Bionic Mamas

you're not losing a vagina, you're gaining a son


24 Comments

Bloody Business

Before I begin, I want to just say, in a small voice, how crushed I feel by May’s latest news, by the utter un-rightness of it, by how badly the universe is flubbing its lines. This is not how the story is supposed to go, dammit. I know we talk a lot about how unfair all of this business is, but sometimes the unfairness is just so fucking unfair. It is not the only thing that has been Not Right lately; that doesn’t make it any less wrong.

I am wondering if any of you happens to know what counts as a normal postpartum drop in hemoglobin and what doesn’t. Imagine you have this patient who, after two days of fairly heavy vaginal bleeding, arrives at a hospital in labor. Her hemoglobin at that point is 13; her hematocrit is 37.8. Following a vaginal delivery, her numbers are 7.3 and 21.7, a drop in the neighborhood of 44%.

Question one: Is that normal? If not, how abnormal?

Question two: Are there causes of postpartum decreases in hemoglobin other than blood loss? Does the placenta itself (or the baby) in some way count towards the starting number?

Question three: Do you do anything about those numbers, beyond suggesting an iron supplement? Do you do anything if the patient calls three weeks later complaining of continued extreme fatigue, dizziness, breathlessness, etc.?

Question four: Supposing a patient with this history is pregnant again. One likely source of postpartum bleeding (vaginal septum) is gone, though possibly the vaginal wall where it attached has scar tissue. Is postpartum hemorrhage in such a case likely to recur? Do you do anything in particular to lessen the chances of her feeling terrible for months again? Is there anything you can say to her to help her feel less frightened?

Question five: Is this patient a good home birth candidate? Just kidding.

My hospital records — the short version only — from the Bean’s birth arrived this week. I’d put off ordering them for a couple of years, which I guess is good, considering that I find myself a little taken aback anyway. This is just the abstract — test results and some nonsense from the lactation consultant, an extremely silly person. There are errors: I am listed as having a didelphic uterus (nope, not that normal), and hemoglobin and hematocrit are reversed in one place. (I flatter myself that a hematocrit of seven might have been more worthy of note.)

Also this week, I finally tracked down a picture I didn’t know existed until recently, of Sugar cutting the Bean’s umbilical cord. That is to say, it’s a picture of my crotch, post delivery but prior to the arrival of the placenta. I thought it might feel sort of empowering to see that, since I was scared to look at that part of my body for weeks after birth, not wanting to see all the stitches. Maybe it would have been, but I found it hard to pay much attention to my flesh, finding the pool of blood I was apparently lying in rather visually distracting. When I say pool, understand, I mean pool. I don’t mean the bed was a mess. I mean liquid. I mean depth. I mean volume.

I thought I was done finding new things to feel angry and scared about, regarding the Bean’s birth, but I guess I was wrong.

I haven’t written in much detail about how sick I was after the Bean was born, partly because at the time, I was filled with confusing hormones, alternately elated and distraught, and, well, sick. I’d been pretty thoroughly conditioned to believe that only people with (unplanned) c-sections were allowed to feel sick or sad after birth, anyway; the websites said I should be exulting in my all-powerful womynhood and resuming my exercise routine while teaching the baby French. All that matters, as you know, is that the baby is healthy. The vessel has done its job.

So, here: I was pretty sick after the Bean was born. For the first week or so, I had an annoying tendency to black out every time I tried to nurse him. The nurse I asked about it told me that was “oxytocin, filling your body with feelings of well being.” Later I realized that was the only time I wasn’t lying flat. I couldn’t hold him during the lactation class and was grateful that lesbian privilege meant I alone among the women there had someone to help. (Men weren’t allowed.) We left early because I couldn’t sit up anymore.

For the endless rounds of pediatrician visits for weight checks in the first few weeks, I took cabs. One day Sugar had a work meeting, and I couldn’t carry the Bean in his carseat. I could barely carry the car seat. We tried to take the subway once. Sugar carried the baby while I shuffled behind her, hips still entirely disconnected, like a troll aunt of some kind. (Sugar got lots of congratulations for her new baby in those days. She deserved them, but my own invisibility beside this gorgeous, healthy, thin woman and her perfect baby was sometimes hard to take. “Don’t worry, honey,” one woman said, “you’re next!”) Sugar went to the store for a different kind of iron supplement for me while I took the dwindling Bean to a lactation group. I remember feeling such utter hatred for the other woman there, so pink and healthy with her fat, pink baby, who was younger than the Bean. While Sugar was gone, I started shaking convulsively. I was losing my vision, trying to figure out how I was going to get myself onto the floor without dropping the baby, who was so, so heavy. Sugar arrived just in time, and held him while I lay my head on the desk and shook. No one asked if I was okay. I took a cab home.

It’s hard to write this without feeling I am exaggerating things, but this happened. Other things happened, too, many of them good. I stayed conscious for the ride home from the hospital, even if I did have to go immediately to bed and so missed the cats greeting the Bean. Friends came over, and I sat and talked with them. But it was months before I could walk around the neighborhood normally. Going up the gentle incline of the train station left me breathless, my vision blotchy. I feel existentially queasy looking at pictures of me with the Bean in the early weeks, because I am so very grey.

I got better. The human body really does have amazing powers of restoration. But does the patient’s recovery mean the treatment regime was wisely chosen? The heroic medicine doctors, the bleeders and purgers and givers of mercury, thought their treatments worked because their patients often survived, when the truth is those patients recovered in spite of the medicine. Regardless of whether I should have had different treatment in objective terms — and I gather from google that sources differ on the guidelines for iron infusions and blood transfusions and so on — I feel sure the other aspects of treatment could have been better. Only one nurse, when I was already in the process of being discharged, mentioned my hematocrit drop and asked if I really felt okay. (Desperate to leave, I said yes.) The nurse practitioner at my OB office told me I should expect to feel tired when I described my trouble breathing while walking. At the infamous postpartum appointment, Dr. Russian didn’t know my hematocrit levels and dismissed my questions on the topic. None of that was helpful, even if it was the case that the best course of action was waiting for my body to rebuild itself. It’s a kind of gaslighting, I think, not to tell a patient that how she feels is not in her head or her weak moral constitution.

