Archive for the 'The Birth Week' Category

What a Week That Was

S tried to visit Baby Felix in intensive care on the night of his birth. One nurse thought she needed a wheelchair, but S insisted she was well enough to walk, and her attending nurse agreed. Fifteen feet later, just steps past the NICU door, her racing heart and light head had her leaning against the wall, panting for air.

“Mommy can’t come here like that,” one nurse shouted at us. “She’s gonna collapse, and we’re trained to help babies, not adults!”

“I have to sit down,” S told me.

She rested for a few minutes at the nurses station, and then I helped her back to the room. This was probably a good thing, because when she saw Felix the next morning he was off respiration and intubation, resting calmly in a small plastic greenhouse-like box called an Isolette. He became alert at the sound of our voices, but we couldn’t remove his monitors or IV to hold him. In fact, except for feeding we had to touch him through twin portholes on the side of his box. Changing his diapers required some hand-eye coordination. But despite these restrictions and the bright lights, constant supervision, and intermittent beeps of the medical equipment supporting the prematurely born babies around us, our first minutes together as a family were far more sweet than they were bitter.

In the Isolette

In the Isolette

The nurses fed Felix at three, six, nine, and twelve o’clock. On Tuesday afternoon S began the routine that she would follow throughout the week of coming every three hours to take his temperature, change his diaper, and put him to the breast. In the beginning, I hoisted her out of bed, supported her when she walked, and did tasks that required mobility, such as finding her a chair, setting up the white cloth screens that gave her a modicum of privacy while feeding, and dampening the cloths for wiping his butt. Between visits with Felix I foraged for meals, kept up with the steady barrage of calls and texts from concerned friends and family, and made sure S was following the doctor’s and midwives’ orders to the letter. If she dropped something, I picked it up so she didn’t have to bend down. If she needed her peri bottle refilled with water in the middle of pooping, I came in to do it. I even helped her in and out of her socks and underwear. The only time I could relax was sitting behind S while she fed the baby. Watching them together, relief and exhaustion would wash over me as I rested without worry for a few minutes.

On late Wednesday afternoon S was deemed fit for discharge, leaving us in a quandary. The midwives were clear that it wasn’t safe for S to travel back and forth from the hospital to Brooklyn in her condition. Nor was it practical. But we were told the baby wasn’t going to be discharged till the next morning. Though I understood that hospital beds cost a lot and were in high demand, I couldn’t accept that a mother of only two days and her son were recognized as two patients, and that the hospital expected my wife to go home and leave her baby. Not only could we not abandon him emotionally, but we wanted him to continue breastfeeding.

We ended up in the Parent’s Room, a charmless, stuffy cell a long walk (from a post-episiotomy point-of-view) from the NICU. It had two squishy, low-to-the-ground cots reserved for mothers, but as long as there was no demand, I could stay there too. Which I needed to. S wasn’t able to get in and out of the bed by herself. We tried to make light of the depressing conditions, figuring we could rough it for a night. It was like camping, but in a hospital.

But on Thursday morning the doctor told us that after overcoming his “transitional difficulties” Felix had now developed jaundice. His skin tone hovered “somewhere between a peach and a mango.” She explained this was a common condition in newborns when the mother has Rh negative blood and the baby’s is positive. Another common cause of jaundice is bruising during birth—something he’d certainly experienced. His forehead in particular had some purple and red marks, and there was also a nasty abrasion from the vacuum device on the back of his head. The skin around the suction site was so swollen with fluid that it jiggled when we picked him up like a water balloon.

The nurses positioned an ultraviolet light positioned over Felix’s Isolette and protected his little eyes with padded goggles. The UV rays broke down the toxins in his body (toxins that, though dangerous in large quantities, have the cute name bilirubens—pronounced like the boy’s name Billy Ruebens), which were then passed in his poop. Throughout the day his bilirubens level went down, giving us hope. The doctor had said that if they dropped sufficiently he could go home on Friday.

On Friday morning we were excited to find that except for an orange tint around his eyes (like a reverse tan, from where the goggles shielded his skin from the UV) Felix was a normal shade of baby. The nurses seemed sure he was about to be discharged, asking if we had any last questions about caring for him at home. But the doctors had changed shifts, and the new doctor wanted to keep him another twenty-four hours “for monitoring—just in case the levels spike back up.”

I wanna go home!

"I wanna go home!"

