
happy. From then until midnight,
Tina was able to nap occasionally.
They told her that she would eventually feel a strong urge for a bowel
movement and to tell them when that feeling arrived, as it would signal time
for the birth.
At
midnight, the doctor came in again.
Tina was dilated between 7 and 8 and the baby was at plus one (meaning
that the tip of the baby’s head was beginning to pass through the cervix and
down the birth canal). They told
me to get some sleep at this point, which I did to the best of my ability. Meanwhile, the nurse assisted Tina in
getting a beanbag on the bed so that she could lay atop it to ease various
pressures. Tina apparently slept
on an off that way for a little over an hour.
By
2AM on Thursday, September 22, Tina’s oxytocin was eased back to 5 mu/min and
she was again lying or sitting up in the bed. At 2:20, we lost yet another nurse and I was fully awake
again. At this point, Tina and I
have had about six hours of sleep each over the preceding two days. Tina reported to me around this time
that it seemed the epidural had been affecting her left side more strongly than
her right, but that it was beginning to feel like it was becoming more even.
Around
3AM, Tina let us know that her contractions were deepening and feeling more
rectal. This continued for most of
the hour. Five minutes before 4AM,
the nurses asked Tina to push with the next contraction. When she did so, they immediately told
her to stop with great urgency in their voices. While she did stop, and one nurse hurried off to get the
doctor, the other nurse asked me if I would like to see my baby’s head. It was clear at that point that there
may be some truth to the old wives’ tale about heartburn and hair: Tina had horrible heartburn towards the
end of the pregnancy, and all I could see looking inside was hair.
The
doctors came in time for the next contraction, and the six of us (two nurses,
two doctors, Tina and me) set to our respective tasks. The first contraction with the doctors
present, Tina was able to push the baby so that the top of the head was
crowning. The second contraction,
half of a head was visible. At the
end of the next contraction, I looked over to see my baby’s full head and face
– which was the most amazing shade of dark, glowing, teal blue that I ever hope
to see.
I
did not, to my credit, say anything about the shape or color of my baby’s
head. But I was more than a little
freaked-out. I looked to the
doctors to be reassured by their expressions and actions; however, there was no
reassurance to be had there. They
seemed more visibly upset and desperate than I. As that contraction subsided, they told Tina not to quit
pushing. If there was any
hesitation on her part, they made it clear that there was no debating – she
needed to push, push hard, and keep pushing. They explained that the baby’s shoulder was caught and that we
all needed to keep going. While
one doctor worked around the baby’s head, trying to reach in and release the
shoulder, the other doctor climbed up with one knee on top of the bed, placed
his fist on Tina’s abdomen, and started pushing/pressing/punching down with enough
strength to lift his knee off the bed.
The better half of this man’s body weight – he’s a head taller than me –
is bearing down on my wife’s pelvis.
(What’s weird is that, in looking back at this, I can clearly see this
image in my head from two completely different positions in the room. I can see him right in front of me, not
two feet from my body as I hold Tina’s right leg; and I can see him from across
the room by the door, with many people standing around, but a clear
line-of-sight to his back as he’s doing what look like one-fisted chest
compressions towering over the bed.
I know where I was, so I have no explanation for why I clearly remember
two perspectives on this specific scene.)
At
some point during this process, I heard one of the people in the room (our
numbers had swelled to at least 10, possibly 15 by this point), clearly say,
“Call 911.” Now I don’t know about
the rest of you, but, in my experience, when someone says, “Call 911,” the end
result is that the people at the hospital are called. Now here we are, in the hospital already, and (for the split
second of time required to have this thought and dismiss it as useless to me in
the current moment), all I can think is, “Call 911??! You ARE 911.
Who do you think is going to show up, a better version of yourself?”
My
focus was primarily on Tina throughout all of this. Clasping her hand, helping her hold up her right leg, and
supporting her back, I echoed the voices around me encouraging her to keep
pushing for all she was worth, while still finding time to tell her how much I
loved her. My next glance down, however,
allowed me to see our baby’s body slip the rest of the way out – still with
that translucent azure hue glowing from the face. I turned to Tina to help her lay back, wanting to give her
my focus and attention, but there was an insistent tapping at my shoulder.
