evelyn: a birth story on a birthday

14 May

Evelyn.  Our sweet, pure-joy second born is a year old today.  Someone once called her an old soul, and that rings true to me, for reasons I can’t fully articulate—maybe because she always seems more patient, tolerant, and observant than the rest of her crazy family.

Kudos to all the moms who write out birth stories in the haze of newborn days.  I am determined to not let the story of her birth fall totally by the wayside, eclipsed by, in most ways, the more dramatic birth of her older sister.

Even in birth, her story starts with that of her sister’s.  Aurelia was born unusually quickly.  Our friend joked, “I hope you don’t like your living room carpet, because her future siblings will be born on it.”  Though I hadn’t had any complications with Ari’s birth, and John has delivered his fair share of babies, a home birth was not something I wanted to try.  I feared the worst-case scenario.  If I was going to deliver a baby, it was going to be at an institution with a level III Neonatal Intensive Care Unit. Period.  So, starting at week 37, we were on high alert.

I was also more anxious (unnecessarily so) about getting to the hospital early because I turned out to be positive for Group B Strep with this pregnancy, meaning that I would need to get IV penicillin during labor in order to minimize risk of Evie developing a serious bacterial infection as a newborn.  My midwife said that, ideally, I would get at least two doses during labor, the first of which being over four hours before delivery.  Considering that my labor with Ari was arguably less than four hours, I wasn’t optimistic that Evie would be appropriately protected.

Now jump to early May 2014…John and I are sitting on pins and needles, with our close friend Stephie staying with us for two weeks leading up to my due date so that we can make a sprint to the hospital and leave Ari with her.  I had just finished my pediatric emergency clinical rotation and had high hopes of getting some work done before #2 arrived.  I managed to dig up and wash Ari’s newborn clothes and do just about nothing else, as a constant nausea (with irregular contractions) set in that made it hard to motivate to do much beyond the bare minimum.  I LOVE to eat, so my last week of pregnancy, when I struggled to eat half a gluten-free dinner roll, was unsettling.  I was convinced that the only way I would manage through labor was if they stuck me with two large bore IVs and pummeled fluids back into me.

I did try to make it to crossfit, if only for the change in scenery and motivation to do something. But I assure you I was just showing up; there were no PRs.

crossfit full term

Here I’m in the middle of doing of modified version of the benchmark WOD Angie, 26 hours before Evie was born:

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The day before my due date, Stephie had to leave us.  Still nothing but a week of irregular contractions and nausea. John had the day off.  We drove Ari to daycare after a particularly brutal meltdown (limbs, torso, head (hers, and perhaps mine in spirit) thrashing violently on our wood floor).  I remember sitting in our living room that day with the lights off, feeling like any fight I had was just gone.  I let John control the remote and watched a movie that I had no interest in.  We strategized in bits and spurts, contacted our neighbors who might be willing to watch Ari when I went into labor.  For unknown reasons, I thought I should defrost short ribs and try out a new slow cooker recipe.  We picked up Ari from daycare, went to a playground, and I ended up having microwave popcorn for dinner (delicious in theory, disappointing in execution).

I woke up at 3am.  My contractions didn’t feel more severe, just different.  John made me promise to wake him up immediately if anything changed. (He still teases me for not waking him up until I was practically ready to push Ari out. I still gently admonish him for taking a shower while I was actively trying to suck Ari back in.)  I nudged him several times, each time more forcefully, and he reluctantly roused.  “Things just feel ‘different’?” he repeated, unimpressed.  He rolled back over and told me to time contractions (6-12 minutes apart).  A few minutes later, he thought better of it, and told me to call the midwife.  (John would later tell me that, as he tried to go back to sleep, he thought to himself, How stupid would I be if I let us wait too long to get to the hospital the second time around?)

I shared my vague symptoms with the midwife-on-call, assuring her that I wasn’t so uncomfortable and wasn’t convinced I was even in labor.  She explained, “Most other woman I would advise to wait it out.  But…I don’t trust your uterus.  Just come in.  And maybe eat something if you can.”  No way I could stomach food.  “Well, then you probably are in labor.”

This time around, we both had time to take showers, not feeling rushed yet.  I finished packing the getaway bag.  John cleaned up the kitchen and moved the short ribs from the slow cooker to the fridge.  I texted Elizabeth, our kind neighbor from across the street, and she came over around 5am.

The drive to the Pennsylvania Hospital this time was so different.  With Ari, I was in a near state of panic, bracing myself with each contraction, which seemed to come one on top of the other.  Strange, pained noises were coming from my throat as I desperately tried not to push.  I had my feet slammed against the floor of the car and my hands tensely pulling the seatbelt away from my body.  John was running most red lights.  He left the car in a tow-away zone at the entrance of the hospital.

During this drive I was comfortable, much more so than I had been the last several days…excited and happy even—adrenaline, man!  I remember at one point raising a finger when John asked me a question during a contraction, and that was it.  We parked in the parking garage this time, and I walked myself to labor and delivery.

In the Perinatal Evaluation and Treatment Unit (PETU), I was hooked up to monitors.  Contractions were present but irregular.  4cm dilated.  We thought we would be sent home for sure, but instead they decided to start me on penicillin and see what happened.

While John was in the cafeteria having breakfast, two nurses came to escort me to Labor and Delivery.  With Ari, I was pushing (and screaming) as they wheeled me on a gurney.  This time, waddling awkwardly but not totally uncomfortably, I was a little embarrassed that I was being admitted when I still wasn’t 100% convinced I was in labor.

