On Birth (part 1)
I want to tell you all how excited I am that I am pregnant, that we are expecting, that our life is going to continue to change and stretch and mold us—but in order to do that, I have to tell you so much other stuff. Because if you had told me—not too long ago, perhaps last winter or early spring even—that I would be OK with getting pregnant, I would have laughed in your face. Last time I was pregnant, I developed a life-threatening condition called HELLP and almost died (and my daughter was born nearly 2 months premature). The doctors told me right away that if I got pregnant again, I would have a 1 in 4 chance of recurrence of HELLP. After all that drama and trauma, I thought the answer was easy: we would adopt through foster care when the time came. Our perspective on that has now changed (a painful, but needed decision) which I plan on writing about in the future. For now, though, I feel compelled to write about my first birth experience, because it is something I have never done before. This is your chance to stop reading right now. I know birth and babies are full of trauma for so many—infertility, stillborn children, broken dreams, crushing disappointments—and I won’t feel slighted in the least if you choose to opt out. But one of the reasons I decided to write about all of this is that we so rarely do talk about the trauma. And that, partially, might be why I was so surprised at what happened to me.
I was 25 when I got pregnant, two years into being married to the best boy. There are only a few pictures of me looking pregnant. We just didn't think to document it at all, we thought we had loads of time. I just knew I was going to be one of those people who go late, who blow up like whales, who waddle into the last stretch. When I was about 30 weeks along, in the middle of the summer, I ran a basketball camp for all of the kids in our apartment complex (this is hilarious for many reasons, not the least of which I know absolutely nothing about the sport). My friends and neighbors would gather in the shades of the trees in the park and watch me run around, directing the volunteers and blowing whistles at the unruly children. The mothers would urge me to sit down, and look worriedly at my expanding belly. But I felt fine (I thought miserable was the baseline, after all), and I was determined to go on as if life was not changing. When I tried to plan a trip to the beach with a bunch of neighbors the next week, they all politely declined. They told me that they would not be going anywhere with me until after I had the baby. I was mystified, and more than a little put out.
Right around that time, my legs started swelling. At the end of a long day of being on my feet, selling over-priced chocolate inside of a high-end mall, I would have what can only be described as massive “cankles”—which my husband and I would laugh over. At first, the swelling would be gone by the morning. Pretty soon, it never went away, and began to creep higher and higher up my legs. I would go to see my midwife (remember, I lived in Portland, where everyone has a midwife and is bound and determined to never use drugs or the hated "medical interventions"). She would caution me about my sudden weight gain. “But I’m not eating any more food!’ I would wail, despondent to see the numbers creeping up. She was hurried, brusque, and unfailingly optimistic. Just lay off those sweets, dear! She would tell me. When I told her who I wasn’t feeling so great, how the swelling was getting worse, she consoled me that these were just normal symptoms. I started to realize that maybe I wasn’t one of those glowing pregnant people. Maybe I was just one of those miserable ones.
When I was almost 33 weeks I woke up and my face was so swollen that I couldn’t even open my eyes all the way. I took a picture of my face and texted it to my husband, who was already at work (he did doubles on Saturdays). He thought it was kind of hilarious, but that maybe I should just call my midwife to see if it was normal. I called her office, but was routed to an answering machine at the hospital that she worked out of. I left a message detailing my swelling and how I felt, and hung up. She called back a while later, and again told me that this was all normal, nothing to be worried about (I didn’t know it then, but she was currently on vacation in Central Oregon). I hung up, resigned myself to my puffy-faced fate, and got ready to go hit up some garage sales with my mom.
I got a call from the hospital a short while later. The doctor on call for the weekend had heard my message and wanted to check in with me. I told him my symptoms and he urged me to come in, just to get my blood pressure checked. Ok, I said, I’ll try and come in sometime this morning. My mom swung by our apartment and we hit up a few sales on the way to the hospital (I bought a bunch of yarn, probably with the intent to make a bunch of lumpy, ill-fitting hipster baby hats). When we got to the hospital, we were ushered up to labor and delivery. A nurse put me in an empty room and took my blood pressure. It was slightly high, but nothing too terrible. She told me was going to wait 15 minutes, then take it again. She did, and she frowned slightly. It was higher. We waited another 30 minutes. It was higher again.