I tried bargaining her down to twelve hours, explaining that S was running on vapors. The walks to and from the NICU had taken their toll. Her feet had swollen to twice their normal size. Her bottom still hurt like hell and between the pain and worry and the feeding schedule she was only getting two or three hours of sleep a night. And of course the emotional toll was draining her as well. She hadn’t been in fresh air for five days, or had a clear view of the outside, and the NICU, crowded with babies in various states of health, was not a cheery place to be. On Thursday, after learning Felix wasn’t getting discharged, one baby went into v-tach as S was feeding and she had a mini-meltdown. I worried she couldn’t handle any more.

As S broke down in tears, I went from pleading with the doctor to arguing. In vain. The bureaucracy had spoken. Felix was staying another night. And the doctor recommended that S go home and rest.

“Oh no,” I said. “We’ve been here all week. We’re not leaving without our son.”

Intellectually I knew it was better for him to stay, but I felt so fucking angry. As awful as the week had been up to then, this was the first time in our hospital stay I felt like we weren’t being recognized as people. The doctor spoke so cold and clinically; instead of communicating concern, it seemed she just wanted to cover her ass in case something went wrong.

Exhausted and depressed, I collapsed back in our cell, sleeping so deep not even my vibrating cell phone woke me up. My fatigue lasted throughout the night, and I didn’t accompany S on her late night feedings. She had the routine down pat by then anyway. Amazingly, after some tears of disappointment, she continued to push herself to make every scheduled visiting time, and finding that her milk had begun to come in.

On Saturday morning there was practically a parade of nurses marching Felix around, as we were told to get our bags ready—he was going home! S asked “Really?”

One of the nurses who had cared for Felix right from the beginning said, “This is your baby, right? Come on!”

Ready to Roll

Ready to Roll

Outside the sun shone for the first time all week, and the breeze felt fresh and clean. The West Side Highway—full of joggers and bikers, families out on strolls, people lounging on the pier—never looked better.

Later that night, at home in our bed, the symptoms of recovery that S had avoided either because of adrenalin or from sheer will came rushing on all at once. Blood pressure changes caused painful tightness and tingling in her legs, hot flashes made her sweat, then tremble with chills, she became dizzy with anxiety and panic. The lack of sleep finally slammed her and she lost it. She spent the next several days sequestered in the bedroom, resting and regaining her strength.

But we made it through, ultimately with a healthy baby. Like during the labor, Felix was a fighter, a survivor. After a slow start, his condition always improved. There was never any doubt he’d be better. Despite our travails, we were among the luckiest of families in the NICU. Felix’s neighbor turned two weeks old while we were there, and was so tiny and premature, he was sure to be there for some time. Every day his parents came in to visit him. The day before we left his mother was sitting in front of his Isolette, clipping out illustrations of Bugs Bunny to decorate it.

There were also some benefits to being in the hospital for so long. Not only did Felix’s wonderful nurses get us used to our new titles by greeting us with “Hello Mommy! Hello Daddy!” but they also taught us how to hold, comfort, wash, and feed him. Perhaps most importantly they showed us that there is no one right way to handle or care for a baby. You do what works.

Instead of coming home nervous, we walked through our front door both overjoyed and confident. If we could handle that week, we told ourselves, we could handle the next six, what many say are some of the hardest of childrearing. And for the most part, so far at least, that’s been true. Though we’re still keeping our fingers crossed.

Labor Epilogue

All was calm when the midwife stitched S up. She had a tear below her urethra, and two incisions, one made laterally to accommodate the vacuum. This last cut, through muscle, would hurt the worst during the next weeks.

“How many stitches am I getting?” S asked.

“Enough,” the midwife said.

While the midwife wielded a nasty curved needle, she talked about the baby nonchalantly, assuring us that he’d be fine—we just needed to wait and see. I think she didn’t want us to get overly upset till we knew what was going on. After a while of discussing the labor and what S could expect during recovery we all but stopped talking about our son, as if getting through the labor itself was the point, and the birth didn’t really happen.

Looking back, I wonder if—in those first couple of hours—our parenting instincts just weren’t operating yet. We had seen him briefly and in such a state of exhaustion and upset that neither of us could’ve picked him out of a lineup. There was no time to bond, to soak him in through smell and sight and sound. And so our main concern was making sure S was as comfortable as possible and going to pull through ok.

