Wednesday, May 1, 2013

Elisha Rose's birth story

Hailey's note: This couple is very dear to me. They took classes with me as I was expecting Maggie and I watched them work together and prepare for their new addition. Their birth and newborn experience was quite a ride and I'm amazed by how hard they worked in becoming parents.  This is a story of love for each other and ultimate love for their new child.

To Barb & Craig: Thanks for your honesty, sacrifice, and devotion. You amaze me and your little girl is very lucky to have you for parents.

(The rest of this post is Barb's words)


It was 5:00pm on February 2nd. I was 3 days overdue, my father who had come into town for the birth had to leave in another 2 days, and it seemed like the baby would never come. We had just gotten back from a short walk around Ensign Peak, showing my parents some nice Utah views, when my water broke. I thought it was discolored urine and only recognized it as my water because it seemed to come involuntarily. Seemingly involuntary urination had become such a common occurrence late in pregnancy that I didn’t think anything of it at first, until it kept coming. My contractions started almost immediately and they were fast and hard. Although we had learned in our birth class that labor beginning with broken waters followed immediately by intense contractions is the stuff movies and TV are made of, not real life, this was exactly my experience. Perhaps fitting considering my obsession with movies. And as with any clich├ęd movie or television script, Craig, my husband, was playing his part as the anxious father to be, pacing and calling the doula and the birth center. Although we were a prepared as possible, nothing could have prepared us for how we would feel in these moments, or what lay ahead. I went over to my dog and knelt beside her on the couch. Petting her soothed my early contractions. Though I didn’t know it at the time, after my child was born my interactions with her would never be the same. We were instructed to come to the birth center at that time, which was not what we were planning on, but as we came to learn, there is much about my birth story that is not what we were planning on.

We arrived at the birth center around 6pm and Adrienne, my midwife, suggested that I start in the shower. I labored there for a while, with Craig pouring hot water over my body. The next thing I remember I was in the Jacuzzi tub, with Craig, Marin (my doula), my mother, and Adrianna (the birth assistant), all at my side. Time during this period of my labor was very strange. There was a big clock on the wall that I told myself I shouldn’t look at, but did anyway. Hours ticked away like minutes. While I was in the tub, Marin would tell me to ride the wave of my contraction and push the pain all the way down into my pelvis. When it stopped, she told me to enjoy the break, take this time for myself. I alternated between feeling sweaty and chilled, and my hair was a disheveled mess that hung around my face and over my eyes. I refused to pull it back; the wildness of it helped me to stay in touch with my raw and uninhibited state of being. I focused on all of my senses besides the pain, the hum of the jets in the tub, the heat of the water, the low and loud primal moans I let out with every contraction, the images in my head. I traveled back to my childhood and memories I haven’t thought of in years came into my mind. It was almost as if my life were flashing before my eyes, but slowly and within my control. I thought mostly of my best friend, Ryan, who had passed away 2 weeks earlier. As I laid in the water on my back, I imagined floating with her late at night in the lake across the street from my parents’ house. When she died, I knew she would be with me during my labor and I just kept picturing her, connecting with her. I thought of the fact that distraction from pain lessened pain, and that at that moment, 130,000 other women around the world were laboring with me. I thought of my child, who with every contraction, came closer and closer to being ready to come out. This was the best part of my labor, the part I would later treasure and romanticize. Although physically painful, I would not trade this part of my labor for anything.

At 1:12AM , I was told to come out of the tub because contractions had stalled. Although I had gone from 4 centimeters to 8.5 rather quickly, I hadn’t made progress in a while and it was thought that changing positions would move things along. I stood and held on to Craig; I was on all fours; I was on the bed. Fluids continued to ooze out of me and everyone told me not to be embarrassed. They didn’t have to say that; I wasn’t. I had completely surrendered myself to the labor state and entrusted my care to the team of support surrounding me. I was unashamed. Adrianne checked my cervix and thought the baby was posterior, which was a huge disappointment to me because I had worked so hard, doing pelvic tilts daily, sitting on a birth ball, forward sitting on the couch, all to ensure that the baby was in a good position. The last time we checked, four days earlier, baby was head down and anterior, just the position baby had maintained throughout my pregnancy. Why at the last minute were things different? “We had a deal!” I told the baby. Next we tried different positions on the bed, which was extremely difficult, but the people surrounding me offered so much support and encouragement that somehow I managed to get there it each time. I drank herbs, Kelly Carb, Cohosh, and Cotton Root Bark and then we tried a Rebozo technique on the bed. When they checked my cervix again, I unfortunately had not progressed, and the baby remained posterior. Adrienne recommended that we transfer to the hospital where I could receive an epidural, rest, and see if more progress could be made. It was 4am on February 3rd and I had been in natural labor for 11 hours. At this point, this was a welcome suggestion.