John met up with us in Room 9, one of the two “birthing suites” or low-intervention rooms, and the same room where Ari was delivered.  The main attraction: a Jacuzzi!  On a white board next to the bed, our truly wonderful and ever-encouraging nurse Dina scribbled our goals of care.  Under pain management, she wrote “natural childbirth,” and I couldn’t help but cringe a little.  (Ever since an attending once corrected me on the wards [You mean “unmedicated” or “low-intervention.”], I’ve been too sensitive about the terminology.  Not to go into it too much here, but I worry about the judgment implied. Please feel free to read more here.)

John asked me what music I wanted to listen to.  I was standing around, bracing myself hunched over the bed during the (still terribly irregular) contractions, feeling antsy and wanting something to pump me up: “I don’t know…Eminem, Bastille, Black Eyed Peas?”  He rolled his eyes, “Don’t you want something relaxing?” and turned on Eric Whitacre. “Oh, you’re right,” I responded because I didn’t feel like being openly pissed at him yet.  But seriously, when you picture a woman in labor, is the soundtrack akin to yoga-esque chant-like choir music?

I was overjoyed when I saw Sandra, one of my favorites of nurse midwives, come to our door after having received sign-out from the last midwife.  I expected no cervical change, but instead Sandra looked up, “Oh I knew I loved you.  8cm.”

“Shit! I better get in the Jacuzzi while I still have time!”  Sandra and Dina glanced at each other, then agreed but reminded me that, by law, I couldn’t deliver in the tub.  No problem.

At this point, it was approaching noon, and John was texting a few of our friends who were on Ari duty.  One replied, “It’s go time!”  I scoffed, “Hardly.”

I don’t know what it is about water, but it dissolved like 90% of any pain I was feeling.  And I don’t have a high tolerance for pain (whatever that means, but I cry when I stub my toe), and I’m not great at mentally toughing things out.  I think I got a lucky break and this tub was magical.

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Dina had me stand up out of the water during a contraction so she could monitor the fetal heartbeat.  As I was standing I felt a subtle pop! that was also heard over the gurgling water, and Dina and my eyes met.  I looked at John, “Now it’s go time.”

Dina said I might be able to stay in the water a bit longer, but I started violently shaking my head as a shockwave of nearly paralyzing pain swept over me.  I needed to get out now, but I couldn’t think about how I was going to move my legs and suddenly felt like a beached whale.  I saw Dina hit a button and call for Sandra.  John helped support me over to the bed while Dina walked with one hand cupped under my pelvis (I guess she feared the kid might come crashing down).

Sandra came in at a sprint, and I told her between clenched teeth that I needed to push.  She firmly instructed, “Just let me get one glove on!”

They encouraged me to bend my knees up to my chest.  I told them I couldn’t move, so Dina and John each grabbed a leg.  I seriously regretted the wait-and-see approach about getting an epidural.  Though I knew I was physically pushing our daughter out, I mentally doubted my capability to do so—a strange insecurity unlike anything I’ve felt outside of childbirth.  Her head came out within two contractions and four minutes of pushing.

“Anna, I need you to not push now.”  I heard John and Dina mumble something about a nuchal cord.  Maybe I was too consumed by pain that I didn’t have it in me to panic, but I remember looking at their faces and no one looked particularly worried, so I decided to try to do what I was told and nothing more.

Sandra clipped/loosened (I don’t remember) the cord quickly.  (I would later find out it was a double nuchal—the umbilical cord was wrapped around Evie’s neck twice—so the tension of the cord had to be relieved before I could push again in order to make sure it didn’t tighten further around her neck.  Sandra said, “A double nuchal doesn’t worry me.  A triple makes me sweat a little.”)  Evie’s shoulders slid out shortly thereafter.  She pinked up, squirmed, and wailed.

Evelyn Adelina was born at 12:41pm, May 14, 2014.  7 pounds, 6 ounces.  Someone put her on my belly immediately. Her body on my body felt so much heavier than her weight as it momentarily relaxed.

But I couldn’t stop shaking.  My legs, that only a minute ago felt incapable of motion, now trembled so violently that the bed shook.  As much as I wanted to hold her, it was too much, so John took her to his chest. She was clearly so ready to be born, as she immediately began routing on John’s chest and tried repeatedly to latch, so John encouraged me gently to hurry the hell up and get it together!

We opted for a small dose of Demerol, which John thought was too little to have any effect, but I swear by it, and my body relaxed into the bed. Remembering how effective it was at post-delivery contraction pains, I also demanded Motrin and lots of it!  (So, that’s Penicillin, Demerol, Motrin, and then Lidocaine injections for the repair—“natural” childbirth my ass!)  And I got Evie back.  Even in those early moments, it felt like her sweet, calm, measured temperament came through.

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So a rather happily mundane childbirth punctuated by a few moments of excitement…and it still took me over 2000 words (over-sharer much?). I saw another friendly face on the postpartum maternity unit: one of my NICU mentors was on Well Baby and supervised Evie’s care. After 36 hours and a few extra tests due to the CMV I contracted during pregnancy (silly, paranoid med student), we brought her home to a surprisingly welcoming big sister.

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We could not be more thankful. For the tremendous care we received during and surrounding Evie’s birth. For the help of many good friends who made sure Ari was safe and happy, brought meals and company, even stayed with us (Stephie!—who took care of us all while continuing remotely with her fulltime job!). For the outpouring of love by family and friends our daughters have felt everyday.

Happy birthday, Evie!!!

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