The midwife showed us the placenta, a flat heart-shaped piece of gore in a shallow blue basin. Thick blue veins ridged one side, spreading out from the base of the umbilical cord in the shape of a tree. I asked for it and without hesitation the midwife bagged it up for me, handing it off with a warning not to show anyone in the hospital or we’d get in trouble. S had clutched one of our pillows on the stretcher ride from the Birthing Center, so we slipped it into the case.

I ventured out and bought sandwiches—egg and cheese for S, chicken salad for me. While we ate, we looked at the clear plastic bottle mounted on the wall above the baby’s warming table, its bottom red and goopy with the stuff they sucked out of his lungs. It was difficult to believe what had happened in this room, on the very table S still reclined upon as she ate. At this point, we still hadn’t called our parents, because we didn’t feel like parents ourselves yet. In fact, except for the friends who were going to give us a ride home from the hospital, no one even knew that S had gone into labor.

Later, a doctor came into the delivery room wearing scrubs. She explained that the baby had swallowed a lot of fluid during his long journey into the world, blood that irritated his throat and stomach and made it difficult to breathe. They had to hook him up to a respirator to help him out. Soon, she told me, I could visit him in the neonatal intensive care unit (NICU), but first we had to move to a post-partum recovery room and collect our stuff from the birthing center.

It was after this talk that we called our parents, and the trauma of the past twenty four hours began to sink in. Questions were raised as to why the labor went on for so long, or why S didn’t have a Caesarian. I explained that extreme interventions like this were never an option for us if they could be avoided. This was why we wanted to work with the midwives and use the Birthing Center. We trusted that if they thought S was safe than she was, and we continue to trust them. S wanted to give birth vaginally, and with a little help she did, soldiering through all twenty three hours without ever expressing regret, facing her fears of incision without blanching. I’m so proud of her for it.

Finally, after S was settled in a new room, I visited my son. The NICU ward was full of isolation boxes, most of them holding tiny, premature babies. Computer screens charted their heart and respiration rates, beeping to alert the nurses of any problems. An attendant introduced me to Felix, stretched out long under a warming lamp, a diaper on his bottom, an IV drip delivering glucose water attached to his right wrist and taped so that his whole hand looked like a paddle, probes stuck on his chest, an intubation tube in his mouth, and tiny plastic pipes in his little nostrils that delivered shots of oxygen whenever his breathing rate dropped too low. It was like he was part machine. The nurse explained what was going on and gave me a quick overview of the monitors and then left me alone with him.

I stroked his non-IVed arm and talked to him, and though he shifted and sighed in his sleep, he didn’t stir. It was impossible to hold or cradle him, or even get a good look at him—the tubes seemed in the way, and forced him into an unnatural position, mouth stuck open, head jutted up at an angle. After a few minutes I headed back to report to S. Right when I got in the room my brother called, and while talking to him I choked up, concerned for the baby, tired, upset, angry even at how things had worked out. These feelings would come up again later in the night, when I tried to bring S to see him and she nearly fainted with exhaustion. This was so far from what we had hoped.

But these were momentary blips. After seeing Felix, my fathering instincts came on full. I promised to do everything I could to get S through her stay in the hospital, and to get her and the baby—perhaps bruised and battered but recovering—back home safely.

This resolve would be tested time and again over the coming week.

Felix in the NICU

Felix in the NICU

Labor, part 3

I helped the nurse move S’s IV as the midwife assisted her onto the stretcher. A contraction hit as she shimmied her legs off the bed and the midwife told S to keep herself from pushing, and instead “bear down” to let it pass. S’s body trembled as she struggled to keep her balance, her eyes went wide, and she shrieked. Her whole being wanted that kid out and at least pushing went with the pain. Not pushing meant fighting it, and after such a long time laboring, her body was barely able to stand the strain.

“Let it out, sweetie, do whatever you need to get through this,” the midwife told her.

S curled into a fetal position on the stretcher, clamping my hand in a vice grip. They threw a white sheet over top and we rolled her out of the Birthing Center and to the elevators. She continued crying and screaming along the way, and as we rode up to the next floor I imagined how we must look to the other expectant mothers in the ward—the obvious pain and terror in S’s yells, the exhaustion evident in her collapsed body, the IV and fetal monitor and stretcher, the brown blot spreading on the sheet between her legs, the lack of control. What a fucking nightmare. Still, we could only consider ourselves lucky for being in a good hospital, and not deciding to give birth at home.