Besides angry, I feel a bit scared by these new documents, in particular the picture. My septum is gone and presumably won’t break and bleed again. I expect it caused some of the trouble, in addition to other tears. The midwife at my new clinic says that didelphic cervices can bleed a lot, and suggested they might try rectal cytotec in addition to pitocin if it seems necessary. (I haven’t talked numbers with her, just my experience of being anemic.) If the pre-labor bleeding was a placental abruption — and we’ll never know, since the head of the OB practice didn’t see fit to take it seriously — there’s a chance that won’t happen again, and a 100% chance I won’t let it be ignored this time. I have the reassurance that I did survive, however sick I got. But there is still that nauseating feeling of almost having been run down by a bus, not realizing it was even there until it passed.


14 Comments

News From the Front

The bottom of the front, specifically. The front bottom, if you will.

The appointment went well. Dr. Baby Factory did not, after all, yell at me, you will be relieved to hear, though as always, he had that sad look that Sugar reminds me is mostly just how his eyebrows are shaped. His hair’s gotten a bit shaggy, as if the four years since we’ve met (is that all?) have taken him from being the 11-year-old star of the piano recital (as I always thought of him after seeing the picture in his office of him sitting ramrod straight up on one of the Today Show’s couches) to a 15-year-old with a garage band and a penchant for eschaton.

Dr. BF is who first suggested I go to Dr. Russian’s practice for OB, although in fairness he specifically recommended Dr. Robot, who left the practice in my first trimester.  Nevertheless, I decided I would tell him to rethink recommending them, if not for Dr. Russian’s appalling manner (which I know you all believe me about, but which could sound like the whining of a delicate flower) then for the way Dr. Skinny, the head of the practice, dismissed out of hand my was-that-an-abruption bleeding in the days before labor.  It is with deep pleasure that I report to you that he already has a call into Dr. Skinny, because he keeps having her patients come to him, get pregnant, and then refuse to return to her practice.  (Smart women!) So I guess it’s not just me.

While we’re on the subject of Dr. BF, can I just say what an absolute artist that man is at a pelvic exam? Seriously, he is the only person ever whose haven’t hurt; even his double pap smears don’t hurt. (Yes, I am a special snowflake and regularly cry over medical messing about in my lady business(es).  My cervices are on the inside for a reason.) I have to say that here because, 1) it is worthy of praise, and 2) there is no non-creepy way to express this sentiment in the moment.

So, the various bottom lines:

  • I will be making a lot more “bottom” jokes around here in the coming months.  Enjoy.
  • My CD 2 numbers are, I think without digging for my old notebook of data, the best they have ever been.  (FSH 5.6, E2 a shockingly low-for-me 39.)
  • My famous endometriomas (aka, “chocolate cycts,” if you are into ruining your ability to enjoy chocolate forever, which I am not) have apparently disappeared (?) (!).  Is this even possible?  I have noticed less back pain in the past few months, but I certainly felt plenty in cycles since being pregnant.  I am befuddled.  I’ll work on being glad, but right now I’m too confused.  At any rate, the dildo-camming didn’t give me the usual sensation that a smoldering rat is trying to scramble out of my lower back, which was a nice change.
  • We have lots of embryos, and Dr. BF seems optimistic about our chances, or as optimistic as his eyebrows will allow.

Scheduling is a bit of a annoyance, more so than I had anticipated.  I have the good insurance for six months, March-August.  I naively assumed this meant time for several cycles, but I had forgotten that the Baby Factory closes for IVF and like matters three months of the year, and two of those months are April and August.  When the scheduler explained that an April cycle, which was what I had begun to imagine, wasn’t going to happen, I felt bathed in adrenaline.  March?  March?!?  That’s so soon! But waiting doesn’t make a lot of sense, under the circumstances, so March it is.  Then I drank the warm apple juice she’d brought when I got woozy missing the half-gallon of blood they’d siphoned off for still more tests.  When a few molecules of sugar reached my brain, I remembered that I can’t do March, because Dr. BF wants me to come back early next cycle to see if a polyp is what’s making me spot so much before my period or if it’s just my good buddy endometriosis.

So May it is.  I am not entirely sorry to wait, though I had gotten myself slightly excited about Just Doing It.  I am worried that between the possible polyp and the closures, my six months of insurance just became three (and that’s assuming there’s no polyp or that it can come out quick-like in April).  However, billing had a surprise for us: the less-good insurance (under whose begrudging, code-careful auspices we had this consult) actually covers quite a bit more than we had thought.  Doing a cycle with them would still be more expensive than with the good insurance, but it sounds at the moment like it wouldn’t be impossible, especially if we planned ahead and got the drugs while I’m still on the good plan.

May gives me time for a few more visits to the favorite cocktail bar I am just now falling back in love with.  It also gives me some time to get worked up about various parts of this whole gig I wasn’t expecting.

For instance: more shots.  When I was first contemplating IVF, I decided I could deal with the little needles for stims but not the big ones for progesterone-in-oil, and Dr. BF agreed that I could use coochie bullets — excuse me, vaginal suppositories; excuse me, non-American readers, pessaries — instead.  They were messy and sort of annoying, but I was never sorry to be missing the intra-muscular missile to the butt I’d read about on other blogs, still less the bruises and lumps and lingering scar tissue.  But I guess now I get to learn for myself what all the fuss is about, because Dr. BF says (and, I regret to say, that the study I found on the topic agrees) that the delivery method really does make a difference in FET cycles.  Dr. BF says that during my IVF cycle, I was making some progesterone on my own, but that during a medicated FET, I won’t, which means that small differences in efficacy can mean big differences in results.

So one thing I guess I could use about now is some PIO pep-talking, should you have any on hand.  I’m not upset by needles per se, but I am no great fan of personal pain, especially deliberately inflicted, in my own home, every day for three months.  Call me crazy.  However, I also realize that a miscarriage I would always fear I could have prevented is worse.  Great choices, these are.

Okay, I know there are worse choices, I KNOW.  I know that, as subfertile lesbians go, I am sitting very pretty, what with the good clinic and the good insurance and the bewildering array of embryos.  It’s just…I had forgotten what this part, when fear and uncertainty loom so very large, feels like.  Frankly, I thought I got to skip it this time.

