I had been having pains on and off all day Saturday, but I thought they were just particularly strong Braxton Hicks (false or "practice" contractions). Around 9 p.m., I joined a bunch of fellow members of the Cambridge Community Chorus (including my mom) at the offices of WGBH, the local PBS station. We had volunteered to answer the phones until 1:00 a.m. for the annual WGBH Auction fund-raiser. We began at around 10 and I answered phones for about two hours, taking people's bids over the phone, which was actually kind of fun once I got the hang of it.
Around 11 p.m. I decided that the pains were strong and regular enough to cause concern, so I started timing them (as best I could amidst the chaos of the auction). When I realized they were quite consistently 4-5 minutes apart and 30-60 seconds in duration, I knew they were real contractions; Braxton-Hicks never fall into such an evident pattern.
Then I went to pee and found some blood in my undies, so I decided it was time to call the midwives at WomenCare. So I did, and when I described my symptoms, the midwife on call immediately told me to come to the hospital. Fortunately, we were quite close. My mom drove me over and we checked in via the emergency room, which you always have to do after hours. The check-in desk girl was handling another patient so she told us to have a seat and wait ... and then she promptly forgot about us. She was wandering around doing random clerical tasks, and finally my mom went over and asked whether she had forgotten us. D'oh!
So she checked us in, and we went up to Labor & Delivery, where, happily, nurse Lori was on duty -- the one who had taught our childbirth class (which we never finished!). She introduced us to nurse Sara, who took care of me. Sara took my various vital signs and hooked me up to two devices: one to monitor the baby's heart rate, and one to monitor uterine contractions.
Then the midwife arrived and checked me out. She took a vaginal culture to test for Group B Strep, a disease which pregnant women are routinely tested for near the end of the pregnancy -- I would have gotten that test at my next regular checkup if none of this had happened. Then she felt my cervix and pronounced me to be 2-3 centimeters dilated and 100% effaced.
So the midwife told the nurse to start an IV for fluids and then to give me the two drugs, betamethasone (henceforth known as Insta-Lung, courtesy of Jessie) which is a steroid related to cortisone and whose purpose was to help baby's lungs mature rapidly; and terbutaline, which is a "smooth muscle relaxant" intended to slow/stop the contractions. (Interesting side note: terbutaline was developed as an asthma drug, because it relaxes the bronchial passages. It was found to slow contractions basically by accident.) Terbutaline, which the nurses all called "terp," was dubbed No-Labr by Jessie, who was having Repo Man flashbacks.
The two drugs were administered by injection: Insta-Lung in the butt, and No-Labr in the arm. The nurse, Sara, asked me whether I wanted the "hard one" (Insta-Lung) first or the "easy one." I said the hard one, so she gave me the shot in the butt, and I was all, "oh, that wasn't so bad at all," and then a minute later it started to burn and I felt dumb. ;) The one in the arm was no problem at all. Good thing I don't mind needles. Then Sara put in my IV and disconnected me from the monitors and let me walk from the exam room to a labor and delivery (L&D) room. There I got hooked up to monitors again and settled into a delivery bed. The midwife came in and said she had decided to put me on antibiotics, the ones they use to treat Group B Strep, as a preventive measure because the results of that test wouldn't be back for a while. So they added the antibiotic to my IV.
By this time it was about 3 a.m. and I was all, "who can I call to tell them about this exciting and scary development?" I called my brother, because he's on PST so it was only midnight for him. He was quite shocked and kept saying "oh my god" and then "I don't know what to say." I told him it was okay. Then I called Jessie, the friend who was supposed to be my birth coach (along with my mom), because I was enamored of the idea of waking her up to say "I'm in labor," but she didn't answer (more on this later).
Then they told me to get some rest, so I tried, but the No-Labr was making my heart pound and my breathing speed up, so I couldn't relax. My mom caught a little sleep. Basically we whiled away the hours until about 7 a.m., during which time I got another dose or two of No-Labr -- fortunately they had decided I could get it in pill form now, rather than by injection. At 7, Sharon the midwife came in to say that she was going off-shift and Meghan would be replacing her. Then Meghan came in and did another vaginal exam and said that there was no change, which was basically good. So we returned to the lying around, taking the drug every four hours thing. Every time I had to pee -- which was a lot since they were pumping IV fluids into me and I was drinking a lot of water because the hospital air made my mouth dry -- I had to call a nurse to disconnect me from the monitors. (The nurses can see my monitor info at their desk, so even though theoretically I could have just disconnected the monitors myself, it would freak them out.)