The Labor and Delivery room was small and full of people—the doctor, several nurses, a pediatrician, our midwife and nurse from downstairs. S was transferred to the labor table, which elevated so she reclined in a half seated position with her legs strapped into stirrups. A blue bag was attached at the end, beneath her, for catching blood. The lights were bright and the walls full of machines and monitors and I had no place or role among the hustle other than to hold S’s hand and try to stay calm.

S received another shot of local anesthetic, though the doctor made sure S could still feel a certain amount of sensation, so she could push properly. I keep up a stream of positive nothings—as much for me now as for her—and don’t watch the second incision being made to accommodate the vacuum, though I caught the doctor assembling the device, a white circular thing with tubes. The tubes applied pressure, clamping the circle onto the baby’s head, and the doctor then pulled along with S’s push, the two of them working together to bring the baby out.

At this point, the birthing center nurse was minding me as much as S. Several times she directed me to look at my wife and not at what was going on between her legs. She must’ve known how close I was to breaking down.

For the most part I followed the nurse’s orders, but I couldn’t help myself from watching the birth as it happened. After the first couple of pushes the top of the baby’s head emerged. I still had trouble imagining a whole baby beyond this red, vaguely lemon shaped thing protruding out of her, but I noticed little brown hairs curling off of it, and I told S excitedly. Again the nurse told me to pay attention to Sara, as (I think) the doctor reattached the vacuum.

A few moments later I witnessed the most amazing thing: the majority of the baby’s head sticking out of S. It was surreal, this large and complete head emerging from between her thighs. The baby’s eyes were closed, his bottom lip sucked in tight below the puffy upper, and his ears so tiny. His skin was pale and covered in red gunk, and immediately the midwife stuck a rubber aspirator in his nose to remove the mucus and blood. I’m in tears now, telling S that she’s doing it, but she’s so inward she doesn’t respond.

After the head the baby slid out quickly, and with it the ghostly white umbilical cord and a lot of yellowish brown meconium—he shat himself on the way out. S burst into tears of relief and I stroke her head.

The doctor cut the pulsating cord and our son was whisked off to the pediatrician, who put him on a table in the corner of the room where I couldn’t see much of what was happening, except that the baby’s little arm had turned purple.

For a moment I’m stunned, and then—and this sounds like a made-for-TV movie, but it’s true—S said, “Why isn’t the baby crying?”

I realize that the room is silent, the doctor and midwife and nurses all attuning to what’s happening on the pediatrician’s table.

“We have a heartbeat,” the pediatrician says. “It’s strong.”

There’s a sound of suctioning, like they’re using a wet-vac on him, but too many people are crowded around him, and I can’t tell what’s going on.

We asked if he’s ok, but the doctor told S she needed to focus because she wasn’t done yet. Another couple of pushes and the afterbirth—a red floppy thing, like a fresh cut of meat—oozed out of her and into a basin. Often, it takes ten minutes or more for the placenta to come out. S’s quick passage of it would lead our midwife to speculate later that the baby’s umbilical cord was short and that the placenta acted like an anchor, holding him back. But no one measured it in the moment, so this remains only a guess.

Finally the baby began making strange grunting sounds, and he’s brought over for S to hold. Notes were made—he was born at 2:14pm, and weighed seven pounds three ounces, and scored a five on the APGAR test, which I didn’t realize was low.

He continued to grunt like a little pig when S held him, and bubbles formed around his mouth. We said his name and S cried a bit, but then the midwife took him and banged his back with her cupped palm, after which the nurse tried, massaging it. The nurse handed him to me to hold, even though I wanted S to have him. I worried about dropping him—I had never held a baby before—and after such a long effort, I thought S should have her reward. But he’s thrust into my arms, small and motionless with his color all blotchy, and still he frothed at the mouth whenever he breathed, making a foam of yellowish bubbles around his lips.

“Is this normal?” I asked, and it was obvious from everyone’s responses that it wasn’t.

The pediatrician took him and this time I watched as he stuck a thin tube down my son’s nose and sucked bloody fluid into a canister mounted on the wall. A lot of fluid, considering the baby’s small body. And then—and again I can’t remember quite the order of events or how this was communicated to us—the baby was gone, taken by the pediatrician for special care.

We have no idea where to, exactly, or for how long he’s going to be apart from us, or what they’re going to do to him. We’ve barely seen him or held him or experienced him as an actual living human being. Just like that, we’re not parents anymore, we’re just Brian and S, exhausted and traumatized and as childless as we had always been, in an empty hospital room with the midwife. It felt really weird.