We decided to go to the U Hospital, as it was our preferred hospital, baby friendly and my condition was not considered an emergency. Making this choice, however, meant a 25-minute car ride instead of a 3-minute one to the closer hospital. I labored in the back of Craig’s jeep, with Marin at my side, for 25 minutes at 4 in the morning, and Craig almost hit a deer. I thought to myself again that this was the perfect dramatic climax to our movie. When we arrived at the hospital I couldn’t get the epidural fast enough, but where time seemed to fly at the Birth Center, it was the opposite at the hospital. And once I had decided to have the pain relief, I wanted it immediately. The first doctor we saw was headed off his shift in another hour and he did not seem to have any appreciation or sensitivity for what I had been trying to do at the Birth Center. His demeanor was pragmatic and cool and as he laid out our options he included a c-section as one of them. I was hypervigilant to this kind of hospital pressure and I immediately reacted, letting him know that he would not talk me into a c-section. I can’t believe it, but I actually had the presence of mind to ask that my care be switched to the midwives and this was the best decision I made while at the hospital. The two women who joined our team after that were incredibly sensitive and warm and thoroughly explained to me every option each step of the way. They were appreciative of my birth goals and the fact that my desire was the least amount of interventions possible. Ironically, though I had spent time on a birth plan which we really only needed in the event of a hospital transfer, we couldn’t find it when we actually needed it. Thankfully, Craig and I had discussed our preferences ahead of time and so when the time came for informed decisions, Craig was amazing. How true it was that even under the pain medication, I was in no state at all to be making decisions for myself. While I was inclined to agree to whatever was offered, Craig asked each time what the benefits, risks, and alternatives were to each intervention. I was so impressed with the way he held his own in those stressful moments.

I labored for 13 more hours in the hospital, and what I remember most about those hours are the people that surrounded me. Craig, my mom, dad, Marin and Adrienna all stayed by my side as the hours crawled by and we waited for my contractions to increase to an “acceptable level”. I remember making conversation with everyone, doing anything to pass the time and keep my mind off of the pain in my left lower back, which even the epidural did not touch. At one point I called my dad, who had been waiting outside, into my room. He held my hand and I wept as I told him what a good dad he was. He kissed my arm and told me how much he loved me. He massaged my lower back where it hurt and joked that he thought he was done with this – he did the same thing for my mom when she was in labor with me. I remember at another point that he and Craig were watching golf in the room, and then watching my contractions on this machine I was hooked up to. I couldn’t even feel them anymore, which was strange to me. They turned it into a game, as they could see the strength of the contractions of the other women in labor in other rooms, and they cheered for me to “beat” the others.

My time in the hospital was defined by waiting, and piece by piece giving up the birth that I had envisioned. We decided that I needed Pitocin to get my contractions going again, and this was followed by a monitor inserted into my cervix to measure the strength of the contractions. The pain in my lower back was considerable and I found myself pushing the pain relief button as much as I could. None of the tools I had found useful at the birth center were helpful anymore as I laid numb in the hospital bed. I prayed for it to all be over soon. Finally, the midwife I had made a significant emotional connection, Christine, to told me tenderly that my baby’s heartrate was slowing down and that my cervix was swelling. My baby was transverse and had not made any progress in 13 hours. She told me that a c-section was her suggestion at this point, and my face wrinkled as I knew this was inescapable at this point. She seemed to cry with me as she said she knew this was not what I wanted but that it was necessary. I was exhausted and had given up everything I had wanted thusfar. I couldn’t believe that after everything I had been through, it had come to this, but I trusted that this was the only option left and I wanted it to be over. Craig said, “Let’s meet our baby” and we conceded to the surgery.