Mel asked the other day, after my first return to the Baby Factory for CD 2 blood work, whether I found that some of being back was much easier and some was ten times harder.  Yes.  That is exactly how I found it.  At first, I was giddy, almost, being back in such a powerful place without the dread and exhaustion I remember from the last time around.  This is a cinch, I thought, walking right up to the check-in computer to type my name.  The first time I came in, I stood awkwardly in front of the receptionist’s desk for some time before a woman in a pompadour, whom I did not yet know was nosy as the day is long and none too quick on the uptake, informed me in one of those New York lady klaxon voices that still startle me that I was doing everything wrong, as though it weren’t understandable that a person might imagine their office worked like every other office on Earth.  This time, the receptionists were new and muscle memory guided my hands through the menus as surely as if they were ticket machines at Grand Central.  Bam! I thought, jabbing the CD2 bloodwork button, my doctor’s name, my insurance carrier.  I got this.  I even made a self-deprecating joke about sperm to the guy ahead of me in line.  (Sorry, sir.  I should probably not be allowed in public alone, at least not while giddy.)

As I waited for my name to be called, a strange nausea crept over me.  I hadn’t, I realized, been comparing my present-day self with the me who had first come to the Baby Factory at all; I’d been comparing myself to my memory of that person, a memory colored by knowing that my first visit was only the beginning, that there were miles to go, disappointments and fears and more than a few crying jags.  In fact, that very first me, the one the receptionist startled, was a lot like this me: happy, excited, hopeful.  I had mainly wanted to go to an RE because of my mysterious lady-part arrangement and because my insurance covered it and the Gyn I’d gone to was a dick, so why not?  I imagined we’d leave with a plan, buy some sperm for home use, and have a baby in less than a year. Although our story ended happily, that original me sure had another think coming.

The PIO surprise was like a bucket of cold water to the face in part because I thought this time was going to be so easy.  Aren’t FETs supposed to be so simple compared to a fresh cycle?  I suppose it is simpler, in that I don’t have to come to the office much and won’t get OHSS this time, but I had forgotten that simpler isn’t the same as easy.  I know what to expect from an IVF cycle, but an FET is nevertheless new to me, bringing with it all the anxiety that attends medical novelty.  That I know how to get to the clinic and where to buy a coke after they exsanguinate me for science does not mean I know anything about what’s going to happen, and worse, it doesn’t mean I have any control over the results. I know I’m a lucky subfertile lesbian, but dammit, why can’t I just be a fertile one?  I thought skipping the rounds of IUI this time would make me feel fertile, but that fantasy is crumbling now that I remember that this “fertility” still involves doctors and needles and tenacula and fear.  I never really believed this when we were trying to conceive the first time, but it turns out this secondary infertility jazz is, to paraphrase Smarshy’s memorable image, just a different bag of ass.


27 Comments

Birth Story Part Five

Back to our story, already in progress. (See parts 1, 2, 3, and 4.)

As you’ve probably gathered, Dr. Jerkwad did not paralyze me. Thank you, Hippocratic oath. Or self-interest — my mother pointed out later that any misstep after I’d called him an asshole would have looked very bad in court. Also: I’m pretty sure you’re supposed to have the patient sign the consent before the procedure, not after.

For anyone reading this while considering options for her own delivery: getting the epidural was not a big deal. It did not hurt or even feel especially strange, and while the thought of a needle in the spine is a bit creepy, at that moment, the finer distinctions of human experience were not exactly at the forefront of my mind. There was no “creepy,” only “good” (a highly theoretical construct, belonging to the world that existed before the cab ride) and “bad” (everything I am feeling right now and for as long as I can remember). I, who am nervous about practically everything, felt no anxiety, only impatience. In terms of physical sensation, it was as I was told it would be: cold skin from the alcohol, very slight stinging from the local anesthetic, then a spreading coolness in my back. It hurt less than the IV. If you don’t want one, don’t get one, but if you think you might, don’t let fear of the procedure itself scare you off.

What can I say about epidurals that hasn’t already been said in a thousand love songs? Whoever invented those things should get the Nobel Prize for Medicine and no, I am not joking. I said some time ago that post-delivery, my anger at people (like that patronizing dick, Dr. Sears) who would try to scare women out of having epidurals had hardened to a murderous rage, and I meant it. (And again, this is not at all to say that those of you who didn’t or don’t want them shouldn’t have the choice, even if you do make me feel like a bit of a wimp.) I’ve had occasion recently to reflect on the unusual level of privilege I enjoy when it comes to medicine. Not only do I have access to good health care (insurance, good local doctors, all that), but I have a unusually (another rant for another day) good science education for someone who didn’t get a science degree, access to library databases and knowledge of how to use them, and an appropriately massive sense of entitlement regarding my medical care. So while I may have my own psychological demons about wanting/needing pain relief, at least I am more able than average to sort through the immense amount of crap out there about the supposed medical reasons to avoid epidurals. It pisses me off to no end that a whole parade of well-meaning nitwits and genuine jackasses would lie to women with fewer resources rather than risk letting women decide for themselves what ideologies to sign up with and what medicine to accept.

Back in the prenatal day, when I was confessing my epidural neuroses, wise Sara said:

The thing that nobody tells you about giving birth with an epidural (or, in my case, being denied an epidural, so giving birth without one after begging for one), is that in addition to dulling the pain, the epidural also totally erases any weird psychological hangups that one might have about epidurals. They actually rock, as it turns out. It’s just a well-kept secret.

And she’s right. I have a lot of strange feelings about how birth went, but not about the epidural. It just rocked, full stop.

Epidurals work very, very fast, but it does take a few contractions. The first contraction after it went in is as painful as the ones before, but somewhat more emotionally difficult for me, since I had been looking forward to being saved, and now I am not saved after all. I feel a sickening fear that it won’t work, but then it starts to. The next two contractions are maybe 85% of what I’ve been feeling, and after that they become manageable. I can sit up and turn around on the bed; I can listen to the nurses again. Kips Bay Mega Hospital uses low-dose, patient-controlled epidurals, which is part of why I wanted to come here: light epidurals compare favorably to traditional ones in studies of practically everything you can think of. Someone shows me the button I can use to boost the dose if I need to. The world begins to reassemble itself.

Despite my stabbing at the button, the low-dose epi is ultimately not enough, so after 45 minutes, a different anesthesiologist — who manages not to be an asshole, imagine that — comes in and gives me a bigger dose. After that, I can still feel the contractions, but they aren’t so bad. (I am glad I got to try the low-dose, though, and I think more hospitals should have that option.)