Labor, part 2

Now come the endless morning hours, when a white, cold light eked through the blinds and our sense of time collapsed to ninety second intervals: that’s how long the contractions lasted, and that’s approximately how far apart they were. S was in transition: the short, intense period before the pushing. Her screams increased in volume and frequency, and she dug into my hand when the contractions crested. The pain cut short S’s breath, so before the midwife handed off the baton to her colleague she taught S to exhale in short, strong bursts of “hee, hee, hooo.” At times things became so intense even this simple rhythm was difficult for S to keep up without gasping, nearly hyperventilating.

For a while this went on, much longer than the fifteen minutes considered typical for transition. A wonderful nurse stayed by our side, relieving me when I needed to use the bathroom, making sure S had enough water. Then the new midwife came on, the matriarch of the practice, who’s been delivering babies for as long as S and I have been alive. She examined S again, and found that though a couple of hours had passed, her cervix hadn’t changed—she was still at eight centimeters. The midwife tried changing S’s position to facilitate the dilation and move the labor along. She propped S up with a wedge of foam on the bed so that S could lean forward on all fours. She had her balance on a birth ball. She walked her to the bathroom and then back to the bed. She rubbed her back and said, “Think ‘out, out, out, baby!’ Tell that baby, ‘it’s time to come out!’ That’s it love, that’s it.”

Clear liquid leaked out during some of the contractions—traces of amniotic fluid.

Through all of this I held S’s hands. If I walked away when the pain hit she would cry out for me in a panic. She needed me close, and to hear me saying the same things I had been saying hours before, “You’re doing great! Keep at it, breathe it out.”

After a long period of varying positions, the midwife examined S again. The baby’s head was visible, she said, right beyond the cervix, which still hadn’t dilated fully. It formed a ring like a stopper, preventing the baby from moving into the vagina, which was when the pushing would begin.

The midwife inserted her hands and tried to manually move the cervix, prying it back during the contractions so the baby’s head could break through. This was incredibly painful for S, and her voice was now ragged and somewhat hoarse from screaming. But it didn’t help. The cervix remained in the way. Hours after it began, S was still technically in transition, though in a normal birth the baby would’ve been born by now.

“You’re just going to have to push him through and out,” the midwife said.

The nurse draped a white pad on the floor, and leaned a small mirror against the bed, and brought in a light on the end of a crooked pole, the kind you might see in an operating room. S crouched in front of the mirror, and the midwife sat on the birthing ball behind her, hands under S’s arms, legs supporting her back. The light was moved so that we could see her bottom clearly. During the contractions the midwife had S hold her elbows away from her body (“like airplane wings”), and taught her to exhale down through her uterus, pushing the baby out. In between contractions, S leaned over the bed, and the midwife rubbed her back, while I ferried her water or a wet washcloth. When S pushed her face scrunched up and became flushed and sweaty with the exertion. It was at this point that the first bits of blood began to spray out of her vagina, at first pink and then a deeper red, stippling the pad beneath her.

S switches back to the bed, to try pushing on her back. The nurse becomes fastidious about checking the baby’s heartbeat between contractions, listening for “one-twenties.” After—how long? An hour? Over an hour? Though these events all happened, I’m not even sure if this is the exact chronology, my memory is so blurred by exhaustion and adrenalin—I help the nurse set up an oxygen lead. There’s hope that the oxygen will give her a boost of energy and also keep the baby stable, since he’s still getting blood through the placenta. The hose doesn’t reach her face, so we take a longer tube and fashion a makeshift mask by shoving it through a plastic cup. Now a new routine begins: pushing with the contraction followed by a whiff of oxygen, a sip of water, and a wipe of the forehead with a cold compress. A push, a whiff, a sip, a wipe. Again and again, for another hour.

Blood beads on her labia, and the room smells tangy and astringent with it. S’s eyes are wide and glassy, and in between efforts she’s white as a ghost, and she doesn’t talk so much as moan for things when she needs them. I can tell she’s deep in herself. Fear begins to grab my chest, and it squeezes tighter when the midwife, who had left for a bit, comes in and says, “The doctor wants to know why we have a woman down here who’s been pushing for over two hours.”

“What should we do?” the nurse responds.

“I told him to give it more time, we have a few other things we can try. But then he’s going to have to come down.”

Another exam. The gloves come in a folded paper packet. Pull one side off and remove a glove, then a little baggie of lubricant. Spread the lubricant out with your ungloved hand. Then remove the other glove. The room smells of these things too—rubber and petroleum gel. I’m trying not to freak out.