So we sat/lay around some more, and eventually Jessie called and it turned out she had gotten back late the previous evening from Ohio, having before that spent a week in France, so she was beat, and had chosen to ignore the phone at 3 a.m. But she promised to come right over, and did, which made my mom happy because it gave her a chance to run home and feed her kitties and take a quick nap in her own bed and get some supplies. So Jessie came over and kept me entertained with many stories. I dozed off a few times, but she wasn't offended; in fact I think she was just as happy because it meant she could tell some of her stories twice. ;) Keeping people entertained by babbling incessantly at them is one of her special talents.
Around 2 p.m. the nurses and midwife came in to give me another dose of Insta-Lung. Previously, they had said they wanted to give the first dose 24 hours to work and then administer a second dose and then let the labor proceed, but apparently they had changed their minds. (It had been twelve hours at this point.) So I got another shot in the butt, and then they said that if I could make it through another 24 hours without going into labor ("breaking through" the No-Labr drug) they would reassess. (They changed their tune several more times, so keep reading. *g*)
So the afternoon basically passed like that. I lay around getting the occasional dose of drugs, catching the occasional ten minutes of sleep, and being entertained by Jessie and a couple of other friends who came by later. In the morning I had optimistically ordered breakfast (they have room service!) but been unable to eat much because the drugs were making me nauseous. In the early evening I ordered dinner and did manage to eat a bunch of it. I also called many, many people on the phone, which is what I typically do when something major happens. :)
Around 7 p.m. they moved me to a postpartum room because I wasn't really in labor any more and they needed the L&D room for an actual laboring mother. My mom went off with a friend to perform the complex logistics of rescuing my car from where we had left it (outside the PBS station's studio, as you may recall) and taking it to my place and getting some of my stuff. At this point we let Jessie go, since she'd been there for like eight hours, and my other friends continued to hang out while I got moved to the other room. It was certainly a more comfortable bed and a nicer room. Also, I wasn't on the monitors any more, which meant I could get up and go pee on my own, wheeling the IV pole along with me. So that was nice.
Then after a while I kicked my friends out so I could get some sleep. At this point the nurses/midwife were telling us that they might keep me in the hospital on bedrest for 2-3 more WEEKS. Augh! So I was trying to adjust to this notion, having already had enough trouble adjusting to the notion that I might be having a baby right here and now. My mom came back (having gone to her place to finish cleaning out the room that the painters were supposed to start painting bright and early) and settled in on the fold-out chair, which of course is meant for new dads to sleep on. We actually got some sleep during the night, despite being interrupted every four hours for me to take a pill, have more antibiotics put into my IV, have my blood pressure and temperature taken, etc.
In the morning they came in and said that they were thinking of springing me. We were quite surprised, since the last we'd heard was that I might have to stay in hospital for three weeks! But they said that since the No-Labr was working so well, there was no reason I couldn't continue the bedrest in the comfort of my own home. They said they would give me some tests and assess baby's condition and then decide for sure. Oh, they also removed my IV, which seemed like a positive sign. They left the needle and hardware attached to my hand, but detached the tubing so I didn't have to wheel the IV pole along with me everywhere. Yay.
So I had breakfast, and eventually the ultrasound/test lady, Nikki, came to get me for the tests. She did the following: a) a non-stress test, b) a biophysical, and c) a measurement of the amniotic fluid. The non-stress test basically measures the baby's response to its own movement. When baby is forced to move around (by an unpleasant stimulus), his/her heartrate should increase. They make the mother drink a bunch of very cold water, which makes the baby cold and makes him/her move around. My baby responded very well to the cold water, moving around a lot with corresponding heartrate increases.
The biophysical profile is done via ultrasound. The technician looks at several key measures of fetal health, such as muscle tone, whether there seems to be liquid in the bladder, and a few others. I had told Nikki ahead of time that I didn't want to know the gender, and she was very good about not letting us see anything that might give us any idea of the gender. But we did get to see baby's little face and hands, the little beating heart (which was still cool to *see* even though we had heard it on monitors many times), the placenta, the bit of the umbilical cord leading into the placenta, the ascending aorta pulsing in baby's neck to bring blood to his/her brain, etc. So that was very cool. And baby passed all points of the biophysical, except the lung one, which Nikki said doesn't mean anything anyway because many babies just don't show lung activity in the womb but the people who devised the test many decades ago refuse to remove that item from the test. Nikki also used the ultrasound to measure the amount of amniotic fluid, which is a key indication of whether the placenta is functioning properly. It was within normal parameters. So all was well, and we returned to the postpartum room to await news of our fate.