The mood shifted in the room. The nurse got me a sandwich. She said I would probably be there for a few hours while they kept an eye on me. But every time they checked me, my blood pressure continued to climb. They brought me forms to fill out: I was being admitted. They did blood and urine tests, but I didn’t know why. I was texting my husband, who was still at work, and I didn’t understand what was going on.
At some point, later in the afternoon, the on-call doctor, the one who had told me to come in, came by. I don’t remember this very well. In fact, from here on out, I hardly remember anything at all. He must have explained what my symptoms were—how I had something called HELLP syndrome, which is a trifecta of bad news—red blood cells breaking down, elevated liver enzymes, and low platelet counts. In practicality, it meant this for me: my body was attacking itself—my liver had shut down, causing all fluids to be retained in my muscle tissue (hence the weight gain), I was at a great risk for stroke, and the only cure was delivery of the baby. Plus, if I didn’t do it soon—with my platelet counts dropping—I was likely to bleed out during birth.
But I had 2 months to go! I didn't have a crib. I was supposed to go to work that day. My husband wasn’t responding to his texts. My dad and my sister were out of town, and my other sister was in Africa. My mom listened to the doctor and asked all the questions that I could not form. I had a hard time grasping that this was a serious situation, but I was trying. The doctor, who I suspect was trying not to frighten me, seemed exceedingly calm about it all. I murmured some things about birth plans and natural birth and he said I could be induced and we could try for it, but it would most likely end up in a c-section anyway. I don't remember this but I guess I called my husband's work and demanded to be put through. But I was crying too hard to talk to him, so my mom got on the phone. You need to be here NOW, she said, and he left right away.
He got there, looking as scared and bewildered as I was. I was given a shot of steroids to help the baby’s lungs (the last organ to be fully developed). How long can we wait? We asked the doctor, scared first and foremost for the baby. The doctor did not want to commit to an answer; we settled for getting my blood drawn every 3 hours and watching the levels closely. We tried to sleep. The next day, Sunday, we spent waiting. I don't remember anything about that day. At some point, they must have put an IV in me. At some point, they put me on magnesium, to keep me from having a stroke. The nurses were so quiet and careful with us. We didn't know this then, but I was too sick to be transported to another hospital, and the one we were at was not equipped with a NICU. If the baby needed more care, she would have to be transported while I remained behind. In the morning, my levels were dropping fast enough we had to make a decision. The doctor did not hem and haw any longer. We need to do this now.
I was alone when they wheeled me into surgery, as alone as I have ever been. I felt like I was dying, which is exactly what was happening. I lay on my side on the cold metal table as they inserted the hollow needle into my spine. If I wasn’t so miserable, I thought, I would be pretty scared right now. I can't be sure, but it seems like I was thinking about terrible Christian artwork--you know, the kind where there is a man, slumped over, being held up by a beatific Jesus. I was thinking about the halo-ed light, I was thinking about what it means to be alone and not alone, I was thinking about what it means to have faith that you are being carried by someone you cannot even see.
My husband came in with scrubs on, and held my hand. I was too sick to be very worried. Everyone was very fast and quiet. I just wanted to know if the baby was ok. They cut me open, and I couldn’t feel it. They tugged and pulled and it was so strange and horrible and miraculous too; then they were telling me I had a baby girl, and she was crying, and it felt like a dream that I was just a minor character in.
My husband says they took her to the incubator to check her lungs; after it appeared like she was doing fine, they washed her up and did a few tests. They bundled her up and someone held her close to my face. I think I gave her a kiss. She was tiny, 4 pounds, with sharp little elvish features. My mom, who badgered her way into the room, took our first family picture.
She was fine, she was fine, she was fine. Relief was the overwhelming feeling, and to this day it lingers, and it colors the way I want to tell this story. Because I want to end it here, in a happy place, I want to show you that we are well we are doing now. But the truth is I almost died that day, and I ended up being so sick that I don't remember the first time I held my daughter, I don't remember feeding her, I don't really remember the first week of her life.
I was saved, she was saved, but I was also robbed of so many dreams of my own. In the end, that matters so little. But it is still worth saying aloud.
(Next week I will write about what happened after the birth. And the week after that I hope to write about our journey through the foster care system. Thanks for reading along).
My favorite site for getting an overview of HELLP/how to raise awareness is here. (but be warned, some of these stories are unbelievably sad).