The baby’s head is visible. She’s pushed it past the cervix, though—and I may be misremembering this—the nurse spots some of it hanging on to him, a bit that’s come along with him. Or maybe it’s just a clot. They move her labia aside and I look, though it’s hard for me to figure out what I’m seeing. The baby has seemed so abstract, and now I’m supposed to recognize that this dark purply mass deep inside my wife is my son?

More pushing. More whiffs, sips, and wipes. We lie to S. “He’s almost there, you can do it, just one good push, bring him closer.” Her weariness is visible in her eyes. She’s clammy. We increase our efforts to keep her hydrated. Ice chips are given along with the sips.

The pattern changes again. Contractions come in double spikes. There’s a big one, then thirty seconds of peace, then a little one, then almost a minute of rest, and then repeat. It’s monotonous, exhausting, awful.

S is hooked back up to the monitoring belt. As the contractions begin, the numbers slowly rise from zero. Around thirty S gets that look that means she feels it coming. When the contractions peak the monitor tops out at 199 and an upward pointing arrow blinks. The baby’s heartbeat fibrillates with each push, sky rocketing up into the 180s, then dropping down into the sixties and seventies. I understand why the nurse regularly checks his pulse. With each contraction the baby’s having a heart attack.

The doctor comes in, a handsome man with a gentle voice—do they train everyone in this profession to speak softly?—and he teaches S a new way to push. “Look at this chart,” the midwife says, showing him the monitor readout. “You’d think she was on pitocin with contractions like these.” He examines her and agrees with the midwife. S’s body is working hard to get the baby out, but he’s coming slowly. S says she can keep going, and the baby’s heartbeat is regular and strong, so they decide to give her more time.

She gets on all fours, and the nurse and midwife press their fists into her ass as S bears back pushing. The new technique gives her a burst of energy. “You’re so strong, sweetie, stronger than anyone could ever ask you to be,” the midwife says. My eyes are tearing with terror and admiration, and sometimes when I talk to her I choke up.

For a while this goes on, and the baby’s head slides forward until it’s just visible beyond the folds of her labia. It looks like a meatball, with strange flecks of red and white. I can’t picture a baby beyond it.

In between contractions the nurse hooks S up to an IV, attaching it with a wad of tape so she won’t yank it out when she struggles. There’s concern she’s dehydrating. We move S closer to the oxygen, replacing the rig we MacGyvered for her to breathe through with a mask that straps over her nose and mouth. She’s told to keep it on throughout the contractions.

There’s talk of the doctor returning. This is used almost like a threat, like you have to push this baby out or else the doctor’s coming back and who knows what’s going to happen. The midwife tells the nurse to prepare The Table.

I figure this means a stretcher, and that soon we’re going to have to go upstairs to the traditional delivery room, but I’m wrong. The nurse wheels in a table hidden under a blue sheet, like the blue of a tarp, but a bit darker. I’m chilled, anticipating something awful. Under the sheet is a variety of scalpels, scissors, and forceps. The midwife pulls out a huge needle and dispenses an arc of clear fluid. This is the local for her episiotomy.

I start to totally lose it. My chest is gripped with panic, and I run off to the bathroom to try and pull myself together. I tell myself to get a grip, for S. She needs me to be strong and confident.

I go back to the bedside but can’t stop tears from leaking out. I’m breathing deep with her, trying to keep hysterics off. S dreaded having to get an episiotomy, and I worried she was going to bleed out on the table, an irrational fear sparked by my own rough delivery, when my mom hemorrhaged after a misplaced cut.

The midwife places a blue sheet under S and goes toward her with the needle and I stare into S’s eyes because I can’t stand to look anywhere else. When I finally peek there’s a dark crimson blotch, so deep it’s almost black, leaking onto the blue field. The midwife inserts her hands and tries to help S bring the baby down. The head is right there, but he’s stuck. He won’t pass beyond, he won’t crown.

The midwife stays low on the bed, coaching S, and during the contractions I hold one leg while the nurse holds the other. The oxygen and IV tubes get in the way, and if we don’t hold her tight her limbs flail about. In between every push the nurse listens to the baby’s heart with growing concern over his health, but it remains strong. S on the other hand is getting tired. At this point everyone knows something’s wrong, but no one’s sure what. The going theory is that the baby’s turned around, coming out with his nose facing up instead of down, as normal. But S didn’t have back pains, which you’d have in ‘back labor’ when the baby is facing up.