Unfortunately, what can’t feel my contractions is the contraction monitor. It picks up maybe one in three or four. The nurse keeps moving the sensor around, asking me to tell her when they come, and feeling all over my belly with her hands, but she can’t find them, either. At this point, I don’t think much of that. Who cares? I am having contractions — I can feel them — and it doesn’t seem surprising in the least that some contraption doesn’t register them. Contraptions! Of course they are prone to failure! Yes, I am the girl who thought for nearly 20 years that tampons didn’t work for me because they just don’t work all that well.

What does need to be registering those contractions is at least one — ideally only one — cervix. (So far, there is no hint of my didelphic nature causing a problem: everyone who sticks a hand in my business agrees with Dr. Skinny that one has obviously taken over.) In the “natural” childbirth literature, there is a lot about how labor pain is not something women have justifiably dreaded for all of recorded history but is actually fantastic because unlike kinds of pain men experience every other kind of pain, labor pain is “productive.” Allow me to add that to the list of things Dr. Sears can shove up his urethra. Frankly, so what? Passing a kidney stone is a thing that happens, too; does that make that pain “productive”and therefore worth having?

However, when the resident comes in and asks to do a cervix check, I am a little excited. If I was four centimeters five hours ago and spent most of those hours having strong, frequent contractions, surely things must be getting close. And my water broke, too. Maybe I really was in transition in the cab. Maybe the resident will look shocked and say, “No wonder you felt bad! It’s almost time!”

Instead, she feels around for a minute and says, “Great, you’re at four centimeters.”

WHAT? All that for NOTHING? Are you kidding me? I am ready to hit the ceiling. She looks like she knows she’s said the wrong thing. “Um, maybe four and a half?”

Oh, and my water hasn’t broken after all, so, um, sorry I peed in your car, cabbie.

While all this is going on, Sugar goes back downstairs to reclaim our luggage, which the man at the information desk let her leave there when it became obvious that she couldn’t carry it and push my wheelchair at the same time, formally checks me in, and gets a health care proxy. At some point, she calls the doulas — we have two, since neither is a full-time doula. It turns out the one we liked can’t come tonight, but the other one shows up a little while later and sits with me while Sugar gets dinner somewhere I don’t have to watch her eat and brings me back some cranberry juice. My main concern with this doula has been that I will find her happy but frantic energy upsetting in labor, but I manage to find the spine to tell her that I don’t want to talk, and to her credit, she listens.

This part, from when Sugar gets back in the room until it’s time to push, I look back on fondly, all thanks to the epidural. Sugar dozes on the fold-out chair/bed in the corner, the doula reads, and I just rest. I am freezing cold, but the nurse brings piles of warmed blankets and bundles me up. The lights are turned down low, and the fetal heart monitor fills the room with the Bean’s steady, reassuring heartbeat. I love the thought that we spent those last hours together that way, he listening to my heartbeat all around him while I heard his all around me. I feel safe and calm.

I’ve read quite a few stories that include praise for being at home or at a birth center; let me throw in some praise for being at the hospital. Because of my father’s devotion to his job, I spent quite a lot of night time at the hospital as a child, waiting for him to visit just one more set of patients on the way home from a piano concert; perhaps my experience is unrepeatably idiosyncratic. I remember the quiet of the wards at night as my father walked from room to room, silently watching his patients, stepping into the hall to ask a resident for details. Of course I like the epidural and feel reassured by the knowledge that there are pediatricians and a NICU right here if the Bean needs them, but I also like feeling that my room is a quiet part of an active hive. By now it is dark out, and my window is filled with a grid of windows from the wing of the hospital across the courtyard, some lit, some dark, some in between. I think I might have felt alone and isolated at home; here I feel watched but not bothered. Like I am in the right place, safe.

At some point, Dr. Russian turns up, seeming cheerful. She checks my cervix now and again, and there’s another thing to love about the epidural: now I am dilating smoothly and rapidly. I can’t remember exactly when I heard each number, but I remember thinking at one point it was two centimeters per hour. The Bean’s head is dropping nicely, too. Everything is fine, except that I am supposedly not contracting enough. At eight centimeters, Dr. Russian wants to break my water to speed things up, which I don’t mind and don’t even really feel. It certainly doesn’t hurt.

Contrary to what you may have read about epidurals, mine in no way leaves me paralyzed or numb-feeling. I can and do move my legs, and when the nurse starts talking about catheters, it’s not because she won’t let me try walking to the bathroom. However, even though she says my bladder is very full, I do not feel any urge to pee, so after a few minutes of focusing on finding that sensation, I agree that the catheter is a good idea. I had really wanted to avoid that, but it isn’t a big deal. Getting cleaned for it hurts in a “clitoral exfoliation” kind of way, but the catheter itself doesn’t. She takes it out as soon as it’s done its job.

The only negative side-effect I have from the epidural is that my belly itches. A lot. And all that moving around the monitor in search of my contractions isn’t helping. Of all the things we threw in the hospital bag, the only one I really want is the washcloth we’ve forgotten. Sugar gets paper towels wet to distract me with cold. It only sort of works, but boy howdy, I will take itching like this any day of the week over the pain I was having.

The nurse who is mostly taking care of me is sweet and young. She thinks the baby will be a girl because it is being so good; Dr. Russian says that surely means boy. The nurse asks about names. We had wanted to give the baby a name from each family, and while the girl names were easy to choose (we have 3 names we like, in four possible combinations), finding a male name from Sugar’s family has not been not easy. There are plenty of men on her dad’s side, but not many names at all. My pick is Sugar’s father’s middle name, which lots of the men have, but she is having none of it.

No one ever says I’m completely dilated, but I gather that I must be at about 10 o’clock, when Dr. Russian tells me I have an hour to develop an urge to push before she wants to turn off the epidural. How about down rather than off, I ask, terrified. She agrees and leaves me with the nurse again.

So for an hour, I try to push. The nurse tries to find my contractions; Sugar and the doula try to help me. I can feel the muscles just fine. I know what to do and I feel a slightly constipated feeling, but never anything more. I roll over a few times, which I don’t like and doesn’t help. The nurse coaches me through pushing anyway, but the resident says I’m not doing it right. I convince the nurse to let me breathe out as through a straw while pushing, because holding my breath makes me feel terrible. I do three 10-count pushes per contraction.