I had wanted my mom in the room for my baby’s birth, and I was overjoyed to have the anesthesiologist permit my request of allowing her in the operating room for my surgery. We said our good-byes to Marin, whose role in my birth concluded with the c-section, as she could not come into the OR. I thanked her profusely and she did the same, for allowing her to be a part of our experience. She said multiple times that our birth was one of the most amazing and powerful births she had ever had the privilege of being a part of.  Although actually I barely know her, she was an integral part of the most intimate and powerful experience of my life. I will forever feel connected to this woman. After Marin left, we all put scrubs on, took some pictures and proceeded to the place where my baby would come into the world. I looked up at the lamp above the operating table and it was almost a mirror. I thought to myself that I could covertly watch the surgery if I wanted to. I couldn’t decide if I wanted to. The midwives joined us and Christine agreed to hold up a mirror when the baby came, at my request. So glad that in my drugged up, exhausted, emotional state, I thought to ask for this. The entire procedure took only 20 minutes, I’m told. My mom watched the entire thing; Craig chose not to, instead holding my hand. I felt a weight lifted off my torso and they held up a big beautiful baby, who started crying immediately. The first thing I said was “it’s a boy!” because I will admit I was looking straight at the genitals, so anxious at this point to know whether we were having a son or a daughter. I was already convinced we were having a son, even before I saw the baby. Craig and my mom both said, somewhat hesitantly, “no, it’s a girl”. I realized that she was so swollen I thought she had a scrotum, and when it hit us that I had just given birth to a daughter, all three of us burst into tears of happiness. They took her away for a moment to examine her, and then placed her on my chest, so we could have our skin-to-skin contact. I touched her forehead with my lips and felt the softest skin I have ever felt. They had to take her away again, because apparently she was struggling to breath a little. I asked Craig to go with her, because I didn’t want her to be alone. He would tell me later that, because he knew how important skin-to-skin was to me, he took off his shirt and did skin to skin with our baby before he let them examine or test her, or whatever it was they were doing. This was the first of many acts as a father that would impress me so much about the man I loved. My mom stayed with me while they sewed me up, and I slept for the first time since I went into labor.





The next thing I remember we were back in the labor and delivery room and they were bringing our daughter in. It makes me very sad that the moments and even days and weeks following this are blurry to me. In the beginning this was due to the anesthesia I was given. While I have to keep reminding myself on the one hand that had surgery not been an option, our daughter may have died inside me, along with me, I still mourn the loss of the birth picture I had in my mind. I imagined bringing her into the world through my body, watching her emerge and maybe catching her myself, and bringing her directly to my chest and holding her there for as long as I wanted. I must have imagined this moment hundreds of time, each time I did my prenatal stretching and perinatal massage, every time I struggled to get to sleep at night and felt my child dancing inside of me. I imagined nursing immediately and enjoying her early state of quiet alertness, bonding. I have a foggy memory of nursing her for the first time and then of talking to my brother and sister in law via skype. I do remember Craig saying to me, “Do you want to tell your parents her name?” I said to my parents “this is Elisha Rose”. I explained that the spelling was with an E, and that her middle name was in honor of Ryan. I wish I could remember more about those first moments.

After I gave birth, time changed again, this time becoming one long, continuous day that lasted for weeks.  Our first weeks with Elisha were in some ways more traumatic than my labor and delivery. I think that ever since her birth I have been trying to make up for what didn’t happen. Just like her birth, I had ideas planned for how I would care for her in her first few weeks. I would nurse on demand, co-sleep, baby-wear, all in accordance with the idea of the “4th trimester” and with attachment parenting principles. Even if we didn’t have the delivery I wanted, I intended to bond with her in other ways now that she was here. I hadn’t planned on an incision in my abdomen that would make it difficult to sit up on my own, among other things, along with an even deeper emotional wound that left me feeling empty and broken, and in which I found in difficult to connect the baby in my arms with the life I had felt inside me for 10 months. Elisha taught me, with my labor and with the weeks following, that even the best laid plans can be broken and that there are some things you can’t control, even if you try really, really hard and do everything “right”.