The doctor comes back and S gives it one last try. He also uses her hands to help pry the baby out. When he removes his gloves they’re slick with blood and black goobery clots. S’s hair’s wet with sweat, and the bags under her eyes hang heavy with weariness. The doctor and the midwife explain that it’s been too long, almost twenty three hours, over four of them spent pushing, and that we need an intervention. He explains that he can use a vacuum to help S bring the baby out—she’ll still need to push, so her work isn’t done yet, but the doctor can pull while she does it.

S agrees. The doctor disappears, and the nurse wheels in a stretcher to take her upstairs to Labor and Delivery. It’s a little before two o’clock in the afternoon.


Note: During our six week postpartum visit to the midwives, we found out that S received just one incision, and it was made in the labor and delivery room, not the birthing center. (This explains why S only found one deep scar down there after the fact.) The table with the equipment was wheeled in, but the blood must have come from S tearing, and not being cut. Strangely, we both remember the midwife holding the needle. Maybe that happened in the labor and delivery room too? Like I said when I started writing this account, the exact chronology is all screwed up.

Labor, part 1

We knew it was coming. Not only was S’s belly hard and lumpy with baby, but in the final week of her pregnancy she carried it slung out in front of her, an almost unnatural looking protrusion. S’s energy rose, and she spent late afternoons puttering in the garden (which we now realize was her nesting instinct), and going for long walks in Prospect Park. A Thursday afternoon acupuncture treatment brought on more Braxton-Hicks contractions, but they didn’t become strong until after a long walk on Sunday, May 24th. Around three in the afternoon S realized they were coming with regularity and could well be the real thing.

By five thirty they were closer together and increasing in intensity, though our midwife said to relax, have a glass of wine, eat dinner, be normal—it could be a false start. So we cracked open our bottle of Special Delivery Pinot Noir, which we bought because it has a picture of a stork on the label, and I made us black beans with spinach and rice, figuring it’d give us a solid protein base if the night turned out to be a long one. (I only mention this because it comes up later.) Then in a last fit of nervous nesting I blared Talking Heads and cleaned the downstairs, getting it ready as if company was coming, while S soaked in the tub with her progressing contractions. Another call to the midwife around ten thirty confirmed that the labor had started.

I got our bag and car seat and snacks ready to roll. When I returned, the bedroom was dim with the light of a single candle, the night silent, and the air moist and earthy smelling, like it had just rained, or was about to. Our cat had spooked. For a short while I took a nap—after S told me she didn’t need me hovering over her—but it was impossible to sleep when she started pacing the room, vocalizing as the discomfort became painful.

Soon she took up position on the bed, laying on the side with her legs propped up. While rubbing her back I was able to measure the ebb and flow of each contraction by the tensing of her hands, which gripped the maroon blanket when the pain spiked (typically forty five to sixty seconds in), preceding her moans. She described these early ones as feeling like someone wringing her insides out, beginning with a sense of lightening around her midsection before squeezing her guts out.

At one point, still able to smile, she said, “This childbirth thing is going to hurt!” But by midnight she had passed the point of joking. Now the contractions were a regular three minutes apart, and were sharp enough that she was distant during them, burrowing in to breathe through the pain. The midwife told us to meet her at the Birthing Center at one thirty in the morning of Monday, May 25, Memorial Day.

At first I couldn’t get any car services on the line—they were either busy or not answering—and I panicked, wondering how the hell we’d get to the hospital. This had happened to S once, when she was going to the airport on a snowy morning. No one answered and she worried she’d miss her plane. But finally I got through and waited outside for the driver, while S slowly eased her way downstairs. Though she was starting to sweat now, she had covered up her lime green nightgown with a thick terry bathrobe, claiming she was chilled. Her cheeks were flushed, feverish looking.

When the car came, I piled our stuff in the back seat and told the driver I’d be back soon with my wife who was in labor. “What is this labor?” he asked, his voice thick with a Middle Eastern accent.

“She’s going to have a baby!” I said, and draped a towel on the seat in case her water broke.

The car made its way to Manhattan with S huddling against me in the back seat, practically hiding under her bathrobe, moaning in my ear when the contractions peaked. The driver told me about how he had four kids, and complained about bad New York driving, and pointed out the pot holes he was going out of his way to avoid, but I was too busy murmuring upbeat nothings to S, like “we’re almost there” and “everything’s gonna be ok,” to get much of a conversation going.