After 45 minutes, Dr. Russian returns, and I agree that it’s time to turn down the epidural. I’m not too worried, since I figure the pain will just return to where it was before the extra dose. And they say epidurals do slow down pushing, so maybe this won’t even last long. Maybe I’ll have a February baby, just like BFF predicted back in October! The anesthesiologist (another one) comes in and lowers the dose; Dr. Russian says, “Don’t you DARE touch that button,” and leaves again.

And here, Gentle Internets, is where the horror movie starts. I can’t tell this part of the story neatly, because I wasn’t in my right mind for it. I often wish I didn’t remember it at all.

Without the epidural, the pain rapidly goes past what I can stand. Now my bones are being broken again, but only after being set on fire. There’s still nothing in my belly at all, just back and hips and especially my thighs. God, my thighs. I feel sick now just thinking about it. Between contractions, I can hear that I’m making those terrible dry sobbing sounds again. At some point, Dr. Russian speaks with scorn about my crying, but I’m not crying in any normal sense. My face is dry. This noise is coming from some dying animal part of me, utterly beyond my control.

I’m on my back still — I know, I KNOW; I “should” be in some other position. I didn’t even want to tell you all this now, because I am afraid someone will come tearing in to lecture me on Best Practices for Back Labor and tell me it’s all my fault. But I can’t stand the thought of any other position. I know I’ll fall apart if anyone tries to move me, and I mean fall apart physically.

At each contraction, Sugar and the doula hold my legs up while I push. At various points, I try holding the bar or my own legs; eventually I settle on holding a sheet-rope tied to the bar. I push for a count of ten, three times per contraction, while someone — usually the resident, sometimes Dr. Russian — tells me I’m not doing it right. I am doing exactly what they describe. A few times, I am told that I have finally done the right thing, that I should keep doing that. I am always doing exactly the same thing, every time. The scolding and praise come at arbitrary intervals, heavy with emotional freight. It’s very like a nightmare.

Dr. Russian is horrified that the nurse has let me hiss breath out during pushing, so it’s back to holding my breath. Which is stupid, by the way. And, as far as I can remember, not supported in the literature. Up until this point in our relationship, Dr. Russian has been so medically rational that I blithely ignored the advice to talk to my OB about her views on coached pushing, a grave mistake.

And now it is too late. For two hours, this goes on. I try to push, despite the fact that I am now in so much pain that some primitive part of my brain simply won’t let my legs spread enough, won’t let my back muscles let go at all. My body is trying to save itself, and I can’t override it. I can’t open more, I can’t relax, I can’t push harder; wanting to doesn’t enter into it, and neither does any conscious idea of fear. I am trying my best with every part of myself still under the control of my brain, but it’s not enough.

Complicating matters, no one can find my contractions on the monitor or by feeling my belly, so they often don’t believe I’m having contractions, just that I’m carrying on, I guess. I have to tell them when one is starting or stopping, which pleases no one. I have since learned (thanks, HFF) that this happens to bionic folks like us reasonably often; I didn’t make the connection until recently, but I was told early on that no matter the normal size and shape of my uterus, there would likely be differences in the muscle tissue at a microscopic level, which is why they wouldn’t have attempted an external version in case of breech presentation. I can only assume that no one at the hospital ever put those ideas together at all.

And then there was Dr. Russian. It’s Dr. Russian who has kept me from writing this down for all these months. It was two months before I could begin to be honest with myself that she was not, in fact, consciously using “tough love” in a misguided attempt to motivate me but is, in fact, the kind of smart, funny, emotionally unstable maniac that I Always Fucking Fall For. (That I have managed to marry someone smart, funny, and also compassionate and gentle is a miracle of the first order.) Four months out, I can confidently say that her behavior was assholic and frankly cruel, but it’s taken some time to get here.

Dr. Russian, as far as I can remember, spends the remainder of labor yelling at me for pushing wrong, for making noise, for holding my face wrong, for not wanting to push the baby out, for not trying.

That last one, that’s the one I can’t shut out, then or now. It cuts to the bone of my childhood insecurities. Recently, a friend whose pregnancy overlapped mine asked why I had liked being pregnant. From her perspective, pregnancy had been a somewhat uncomfortable, often inconvenient means to an end, not something she enjoyed for its own sake. But I did love it, and talking to her made me realize that a big part of why is that for the first time, after a lifetime of being told I was failing at gym and the like because I wasn’t trying (not, say, because I had untreated asthma), I felt physically competent at something important. I was doing it right, and until the last day, no one said otherwise.

Over the course of two hours, everyone in the room realizes that however typically helpful it is to turn down the epidural at this stage, in my case it is a rank disaster. When Dr. Russian leaves the room, the nurse starts asking if maybe, really I do want to push that button. I refuse. Things are bad enough; I am terrified of what Dr. Russian will say if I do that.

Dr. Russian comes and goes. At some point she threatens me with a c-section if I don’t start trying, which, despite the high rate of sections at this hospital, is curiously the only thing she says that doesn’t frighten me. I know I’ve dilated smoothly, I know The Bean is very far down, I know my water hasn’t been broken for long. The Bean’s heartbeat is steady and strong, no distress there. For the first time since I googled “double vagina,” I know I’m not having a c-section. I am sure of that, and the threat doesn’t touch me.

Eventually, the mood in the room changes enough that I can say, yes, I give up, I need the epidural back. Sugar tells me later that the resident and a collection of nurses bundled Dr. Russian off to the hallway to convince her it was not working. The anesthesiologist who had turned it down comes and turns it back up, without comment. I rest a little while. It starts to work, and while I’m never out of pain again, I stop sobbing.

Dr. Russian spends the rest of labor sulking. At some point, when I say how much better I think things are going with the epidural back on, she rolls her eyes at the ceiling.

Pushing continues. I’m exhausted and shaking all over. In between contractions, when my legs are released to the bed, I have to tell myself, out loud, over and over, that the bed will hold me up. Again and again, I’m told I’m not pushing hard enough or long enough or right. They say I’m not having enough contractions. I am. I’m tempted to lie sometimes, to not mention one is starting, just so I can get a break, but I don’t. They give me pitocin — or maybe that was before the epidural was turned down; I can’t remember now because I didn’t care at the time.