“You
need to identify the gender.”
I
looked between my baby’s legs and tried to make my brain shift gears. Switching from absolute focus on being
loving, supportive, and attentive to my wife, I was now being asked to use some
other part of my brain. They
wanted me to look at something and make a choice – no, an identification. What am I doing, I thought to myself. What do they want from me?
“Is
it a boy or a girl?” asked an insistent voice somewhere out of my field of
vision.
I saw bumps. What did bumps mean? What am I looking for, again? Sex. Gender. Is it a
boy or a girl? Do I have a son or
a daughter? Bumps. Okay, what would I look for? How to make bumps fit what I’m supposed
to be looking for? It’s not a
little tiny penis, but instead, they’re bumps.
“It’s a
girl,” I heard myself saying as I turned back towards Tina, “How would you like
to have a daughter, my love?”
“Does she have a
name?” asked the voice again.
While I replied a
feeble yes, Tina said more clearly, “Her name is Esme.” As I looked once again at my beautiful
wife, who I now found I loved even more than the ‘as much as possible’ it had
been only a few minutes ago, they put our daughter on her chest. Instead of being able to watch in awe
as my wife met our daughter, I was once again pulled away by another insistent
tapping at my shoulder.
Shifting my focus
once again, I saw a metal instrument being held in my direction with two
doctors asking me if I still wished to cut the cord. Completely stupefied, I reached toward the shining metal,
only to have them brush away my hand, telling me that was the clamp. They then handed me a pair of medical
scissors and pointed to a length of umbilical chord between one white, plastic
clamp, beyond which I could see my daughter, and the shiny, metal clamp I had
attempted to grab. As I took the
scissors into my hand, I looked at the cord. Mainly a creamy bone white in color, it also seemed to have
arteries and veins around it, all encased in a transparent sheath. I opened and positioned the scissors. As I cut down, I could feel the
material, somewhat rubbery and tendon-like, start to slide up the blades then gradually
give way. As I once again turned
my focus to Tina, there was some momentary awareness of Esme being whisked away
to the other side of the room, but I was too focused on Tina to really notice.
What I did not
know at the time was that, while I had been forcibly distracted with things I
had earlier claimed I wished to do, Tina had watched Esme wriggle around on her
belly. At one point, Esme looked
up and directly into Tina’s eyes before continuing to wriggle face down on
Tina’s body.
It was only as I
turned back to Tina that they took her away. The next few minutes were spent applying every multi-tasking,
eavesdropping, information-collecting skill in my repertoire. The doctors nearest me were talking
about the potential for damage to the shoulder or upper arm. A couple of nurses in the mid-range
were discussing facial bruising.
On one side of the baby warmer they were recording weight and
length. On the other side there
was further shoulder discussion as the arm itself was being moved around. And right in front of me was the woman
I love trying to tell me that Esme was beautiful and had moved around on her
chest. Strangely, that was the
only part of this paragraph that I don’t remember.
Somewhere along
the way, we heard our baby girl crying out and we both visibly relaxed and
rejoiced. Somehow, that was the
signal to both of us that everything was going to be okay. Voices from around the room shared
their findings loud enough to be heard by all.
“Eight pounds,
eleven point seven ounces.”
“Four thirteen A
M.”
“No dislocation
in the shoulder.”
“Twenty-one and a
half inches.”
“Both arms
respond equally to stimulus.”
“Go over and see
our daughter.”
This last one was
Tina telling me to leave her side.
I looked at her and she again encouraged me to go.
I can’t say that
I remember anyone being between me and my daughter. Realistically, there had to be 8-10 people still in the room
going back and forth, but all I saw was the little girl lying on her back
across the room, little legs and arms flailing in the air. As I was moving, I was pulling out my
iPod. (My constant companion and
the only reason I was able to share this narrative. I had taken extensive notes throughout the process, getting
more than a few looks of dismay as they saw me typing away, before having their
looks soften as I shot out a question about say, the oxytocin level at the
moment and when it had last been changed, making them realize I was taking
notes, not playing Angry Birds or updating my facebook.) By the time I’d crossed the room, the
camera was on and ready. This is
the first ever picture of Esme Lynn Davis:
