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(The following may not be totally accurate
– but it’s what I remember. Another reason it’s good to hire a doula – or two –
they record all the details)
By 5:15am we were in labor and
delivery triage. I was running a 102-degree fever, my blood pressure was 84/47,
and my heart rate was in the 120s. That’s not good.
I can remember being freezing cold
and so frustrated that the nurse wouldn’t give me a warm blanket or any blanket
for that matter (which is exactly what she was supposed to do. Can’t cover up a
person running fever). They took blood, started the first of what would be
multiple IV ports, and tried to find the girl’s heartbeats. Every time they
thought they found it – it would turn out to be mine. It was finally decided
that the sonogram machine would have to be pulled out to detect the girl’s
vitals and check their positions.
At some point in all this triage
business my doulas arrived. I can’t give them enough praise. Let me tell you –
this is not what they sign up for. Dying babies, sick mothers – this is the
exact opposite of what they’re in this line of work to do. And yet they served
me, my husband, my family, and my daughters with such grace, courage, and
professional wisdom. Always hire a
doula.
Our nurse found the girls, both
head down and with strong heartbeats. A sigh of relief. At this point I’m still
operating under the delusion that we’re all OK. We are nearly 23 weeks. Smaller
babies have made it. In fact Ray met a father of a 21 weeker our first hospital
stay – surely our girls had a chance.
6am(ish), the high-risk on-call
doctor comes in to talk with us. Clearly I’m infected, but how badly? What kind
of infection? Things we need to find out before we can proceed. “I’m sorry,
shouldn’t we be in surgery? Shouldn’t we hurry this along and save our girls?”
I was confused at the slow pace in which my situation was being handled.
Surgery? Nope. Not an option. The infection was so bad opening me up would be
dangerous. I would be giving birth vaginally.
I’d been psyching myself up for a
c-section for what felt like months now. I should be celebrating a vaginal
birth – I’m a doula for crying out loud. But I wasn’t happy. This wasn’t right;
a vaginal birth. The girls were so small and so sick and so much could go
wrong. They must not think the girls will make it.
7am – shift change. It’s at this
point that I’m moved from triage to a laboring suite. Our nurse, Samantha,
hooks me up to fluids and antibiotics. I know the drill. The drill. How
bizarre? I shouldn’t “know the drill,” I should just be a normal pregnant
woman. My head is getting fuzzy. She checks my vitals. 80/40 - heart rate in
the 150s. That’s really not good.
8am – Dr. Smith comes in. She’s one
of the head honcho high-risk docs. She’s wonderful, but is pretty dry and has
always seemed a bit melodramatic to me. She tells me I’m very sick (sure, sure,
I think to myself). My white blood cell count is 18,000 (only 8,000 higher than
it should be). I’m clearly getting worse.
We need to get me delivered. She tells me I’m at a high risk for
excessive bleeding, needing a blood transfusion or surgery. She tells me we
need to start pitocin. She tells me the girls won’t survive and she isn’t going
to bring in a neonatal team.
I have found there’s a big difference
between being devastated and being traumatized in birth. Devastation involves
sadness and mourning a situation; trauma involves things happening to you
against your will. Sadness imprints itself on you and changes you. Trauma scars
you in a way you are never really free from.
I will forever be thankful for my
birth team. Because of them I walked away from a life-changing day devastated
but not traumatized.
Doctor Smith allowed us time to
talk and process and gave me the power to start the pitocin when I was ready.
She also had the neonatal doctor come see us, per our request.
I am terrified of needles. You’d
think I’d be good by this point. Thanks to a blood culture I now had two IV
ports (one in each arm) and multiple blood draws. The idea of an epidural makes
me want to pass out. But at this point I’m wondering how much I can handle emotionally,
physically, oh, and emotionally.
Maybe it would be good to not feel so much? Yes, it’s decided, I’ll suck up the
fear of needles so I don’t have to feel the pain. I let Samantha know I do want
pain meds and she goes to get the anesthesiologist.
9am (I think – who knows) - The
anesthesiologist comes in. He is kind and serious. Says he’s been discussing my
case with 6 other colleagues. They are split: half say it’s safe for me to have
an epidural, half say it’s not. He’s more on the not-so-safe side, but doesn’t
want me in pain. He’ll take a look at my newest white blood cell count and see
if it has gone down. Maybe we can figure something out.