At some point, Dr. Russian asks whether the heart rate on the monitor is mine or the baby’s. “The baby’s, I think,” says the resident.

“No. About this I am very particular. Find out for sure.” I am grateful for Dr. Russian in that moment, glad she is watching out for The Bean.

There is a small flurry of activity as the resident and nurse try to figure out what to do, how to move the monitor, how to be sure, but then Nurse Ringer, an older Latina says calmly, “Why not take mom’s pulse and see if it matches?” They do and it doesn’t. Thanks, Nurse Ringer, for saving me from internal monitoring with the power of logic.

The Bean’s heart keeps steady on, steady on through all of this. At one point, I hear Dr. Russian remark to a nurse that he has an “enviable trace.” I glow with pride and silently thank the Bean for being so strong, for causing no worry.

Eventually, it is Nurse RInger who saves the contraction-monitoring day, too, as she finds a magic spot, very low on my belly, where she can feel them. Everyone is gathered around the bed at this point. The doula reminds me at every contraction to keep my face relaxed and my chin down; I am grateful that she can say that gently, since it saves me from being yelled at by Dr. Russian. They keep saying I’m pushing wrong. Someone gets a mirror, tells me I can see the head, but I never do, just my swollen lady bits and blood. (They had tried to clean the blood away before bringing the mirror, for fear of upsetting me, but I’m not bothered.) I carry on. Nurse Ringer is yelling that she wants to meet this baby; she reminds me of the baby-crazy secretary at Sugar’s office, and I don’t mind her yelling.

And here is what happens, after four hours of pushing three times per contraction, exactly the same way every time: I have another contraction, just like the others. I push twice, and am told I’m not doing it right. I push one more time — exactly the same way I’ve done it before, except maybe for two seconds longer — and out comes the Bean, all at once. Dr. Russian is across the room. The resident catches him, and “catch” is no metaphor here: he was flying.

* * *

And everything is happening at once again, only now it’s in a good way. Someone says he’s a boy. Someone puts him on my chest. The placenta comes out, and he’s passed back down so Sugar can cut the cord. Someone asks if we have a name. We have a first name…. Everyone else has to wear gloves to touch him, but we don’t, because we belong to each other.  We talk gently to him and are awed.

His initial Apgar is 9, with a point off for not crying much. (A very polite way to lose a point, in my opinion.) After a few minutes, Nurse Ringer takes him to the bassinet and warming station in the corner to suction him and clean him up a bit. Sugar goes with him, and I’m so glad she can. Holding him was one kind of amazing, but watching her with him is another kind altogether. I hope she’ll tell you about it herself.

P1000968

Meanwhile, I am getting stitched up. Dr. Russian is giddy now, and she and the resident are working together, stitching and pulling and filling me up with gauze and pulling it back out again. I ask to see the placenta, and the resident shows me, after asking if I want to go skin to skin with it.  It’s smaller than I had expected.  They can’t get the bleeding to stop. The epidural is turned up higher and they’re using lidocaine, but it hurts. This indicates to me that I had plenty of sensation in my vagina all along and that the woman who told me tearing wouldn’t really hurt in the moment was right, because I certainly didn’t notice it happening. Mr. Hyde Dr. Russian had said when the epidural was tuned back up that it wouldn’t stop me feeling pain as he came through my vagina and that I had to not “freak out,” but really, it was nothing compared to everything else.

The Bean was born at 3:06 am, after four and a half hours of pushing. I hear Dr. Russian declare to the resident that it was really only two hours, since I apparently wasn’t trying the rest of the time. She has very sharp things in my crotch.  I don’t kick her.

Meanwhile, Sugar is still with the Bean. Suddenly she looks up at me, teary-eyed, and cries out, “I want to give him my dad’s middle name!”  I agree, and he has a name.

Eventually, the stitching and gauze-stuffing stops, my legs are released to the bed, and Sugar brings The Bean back to nurse. And he does, or at least makes a good effort. The doula swoops in to give me confusing advice, but mostly we just lie there together.

P1000974

(What ever did happen to my vagina, anyway? Stay tuned for the Recovery Epilogue.)


Leave a comment

Birth Story, Part Two

(For backstory, disclaimers, and jokes about the Crimean War, see Part One.)

In a comment on the last post, Bunny asked whether my granny cart broke because of the hundred-ish pounds of groceries I had piled in it in my attempt to keep the cats from eating us alive. The answer is no. A superficial analysis would suggest that it broke because I was lazy the last time I fixed it (the linchpins on the axle are just wire, crappy wire at that, so the wheels fly off from time to time when the wire wears through) and didn’t neaten up the ends of the new wire, which then got bent out of shape when the cart was repeatedly folded and unfolded over the course of a month or so and, thus weakened, sheared off at a bad moment.. (And by “new wire” I mean cheap key ring, which I am telling you because I still think my discovery that those were the right gauge of wire was brilliant, not least because it means I can keep a “repair kit” of several of them jingling from the cart at all times.) But that’s not the real reason it broke, any more than the washer broke because its belt stretched out. (And while we’re on the subject of my enormous pride over trivial mechanical competence, yes, I was pretty damn pleased with myself when I thought of that and therefore saved us hauling the sucker to a handyman, thank you very. Sure, Sugar actually fixed it, but I did the intellectual heavy-lifting, okay?)

No, the washer and the granny cart and also our printer and Sugar’s Wacom tablet and a half dozen other household mainstays broke that week because of a little-known fuse built into all mechanical and electric items, known as the Critical Detector. The Critical Detector, says my father, who imbued me with most of my obviously enormous understanding of the gadget world [No, I still can’t get the damn blog to import to WordPress; why do you ask?], is that widget that, sensitive to the relative importance of a given device at a particular moment, chooses the optimal moment for said device to fail. It is the Critical Detector that causes catastrophic copier failure ten minutes before the FedEx deadline of a grant you’ve spent a year writing, that makes your car die on the way to your sister’s graduation, that killed the digital camera the day of our courthouse wedding. Naturally, with my due date approaching, every CD in the house was on alert. We’re lucky the place didn’t explode.