None of the plans I made panned out the way I had hoped. After day 1 of her life, Elisha cried constantly. It was the kind of cries that make you want to crawl out of your skin and melt into a puddle. In the beginning I had the energy to stick with it and told myself it was just gas or I just had to nurse her again or she had a diaper rash. I nursed so often that 90% of my meals were spoon fed to me by Craig. After a while her intense cries began to paralyze me and I found myself crying along with her. I would give her to Craig, who became a master at soothing her. This was a double-edged sword for me, because while on the one hand I was happy someone could make her feel better, on the other I felt guilty that it wasn’t me. Guilt seemed to define me in that first month, likely stemming from the fact that I found it difficult to accept on an emotional level that the c-section wasn’t somehow my fault. The idea that it was simply out of my control was unfathomable to me. We made countless visits to the pediatrician in the first month. Elisha’s weight was too low and so we had to be extra vigilant about the number of wet and dirty diapers. We began trying different remedies for gas for her, certain that this was what caused her to scream so intensely. We devised a tracking system for each time I nursed, tracking the length of each feeding, which breast it was on, and the medications both Elisha and I were taking. This alone was exhausting. Having to do math at 3am while on zero sleep was not part of what I had signed up for. At about week 3 we were diagnosed with thrush/yeast. More medications for both of us, more dietary supplements. I tried giving up dairy for a few days to see if she had a milk allergy. Nothing helped. Throughout this ordeal I often marveled at the parallel processes my daughter and I were experiencing together. Both of us depended on others to feed us, both of us had lives that were defined entirely by eating, sleeping and pooping. (I was taking two different stool softeners multiple times a day, another fun perk of childbirth.) Both of us had yeast. Both of us were crying constantly. I even developed a diaper rash due to wearing those giant maxi pads 24/7. I used her Desitin and it cleared up pretty quickly. Perhaps the most striking similarity was that Elisha and I both had mothers that were worried about us and constantly trying to sooth us. I even asked mine to stay an extra 10 days past when she was scheduled to leave.

After 4 weeks of nights and days that ran together, the pediatrician suggested that Elisha was not getting enough calories and that we should probably supplement with formula temporarily. Another way for me to feel inadequate as a mother, I wept at the thought that despite my best efforts I could not provide enough food for my baby. And I could not get away from the idea that this too, was somehow my fault. Once we began supplementing, Elisha turned into a different baby. She slept better, became less fussy and her “freak-outs” dwindled significantly. However, now that were supplementing, my milk supply was really in jeopardy. We had already been meeting with a lactation consultant, and she gave me a plan for how to increase my milk supply. Among other things, more pills were added to my daily regimen, along with three cups of mother’s milk tea a day. The process of increasing my supply required nursing as much as possible, supplementing with formula following each feeding (the pediatrician’s request), and then pumping after that. This also included administering her yeast drops four times a day, along with any gas/intestinal PRNs we wanted. I was driving myself crazy trying to do it all perfectly, and with an infant, who doesn’t always go to sleep or stay calm after each feeding, it was impossible. I felt I had reached my breaking point when it was suggested to me that Elisha might have a lip and tongue tie that had impacted her nursing. I was tired of chasing down the problem and tired of people offering conflicting suggestions. I wanted so badly for things to be better, and with sleep deprivation having robbed me of my executive function, I lost the ability to think critically. I tried to incorporate every suggestion I received. We got several opinions on Elisha’s lip/tongue tie and I did some of my own research as well, while nursing her all hours of the morning. We decided to have the procedure done since there seemed to be virtually no down-side, other than the fact that it may make no difference in her nursing.

Since the lip/tongue tie procedure Elisha has had a better latch and has continued to improve in her good spirits. I am continuing to work on increasing my supply, but it wasn’t until my midwife gave me permission to just relax and get some more sleep that I really began to feel myself come back again and resumed some sense of normalcy. Elisha was born on February 3rd and it is now March 25th. The snow is melting in the valley now and for the past week, we have felt ourselves turning a corner here. Her moments of wakeful peacefulness increase everyday, as do her smiles. I am working hard to increase my milk supply but I’m also prioritizing sleep and just enjoying my daughter. I admit that this is partially because I was reminded that lack of sleep impacts milk supply, but also because I am remembering that I need to care for myself adequately if I am to be the type of mother I want to be, and also because I deserve it. Even though it kills me each time we give Elisha a bottle of formula, I remind myself that I am doing this because I am a good mom. It’s what she needs and sometimes it’s what I need in order to take good care of myself. I try to also remind myself that how good of a mother I am is not solely dependent on my ability to breastfeed, that there is so much more to my relationship with my daughter. I treasure those moments now when she has finished eating and we smile and look at each other, when I nurse her side by side in bed and we are skin-to-skin, belly-to-belly, connected physically once again. The challenges we had during her delivery and in the first 6 weeks of her life will I am sure be a distant memory when we reach the next challenge and will for sure pale in comparison to the parenting tests we have yet to encounter. I think of this time as my first reminder as a parent of the important lessons I can never forget. Nothing is perfect, nothing is exactly as planned, and nothing is completely controllable. In spite of all of this, I know I’ll never regret the decision to be a mother and I’ll treasure all of our moments together. Imperfect, spontaneous and beautiful.