Esme's Arrival

Well, my friends, this is long.  But it also goes a long way to explain why I haven't been answering my phone, making it to class, or generally doing much outside of the hospital and home lately.  As you read, know that we're all happy and healthy -- nothing to worry about now.  Also keep in mind that this is a birth story from a dad's perspective.  As that's the only perspective from which I can write, it fits.

Esme’s Arrival

       After a Monday meeting with the doctor following our Saturday due date, they decided it would be best to set up an appointment to induce Tina on Wednesday, September 21 at 7AM.  For some reason, we decided to watch a movie Tuesday night, possibly because we were so excited about the upcoming day that we couldn’t have gotten to sleep if we’d wanted to, so we went to bed after midnight and woke up at 4:30 to call the hospital and find out exactly when to show up.  (This starts the sleep counter at 4 hours, counting from Tuesday morning when we awoke.)

       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:

                       

       

I snapped a few more photos and held her little hand before we both went back over to join Tina.  As she was again laid on Tina’s chest, Esme immediately started rooting around, seeking her mother’s breast.  Once again, love swelled within me, making me somehow capable of loving Tina even more and also loving a completely new being.

At one point, I stepped away for some reason, and found myself face to face with the doctor who had climbed up on the bed.  The only thing I could do as I faced this man who had most recently been driving his fist into my wife’s abdomen was to open my arms and give him a tearful hug.  As thanks spilled out of my mouth, I turned to the other doctor and gave her a huge hug also.  These two had worked in tandem to help us have a healthy, uninjured baby; from what I had just observed, that seemed to me to be a miracle.
As folks began to clear out of the room, I heard strains of music and singing in my head, almost as if I were wearing headphones:  "Four in the morning, Crapped out, yawning, Longing my life away."  As it was (around) four in the morning, I was crapped out and yawning, I suddenly knew the first song Esme would hear outside of the womb.  Once again, my iPod came out and I flipped through to find it.  And again, my brain wasn't quite working to full capacity and I could not think of the title of the song.  As I flipped through song titles, I could almost hear snippets of each song as if someone were tuning an old radio.  The correct notes finally came through and I pressed play on "Still Crazy After All These Years."  I followed it with "Father and Daughter" from Surprise somewhere along the way.

By 4:35 AM, we were left alone in the delivery room with our baby.  They gave us a few moments before coming back to check vital signs again.  The next two hours passed in a weird, exhausted, joyous delirium.  Though I have no memory of anything but Tina and Esme, perhaps there was some sleep had or some drinks obtained from the nutrition room. 

At 6:30 we had gathered ourselves up and were ready to head over to the recovery room.  St. Joe’s has a tradition of playing a few bars of Brahm’s Lullaby as families walk from delivery to recovery, and I can’t tell you how special it was for us, with Esme crying in Tina’s arms, to hear that come on just for us.  Esme immediately stopped crying for the duration of the song. 

By 6:45 we were safely ensconced in our new room, with the warning that we would start getting visitors – various nurses, doctors, pediatricians, meal deliverers, cleaners, photo representatives – starting around 8:00.  So we all slept for almost an hour!  (Sleep count: 26 hours passed, 2 hours of sleep; remember that we only had 4 hours of sleep the night before that.)

When we started functioning again due to necessity, we were not left alone with our baby for more than fifteen minutes until 11:30AM.  We had until noon to enjoy each other before the afternoon began.  Reality, for me, started to be more than blurry at the edges.  There may have been more snippets of sleep before, sitting at the edge of the bed, looking at Tina, then Esme, then out the window, I realized that I needed to refresh and refocus.  (It has long been a theory of mine that I have shared widely that one cannot take care of others unless one first takes care of oneself.  It is rare, perhaps, that I take my own advice – though I also espouse the theory that the advice one gives others is most frequently the advice one should take oneself – but in this case I did so.)

At 6PM, I kissed them both gingerly and headed home to shower, eat a real meal, and head back to the hospital a new man.  We continued to be visited throughout the evening and the night.  By the time Friday morning came, we had passed the required time for us to be in the hospital and were thoroughly ready to be home and uninterrupted. 

At 11:57AM, we were pulling out of the hospital drive with our baby in the car seat.  We had been in the hospital over 52 hours and had slept approximately six hours each over the preceding 54 (or 10 hours each over the preceding 75).  We’ve had 48 hours at home by now, and even slept reasonably well last night.  Perhaps we’ll adjust to the ‘new normal’ sometime soon.

In the meantime, we send our thanks to all of our friends and family who have shared so much love and sent well wishes our way.  You helped us welcome Esme into the world!

    

     

PS.   On Sept 24, our first full day home, I took 101 photos of Esme.