Back to our story, already in progress:

Saturday: You know those dreamy, drapey pregnancy photo shoots that people do? The ones that are sort of romantic and beautiful and sort of too reminiscent of douche ads? I have mixed feelings about them — who’s ever going to want to look at them anyway? And isn’t it all a bit self-indulgent? But what if I regret being too cool for them later, when it’s my stomach flesh that’s drapey and white and I realize that I Will Never Be Beautiful Again??? Better safe than sorry. Also, I always wanted to be pregnant in the summer so that I could go to the beach and for once in my life know for certain that no one was allowed to even think boo about what my stomach looks like in a two-piece, but here it is cold weather and yes, I was pregnant at the beach last year but only enough to look chunky except for the time I didn’t know I was pregnant yet but I looked 5 months gone because of the OHSS, and so maybe we should just cover the bedroom in white cloth and get out the camera and give it a shot? Or is that cheesy and hypocritical?

Oddly, Sugar prefers draping the bedroom in white and spending a few hours with her camera to listening to me deliberate. Can’t imagine why.

While she digs the wedding tablecloths out of the depths of the “nursery” closet, my body does what our bodies do when we prepare to drape them in white cotton: start bleeding from the hooha.

It’s not a lot of blood, but it is blood, so I call in. Dr. Skinny is on call assures me that an abruption would hurt, that this is probably just the Return of The Irritable Cervices. She asks if I’m having contractions, and though I am plenty achey, I say no, because I’m not having any rhythmic belly business, and I’d know if I were having contractions, right?

The bleeding stops after a couple of hours, and the photo shoot goes on. I figure the light is too good to put it off and anyway, this way we’ll have time to reshoot if it doesn’t go well.

37 weeks 5 days

[Sugar only ever got around to fixing up one of those pictures, and it is sad but true that no one really cares how pregnant you looked once the baby is out. Someday, when I get WordPress working, I will get her to spruce up some of the others for a password-protected post and I will g-d FORCE you all to look at them and say something nice. Because in fact, I am not 100% overjoyed with the current state of the ol’ bod, and while I’ll probably one day go back to aggressively wearing a two-piece bathing suit despite never having had a “bikini body,” it ain’t going to be this summer.]

We go to a friends’ house for dinner, and realizing that I’ve invited guests for brunch and accepted another dinner invitation for Sunday, I make some joke to Sugar about how typical it would be for me to use all my nesting energy on socializing, leaving the house a disaster when the baby comes. Ha.

Sunday: God, I felt good Sunday morning. I slept pretty well — I understand that may happen again in 18 or 20 years — and even in a bit. Then my BFF calls and Sugar brings me the phone in bed and I lie there and talk to her while Sugar runs around making quiche and getting the house ready for our brunch guests. BFF talks to me about her labor; the only thing I remember is how much she hated laboring on the ball, but the conversation leaves me feeling relaxed about the prospect of labor, since after all, I have a few weeks before anything is going to happen. [You may find all this foreshadowing heavy-handed, but the idea that I had another 3 weeks really was in my mind constantly.] Eventually, Sugar says it’s time to get going if I want to be wearing clothes when our guests arrive in 20 minutes — and that seems like a nice idea, since I’ve only met one of them and her only once — so I get off the phone and head towards the bathroom, thinking things feel a little mucous-ier even than usual in the pants department.

But I am wrong about that: there’s no mucous at all.

Just lots and lots and lots of blood.

I stay put on the toilet while I call the doctor again. Sugar ruins the pie crust, which I have never, ever seen her do. Dr. Skinny calls back and says again that I don’t have an abruption, that of course I’m worried by blood but it is really okay. Am I having any contractions?

Funny thing about that, I say. Last night in bed I was thinking about it, and the only thing that comes and goes in a wave-like pattern is my backache. Is that a contraction?

Turns out it is. Dr. Skinny suggests that rocking on my hands and knees and doing some walking might ward off back labor, but I’m not all that worried because that’s not going to happen to me.

We debate canceling brunch, but the thing about city life is that no one has cars. They’ll be on the subway already, and even if we can reach them (possible, since most of the line they’re on is above ground), turning around will be a giant pain. Plus, we don’t really know them and it’s rude to uninvite people. Exsanguination before awkwardness!

I clean myself up, Sugar makes a new crust, and we all have a nice time at brunch. In fact, those guests are the perfect ones to have, since not only are they charming but one of them had a severe postpartum hemorrhage and is hence able to assure me that bleeding too much in an obstetric context is not something I’m likely to be in doubt about: I will know for sure that something is not right. I spend a while gawping at their baby, who is objectively fantastic but at that moment seems huge and terrifying and given to unfathomable moods and sudden noises.

After brunch, Sugar and I go for a walk in the Botanic Garden. We both remark on how much farther I’m able to walk than last time we went, not up to my normal standard, certainly, but over a mile. In fact, I’d been very sad after our last trip, because I’d imagined spending early labor walking here, but it seemed like I wouldn’t be able to manage it. Wouldn’t it be funny if this were the famous burst of energy that precedes labor? It’s not, of course. This would be a ridiculous way to use that. Just let me sit here for a minute until my back stops hurting again.

By dinner time, it is hard to ignore that I’m having some contractions, maybe two or three an hour. Obviously these are Toni Braxtons because I’m not having this baby for weeks yet. We take a car to our dinner friends’ anyway, though. Wait, I just remembered that we actually took the subway and then walked! Hilarious! I thought we had taken a car because only an insane person would have been too cheap to do so. Ahem. It occurs to us that even though these friends are usually good for some very nice wine, there might not be any because the wife and I are both pregnant. We promise each other that if GOD FORBID that happens, we will BY GOD get some wine on the way home. And yes, we are feeling strongly enough to use that many GODs.

Decency prevails! There is wine! I have two honkin’ glasses of it and remark that while I find the idea one of the women in birth class had of waiting until the night she went into labor to have a glass of wine (to slow the contractions) very sweet, I need a drink, dammit. The Oscars are on. We eat some very spicy beef that seems like the best thing in the whole word; I all but demand to be sent home with leftovers. The contractions — which still just feel like wretched back pain — keep coming. I can talk through them, but I’d rather not. Still bleeding like crazy. We really do take a cab home.