We beat the midwife to the Birthing Center by a few minutes, but when she arrived her voice was as even-toned and gentle as during our first office visit with her, when she gave us such a warm vibe. She asked S some basic questions about the contractions, helped us get settled in our room, and then put a monitoring belt around S’s belly. A display of green numbers rose whenever a contraction came on, and a series of yellow numbers measured the fetal heartbeat. The baby’s pulse rose as the tightening peaked, then dropped a bit, before leveling back into what the nurses called “the one-twenties,” meaning somewhere in the one hundred twenty beats per minute range—normal.

Around two o’clock in the morning, after eleven hours of labor, S’s cervix was dilated six centimeters. By this time the contraction pattern was well established—but during the next few hours things plateaued. Though they varied in intensity and interval, they never increased with any regularity. We tried a variety of methods to kick them into a higher gear, positioning S on the toilet, in a crouch, and in the hot tub, which caused S’s legs to seize up in Charlie horses. This was the first time the pain became so intense she was unable to vocalize; it caught in her throat and made her eyes wild and wide. The midwife rubbed her legs while I held her hand, talking her through it. I had quickly picked up the patter and rhythm of the midwife’s language, bolstering her with whispered “breathe it out, you can do it, hang in there, you’re doing great, deep breaths.”

Finally, with the midwife on one side of her and me on the other, we walked back and forth through the hospital hallway, S grabbing on to a bar on the wall whenever a contraction hit. Like in the weeks leading to the labor, the walk stimulated the contractions, and they began to come faster. Whenever we reached the window at the end of the hall we saw the sky lightening as the sun began to rise.

As tired as I was, I knew S must be exhausted. I took quick breaks for a bite of Cliff bar or muffin when I felt light headed, but S hadn’t eaten much besides banana and watered down Gatorade. Labor is often compared to a marathon, but these hazy dark hours were like a long car ride across unchanging country, like the terrain I drove through Midwestern Pennsylvania going back and forth to college. During these trips, a delirium set in because of the monotony of driving, a weariness that was paradoxically coupled with nerves jangled by the road’s many dangers—the speeding eighteen wheelers, the sudden sharp curves that came in the Alleghenies, and of course the risk of falling asleep itself. Just as during these trips, the labor seemed to go on without end, and I couldn’t keep a slight impatience from lurking underneath my concern for S.

When S’s legs tired we came back into our room and she felt pressure in her abdomen, like she had to go to the bathroom. At five forty, after moving her bowls, there was a large deep sound and a splash in the toilet bowl as her water broke. We got her back to the bed and S threw up, at first mushy chunks of banana, and then a mess of watery spinach and beans from dinner, which at this point felt like a million years ago. Another exam revealed that, four hours after the last check, S’s cervix was dilated eight centimeters, and still had a little ways to go.

But the midwife said all the signs were there, and the intensity of the contractions began to pick up. It shouldn’t be long now, she told us. She had delivered two babies the day before so was switching off with another midwife in the practice, though she told us she’d take a nap and then stop back down to see the baby before she went home. It was around seven in the morning and S had been laboring for sixteen hours.

Felicidades Felix

We have a beautiful, healthy baby boy! Right now baby Felix is sleeping on the bed next to his mother, who’s reading and finishing up a leisurely breakfast. After a harrowing first week of life, seeing him home still leaves me feeling light and warm and cheesy. (I sound like a soufflé.) I was terribly wound up while he was in intensive care.

Of course, having a baby at home is still scary at times, like when the responsibility of his care looms huge, or when we can’t figure out why he’s crying or how to calm him down, or when we’re both tired and grumpy and want a full night’s sleep without interruption every two hours or so. But for the most part, an incredible sense of relief and warmth permeates our household these days.

In the upcoming posts, I’ll be writing more in-depth about the travails of Felix’s birth. I’ll also continue plotting the ups and downs of the fourth trimester—the first three months of the baby’s life—as S and I adjust to our new roles, and as Felix completes his development from an infant to a baby who is able to react to the outside world. But I wanted to start this new spate of posts with his birth announcement, and his picture, because I’m so proud of him, and happy, and sometimes am so full of love for the little guy I can’t keep a stupid big grin from spreading across my face. Please keep in mind that no matter how much I might bitch, or how awful some of the details about his birth are, it’s the most wonderful thing in the world to hold him in my arms, and see him with his beautiful mother.