Then Sharon the midwife came in and said that I could go home. Yay! She gave me strict instructions about not getting up except to pee, although she did also say that I could take a very quick shower ("whirlwind" was her word), which made me VERY happy. I was starting to feel quite icky by this point. She also said that I must make an appointment for Wednesday to be reassessed, and she wrote me a prescription for No-Labr so that I could continue to take it every four hours.
So we packed up and left. Altogether it was almost exactly 36 hours from the moment we entered the hospital till the moment we left.
The next day, mom had to go to work, so various friends came over to babysit me. I had planned to go to the Red Sox game with mom, but had to give the ticket away. :( My friend Mark came over in the evening to "babysit" and watch the game on TV with me. I was having a few contractions, but the midwives had said not to worry unless it was more than four in an hour. Between 10:15pm and 11:15pm I had five, but I wasn't totally sure they all counted, so I didn't worry just yet. Mom came home from the game, Mark left, I took my 11:30 pill, and we went to bed.
I yelled for my mom, who was sleeping in the next room. She came running and started helpfully saying things of the "ohmigod" variety. ;) I grabbed the phone and dashed for the toilet because stuff was still trickling out. While I waited for the midwife to answer my page, my mom was dithering around saying things of the "what to do, what to do?!" variety. Finally I was like, "mom, maybe you should get dressed." She gave me this wide-eyed look, "Yeah, you're right!! That's what I should do!" LOL! I was also making fun of myself for having said to the page operator, "I think my waters broke." I think?!? Yeesh. ;)
Anyway, I got hold of the midwife and of course she said to come to the hospital. My mom found us both some clothes and we ran around wildly trying to grab stuff we thought we might need. (You might think that in the intervening time while I had been on bedrest, we would have taken a few minutes to put together a going-to-hospital bag, but, uh, you'd be wrong. D'oh.) I also called Jessie, who didn't answer, and I made much fun of her for not answering her phone at 3 a.m. twice in a row now, but then she called back saying it was just that she couldn't find her phone. So I told her to head to the hospital.
Then we hopped in the car and my mom ran several red lights on the way to the hospital. We kept telling each other, "Sorry Officer, but it's preterm labor!" I was greatly entertained by the idea of becoming a cliche. Hey, it was 4 a.m. by now, it's not like there was much traffic.
We got to the hospital and were checked in via emergency by the same sleepy chick as previously. By now we were old pros so we went right up to labor & delivery with no trouble. We got whisked into our old pal, L&D Room Five, with our old pal Sara the nurse. I got hooked up to the monitors again -- one to monitor the baby's heartbeat, one to monitor the timing and severity of contractions. The midwife showed up and said she didn't want to check my cervix for dilation because sometimes the process of doing so can irritate it and speed labor along; on the off-chance that I was still only 2-3 centimeters dilated, she thought she'd wait. But after observing the regularity of my contractions for a while, she decided to do the exam anyway, and found that I was 8cm dilated. (In case you aren't familiar with the way labor usually goes, let me just say that it's very unusual to get to 8cm before you even get to the hospital, at least with a first baby. For most women, especially on the first baby, the longest part of labor is the part where you try to get fully dilated. If a woman tells you she was in labor for, say, 18 hours, you can assume that she probably spent about 16 hours having contractions and slowly dilating, then the remaining two hours pushing.)
Anyway, so everyone in L&D was quite amazed to learn that I had gotten to 8cm dilation without even "noticing" it. I mean, I had noticed the contractions, obviously, but they hadn't been all that bad. I kept expecting them to get a lot worse but they never really did. The nurse, Sara, kept laughing at me because they would see a peak on the monitor and say, "Are you having a contraction now?" and I would go, "I dunno, I guess so. *shrug*" A friend of mine had said, "now remember, when the pain is unbearable and you think you're going to die from it, that's transition." (Transition is the term for the stage of labor where you're trying to go from approx. 6 or 7 cm dilated to full dilation -- the last stage before pushing begins.) But, well, that just never really happened.