Leave a comment

Birth Story, Part One

This is hard to write. I still feel strange about parts of this story, and I can’t seem to get it to coalesce into better writing. But I told myself I would get it done before the arrival of several specific babies, two of whom are now past their due dates. So here goes. The first of …4, maybe? [Ed. — who am I kidding? Maybe 8.] parts, which I’m going to post as soon as I have them written, since sitting around thinking about how to do it better isn’t getting me anywhere.

Right after the Bean was born, people started asking whether it had been a long labor. I always said emphatically not, that it had been the shortest first-baby labor imaginable, barely a blink of an obstetrical eye. …Which is only true if you take in account that I was in deep, deep denial about what was happening until nearly the end. So while I want to include the week before, which now seems part of it, keep in mind that any sense of inevitability is strictly revisionist.

Since this is so long overdue, let’s start with a little context, shall we? Y’all might have forgotten what brands of crazy I was.

Monday, 2/21: Week 37 begins. Sugar and I meet the pediatrician our friend has recommended, who holds information sessions for expectant parents on Monday nights. Sugar thinks she’ll be late because she’s coming from work; instead, she is on time and I am 20 minutes late because I’m too tired to walk there and the subway is all messed up. I use both hands to haul myself up the railings of the subway staircases.

Tuesday: Hahaha, Tuesday. That was a fun one. Crampy. Exhausted. I get told my insurance has been canceled. This is all my disastrously fragile mental state needs. (I’d forgotten how bad it was until I reread this post. Yikes.)

Wednesday: First cervix check. One cm dilated, 50% effaced. Or one of them is; Dr. Skinny claims only one is active, which she somehow knows without checking. I don’t argue, because ouch. Spotting afterwards and feelings of general emotional turmoil, such as always seem to accompany any cervix-poking. I trot out my fancy math skillz and figure I’ll be pregnant for another six and a half years.

I spent another hundred years on hold, trying to figure out what the hell is going on with my insurance, while I wander Target, looking for that dark-colored nightgown and robe they say you’re supposed to have for the hospital. I can’t find anything, which I figure doesn’t matter since I have another six and a half years to deal with it, and I can’t bear the thought of taking off any clothes to try on nursing tank tops, so that will have to wait. I buy a pack of newborn onesies, since I’ve just found out that “newborn” isn’t the same as “0-3 months.”

I go to my last pre-term acupuncture appointment and plan to start the “preparing for labor” series in a few days. Oh, but supposedly my insurance is fine, no need to panic. (Aside: basically this same thing just happened to us again, only with Sugar’s insurance. And after the panic attacks and the insomnia and the endless waiting on hold, it turns out everything is okay, but I WANT EMOTIONAL REPARATIONS, DAMMIT. Or at least someone to really, thoroughly yell at.)

I am finally driven to drink.

Thursday: I visit Schroe and meet the illustrious Speedster, Speedy, and the whole marvelous menagerie. We eat cookies and drink tea while Speedy gives the dogs acupuncture treatments and exclaims over her new love of cooking dry beans. Speedy wins my heart by stating with absolute assurance that my didelphic tendencies aren’t going to be a problem in labor.

I spend 95% of the visit gawping at Schroe and internally (?) panicking. Look at the way she handles the Speedster! She knows what to do! She knows what he wants! She can nurse him and change diapers and everything. I have no idea whatsoever what to do with a baby, I realize. This is going to be a disaster. Also: they have a real washer and dryer! We just have a little washer that hooks to the sink, no dryer at all. We are so unprepared.

I spend the bus and subway ride home looking at the adorable newborn sized clothes Schroe has given us. At least the baby (Aaaahhh!! Baby! Aaaaahhhhh!!!!!) won’t have to be naked. There’s that.

I get home and the washing machine breaks.

Friday: We are having dinner guests! I drag myself to the hippie coop grocery — via subway and bus; the last time I tried to walk there and back, I couldn’t walk at all the next day — and undertake the first of what I plan to be two or three major stocking up trips. Two cases of cat food, that kind of thing. [Hindsight sez: Nesting. Check.] I assure my supervisor that I’ll be in for my next shift unless, haha, I go into labor. I look so pathetic when the cab arrives that the driver puts my bags in the trunk for me despite what I belatedly realize is a major hand wound. Blood is coming through the torn strips of cloth wrapped around his palm. Seriously: it’s like we’re in a movie about the Crimean War, shot in Park Slope. I tip well, at least. (I think. Car service tipping is confusing!)

On the way down the ramp of my building, my granny cart breaks.

In lieu of cleaning the house even a little bit, I collapse on the bed. Later, I stumble my way through a passable lamb tagine, and Sugar saves me from burning the couscous beyond recognition. I have to sit down a few times because of extreme, stabbing cervix pain, but that’s been happening for at least a month. We show off our fancy stroller — the guests are the expectant parents of one of those aforementioned slightly overdue babies — and realize we don’t really know how it works. Suave. We show off the “nursery” and assure them there is a mattress in the crib, somewhere under all that junk. Good thing we have like 3 more weeks to clean up in there….


18 Comments

Resolve

Update: 1-minute contractions every 10 minutes from 4am on. They start in my back, then come around to belly and shoot down legs. Maybe a bit more frequent now.

Talked to Dr. Skinny late last night, because I didn’t understand that this blood business was just going to go on and on (intermittently). Frankly, she was kind of a bitch about it. Poop on her. (Actually, if she ends up at the delivery, perhaps the opportunity to do just that will be the silver lining….)

So, FYI, since all the books and stuff just talk about “blood-tinged mucous”: apparently if your bloody show looks like a heavy period and the doctor says that’s okay, you should not expect it to stop.

I don’t know if this is early labor or pre-labor or what, but I do know that whatever it is, it is not shaking my resolve vis-a-vis that epidural. Just for the record.


9 Comments

Lady Parts Pop Quiz

Okay, class; clear your desks.

Q: You have arranged to cover or otherwise surround yourself in white fabric — wearing white pants, a white dress, a white bathing suit, or, in my case, the many white draperies Sugar has thrown around our bedroom in preparation for one of those slightly cheesy pregnancy photo shoots. What happens next?

˙ǝsɹnoɔ ɟo `ƃuıpǝǝlq ʇɹɐʇs noʎ :ɐ

(Don’t worry — not very much. I already talked to Dr. Skinny, who agrees with me that it’s likely the Return of The Irritable Cervices, nothing more. It’s just amazing to know that my body, which I so often doubt, still responds to primal cues like white cotton.)