It’s at this point I have one of
the most important and momentarily frustrating conversations of my life. The doctor
leaves and one of my doulas boldly steps up to talk with me. My doulas are
there to support my decisions, and me, and under normal circumstances, with a
non-doula client, this conversation would probably never, ever happen. But I’m
not a normal client and this isn’t a normal birthing day.
“I’m worried when you look back on this day there will be
holes in your memory,” she says. “I’m concerned that if you numb the pain you
won’t have everything you need to work through this and grieve.” I know she’s
right, but I’m tired and terrified. “I’ll support you no matter what, but I
don’t think you should get an epidural. You can do this. We will help you.”
I agree with her even though I
don’t want to. I know she’s right. I decide against the epidural.
No idea what time it is at this
point. I’ve given the OK for pitocin, it has started at 1 unit, and I’ve begun
walking around a bit.
It’s an odd thing to watch your
mind and body relearn how to work together. I’ve been walking less than 50
steps a day for six weeks; now I’m halfheartedly lunging across the room.
The neonatal doctor comes to see
us. She is brilliant. How anyone can give such horrible news with such grace is
beyond me. She can’t medically give us a 0% chance, but in all reality, that’s
what Maggie and Ellen have for surviving - a 0% chance. She explains that even
though I’m 23 weeks they are closer to 20. Having been without fluid for so
long, they never would have had the chance to practice breathing. They will not
survive.
Pain. My biggest fear is the girls
being born alive and being in pain. She assures me that if they go straight to
my chest and aren’t passed around and prodded by the neonatal team they won’t
suffer. Nevertheless, she promises to be there with her team just in case Ellen
is big enough to be saved.
Ray goes to get lunch. When he
returns we send our doulas, my mother and sister to eat as well.
1pm the anesthesiologist comes back
in. It’s not good. My heart rate is still in the 150s, my blood pressure still
80/40s, my fever still 102 and now my white blood cell count is nearly 38,000.
He tells me if he were to give me an epidural the infection (which they now
think is in my blood) could go to my brain. If I begin to bleed out or need a
D&C (surgery), he can’t put me under because my body can’t handle it. The
only thing he could do in an emergency is a spinal, and that in itself would be
very risky.
“Sarah, I’m so sorry for your
girls, but you are my patient, not them. You have a little girl at home,
right?” I nod yes. “We need to get you delivered. I want you to go home to
her.”
That’s the moment. That’s the
moment everything shifts and it sinks in that I’m really sick; that this is
serious and doctors are concerned about keeping me alive.
The rest of the afternoon and early
evening was spent laboring. Steven Curtis Chapman’s Beauty Will Rise album played as I did squats, lunges, had
acupressure done, rocked on the birthing ball and labored on the toilet (which,
by the way, is pretty much torture).
Pitocin. That drug is the freaking
devil. Thankfully, I never thought to ask how much pitocin was being pumped
into my body. I think if I’d known I was up to 16 units of pit I would have
panicked. It was later explained that the dosage got so high because an infected
uterus only works at half strength, if that.
I had been warned that once active
labor arrived things would progress quickly. It was true. The pain was intensifying
and becoming increasingly difficult to handle. Pretty sure I wouldn’t have
survived without my doulas doing hip squeezes and Ray’s constant encouragement.
Then the pain changed – worsened –
unimaginably so. My nurse was alerted that delivery was fast approaching; the
room became active as the staff prepared for multiple possibilities. Dr.
Eppard, the on-call high-risk doc arrived. I don’t remember him arriving; it
was more like he materialized out of nowhere. He came in quietly and set the
tone for the room – peace. There was no chaos or confusion, just peace and
reverence. I will be forever grateful for this man and his peace.
7pm – Dr. Eppard tells me I can
push whenever I’m ready.
That’s when I begin to weep.
Pushing is good. It means the pain
will soon be over. It means my life will not be in as much danger. It means
rest is coming.
Pushing is awful. It means my girls
will be born soon. It means my girls will be born too soon. It means death is
coming.
I can’t do it. I won’t do it.