Anyway, Jessie showed up and we basically sat around for a while waiting for me to get the last two centimeters. I spent some time on a birthing ball, which is basically just like the exercise balls you see at the gym, only with an absorbent pad spread on top of it in case you leak. It was fun to bounce on. My mom took many embarrassing pictures. ;) She also took pictures of me talking to friends on the phone, which everyone seemed to find completely wacky -- "you're on the phone while in labor?!"
Eventually the midwife went off shift and another one came on. Her name was Pam and she was officially retired and just filling in on a per diem basis. She was an older woman, maybe 60-65, with an Irish accent and a very calm no-nonsense manner. She examined me again and said that although I was at about 9.5cm, there was a little "lip" of cervix left that hadn't gone down yet. So we waited a few more hours for that to go away, but it didn't. Pam examined me again and said that the baby's head was at plus-two, which means it was well down into the birthing canal. Then Pam said, how about if she tried pushing the "lip" of cervix back with her fingers. So we tried that, and it hurt a LOT, and an hour or two later the lip was back :P but they told me to let them know when I felt like pushing.
Well, I was kind of annoyed because I didn't know what "feel like pushing" would feel like, and I hate hearing "you'll know it when you feel it." So finally I decided to say that I wanted to push even though I wasn't really feeling anything that said "must push now!" They let me try some of the positions I had wanted to try for delivery -- squatting on the floor, on all fours on the floor, kneeling on the bed and leaning against its raised back, on all fours on the bed -- but I didn't like any of them. I couldn't feel the contractions strongly enough in those positions; and you need to be able to feel them in order to push during them. When the midwife decided to examine me again, I realized that I was feeling the contractions most strongly while in the "stuck beetle" position, much to my chagrin! I had been very opposed to this position because it seems so unnatural, but my body had other ideas.
So we decided to have me try pushing in that position, again with the midwife pushing the lip of the cervix aside, which again hurt like crazy and I got a little tetchy (ahem) but then they were all, "we can see the head!" and so we were all, "okay, I guess this is it then."
I was sort of reclining, sitting more up during contractions, holding my knees, with my mom and Jessie holding my feet for encouragement. Sara, the wonderful nurse, had brought a mirror which was positioned at the foot of the bed so I could watch the, ahem, proceedings. The first few minutes of pushing didn't seem to do much, although Pam the midwife said she could see the head when she held my vagina open with her fingers during a push. Then gradually the head became visible without that -- just a small patch of it, which got a bit bigger with each push. It looked like a weird greenish alien moss thingie, because Isaac had a lot of hair and there was part of the amniotic sac covering his head (hence the green tinge).
The pushing was definitely more painful than the contractions had been, especially once it reached the point where I was stretched more than was comfortable. The mirror was *very* helpful because it gave me a sense of the progress that was happening, and of what still needed to happen. Soon I began to feel like I was going to tear, so I said that, and Pam got some mineral oil which she poured and rubbed into my skin, mostly on the perineum (the bit between the vagina and anus). I still felt way too stretched, but at least I didn't tear.
Anyway, so I got more and more stretched, there was more and more of Isaac's head revealed, and the pain got worse. I did at one point have a moment of "I can't do this, it isn't possible, let's stop now," but since it was much too late to stop, I had to shrug it off and keep going.
And then his head popped out. I think my mom, Jessie, and I all went "Omigod" in unison. It was pretty amazing. The head is the hardest part, so then I just gave one or two more pushes, and out came his little body. I saw his little penis right away so I don’t even remember whether anyone said "it's a boy" because I already knew.
It was 11:39 a.m., Wednesday, June 11th, 2003.
Anyway, after they had finished checking him over, they wrapped him up in a blanket and gave him to me, and we took some pictures, and nurse Sara helped me with the first breastfeeding attempt -- they say you should put the baby to breast as soon as possible after birth, to help various biological processes get underway (baby's and mom's). He was too sleepy to really eat much, though. So we took a bunch more pictures and stuff, and this was when I named him Isaac, which apparently surprised my mom (but she got used to it pretty fast).
Then nurse Sara took me into the bathroom to get cleaned up a bit. I won't go into too much detail on the ick, but let me just mention two very nifty inventions, the inventors of which should, if there's any justice in the world, be very rich right now. The first, which we actually discovered when we first got to the hospital, was special underwear, basically a very loose cotton mesh -- more like netting than cloth -- in a stylish white with green stripe. ;) They had me put these on after taking off my regular undies. Basically, the only purpose these things serve is to hold your sanitary pad in place -- more on that later -- and to be very comfy and non-restrictive. When I first put them on upon arriving at the hospital, midwife Pam said, "ah, I see you've got some of our glamorous undies," and Jessie found that quite funny, so forevermore we shall know them as glamorous undies.
The second wonderful invention is this little squirt-bottle which you use to clean yourself off instead of toilet paper. For the first couple of days after giving birth, you don't want to put anything raspy or irritating on those tender tissues -- not even the softest of toilet paper -- so instead you use this bottle, filled with warm water, to spritz yourself, and it feels so nice. *wistful sigh* The Europeans with their bidets have the right idea, dude.
Anyway, so Sara showed me how to do this, and she cleaned me up a bit and put ice in my glamorous undies to soothe my perineum, and then we went back out into the delivery room. My friend and coworker Ro arrived just in time, just before the doctors came to reclaim Isaac, so she got her picture taken with him. Oh, Nurse Sara also massaged my belly to get my uterus started on shrinking back down -- this was quite painful and she said "I know, you can hate me for it later."
Then Jessie went home to sleep, and my mom and I went with Isaac to the nursery. He was in what they called the Level Two nursery, which is for babies who need more care than the regular nursery, but not as much as the actual ICU. I was in a wheelchair, and mom and I watched the doctors/nurses doing a more thorough exam on Isaac and hooking him up to several monitors. He was being worked on by a very nice lady named Sarah (not the same as Nurse Sara), who I believe was one of the neonatologists.
For the next six days Isaac would have a sensor attached to his foot, monitoring his blood oxygen level (called "sats" for saturation) and his pulse rate, and another three sensors on his chest, taking more detailed readings of his heart rate. The machines gave annoying beeps if the sats fell below 90% or if the two heart rate monitors had results that differed by too much. He also had, for the first couple of days, a feeding tube in his nose. They used this not so much to feed him -- at least after the first while, when it became clear that he was willing and able to eat by mouth -- but to monitor how much he was eating, by actually using the tube to *remove* the contents of his stomach, at predetermined intervals after they fed him a predetermined amount, so they could see how much he had digested.
Anyway, so doctor Sarah was hooking all this up and explaining it to us. Then another nurse came and told my mom that she (nurse) wanted to show her (mom) where they would be putting me, my postpartum room. So she and mom went off, and I was left sitting in my wheelchair watching Doctor Sarah work on Isaac.
Then I started to feel a bit lightheaded. A couple of other nurses walked by and I must have looked bad, because one of them was like, "are you okay?" and I was like, "I think I might pass out." All of a sudden, there were like six nurses surrounding me. It was amazing -- they came out of the woodwork. They whisked me at top speed out through what I later found out was the staff-only door, and down the hall into my postpartum room. Then this other nurse, whose name I have sadly forgotten, who was a huge bear of a woman, literally picked me up out of the wheelchair and put me in the bed. I felt better as soon as I was lying down, and the nurses put cold cloths on my face, and I felt much better. Then most of them left, and the ones who remained gave me a stern lecture to the tune of: "do NOT go to the bathroom on your own. When you need to pee, ring the call button." To which I meekly assented.
Some time passed, during which my mom went back to the nursery several times to check on Isaac, and reported back to me what they were doing to/with him. When I needed to pee, I did as ordered and rang my call button. A nurse came and helped me get up out of bed. As soon as I got to the toilet and took down my glamorous undies, a huge gush of stuff came out. (To be fair, some of it was the melted ice. But most of it was blood and assorted other fluids from me.) I started to feel faint again, and I believe I passed out again on the toilet, because there was some blank time and then there were two nurses, saying "Are you okay?" and all. And one of them was The Bear, who got to once again lift me bodily back into bed. I think that second episode was partly from loss of blood, partly from *seeing* all the blood, partly from not having eaten or slept in a long time. Anyway, it caused quite a commotion amongst the nurses and each new shift, when they came by to introduce themselves, commented on it (and instructed me yet again not to pee unassisted).
I shall gloss over the next few days and just sum up:
Finally, on Tuesday, his bilirubin (jaundice) test came back within acceptable parameters, and they were satisfied with his ability to eat and regulate his temperature and grow, so they let us take him home. Yay!!!
Email Isaac's Mom