Tuesday, July 28, 2009

Notes After Leo's Birth

Baby Lenard, whose birth certificate was left unsigned for one week while we deliberated about his name, was born at 2:01 am on June 30th, 2009. As I begin to compose the story of his birth, he is soundly asleep on our couch. He is four weeks old today. He is a beautiful baby. But I am getting ahead of myself.

Leo's birth story starts with his sister. I was nursing his sister, Izabella, to sleep when my water broke at about 8:30 pm on a Monday evening. It was a small leak at first and frankly I wasn't entirely sure that it was my waters. I continued to nurse Izabella until she was drowsy and almost fully asleep. I became entirely calm. Just as my doula had told me, my body needed to know that my seventeen-month-old baby was deeply asleep before I began to labor.

I put Izabella down to sleep knowing that the next I held her she would be a big sister. I crept out of her room and went downstairs to speak with my husband and babysitter. I had requested that our babysitter, Nikki, who had moved in with us a few weeks earlier, and my husband wait for me so that I could explain to them my wishes regarding Izabella's care in the event I went into labor. I proceeded to explain to them my directions. Only after I had made myself clear about my wishes did I mention that my waters, I suspected, had broken.

At about seven that evening I had noticed some bloody show, blood streaked mucous, indicating that labor might be near. It was beginning to look a lot like labor. I was thirty-eight weeks plus several days into the pregnancy.

Soon after telling my husband that labor might have begun, the waters began to gush. I text-messaged my doula. I called the midwife on duty at the hospital to give her a warning that I would be making my way there sometime in the near future. At first my husband and babysitter stayed near me. Contractions had not yet started. So we turned on the TV and watched "Ice Age." At least it played while we all sat there "relaxing." Finally at about ten pm I sent them upstairs to bed. I needed to be alone. Still no contractions.

A few weeks earlier I had learned that I was Group B Strep (GBS) positive. (This means that I tested positive for a normal bacteria which is nevertheless potentially harmful if passed on to the baby during delivery.) If you are positive, you should receive two doses (four hours apart) of antibiotics by IV before delivery. My midwife informed me of this disappointing news as my husband stood there with two broken arms. Yes, that day he had a bicycle accident which would result in two plaster casts. Needless to say I was a bit confounded. My husband couldn't lift my toddler. Not to mention change a diaper. And the GBS meant an IV in my arm during labor and a need to "rush" to the hospital to start the medication before I delivered.

As it turned out, however, I would not be rushed by anyone else in labor.

When I spoke to the midwife on call that night she made a comment that drastically changed my birth plan. I had planned to rush in and start the antibiotics. If I failed to get the proper dosage, then the protocol meant that my son would have to have blood extracted within the first hour of birth and stay for observation for twenty four hours. I did not want him to be subjected to an avoidable blood test so soon after birth and I hoped to get home sooner than that. When I mentioned my GBS status to the midwife, she said something like, "They like to induce mothers who are GBB positive." What? Did she mean, "they" as in other people and not me? Or did she mean that she was obligated to be part of the "they" since we were at the hospital? All I know is that I weighed the risk of passing GBS on to my baby and the reality of being induced. And I stayed home. (I never did get a chance to ask her for clarification. Later my midwife who gives me regular care told me that I would have had the right to refuse an induction. But I didn't know that at the time. And it is so very difficult to refuse medical care especially while in labor.)

I am not sure when the contractions really started. I do recall that at 11:30 pm I thought that I should start recording the time for each one. By midnight I thought it was time to go to the hospital. The contractions were strong and coming at three minutes, then five minutes, then ten minutes apart. I just knew it was time. My husband drove me to the hospital. It should be noted that he drove me with two broken hands. We drove slowly, ever so slowly, because each bend in the road was painful for him. Picture that.

It was after regular hospital hours and so we had to enter through the emergency room. They moved me directly to the delivery room. I asked them to fire up the bathtub. Quickly they began to insert the IV to administer the antibiotic. I was in active labor and the contractions were strong. I would have felt sorry for the poor nurse who had to insert the needle if I wasn't upset and resistant that it had to be done. Somewhere in there the midwife did a vaginal exam to determine dilation. It must have been done before the IV, but I would have to check my doula's notes. I do remember that I tried to refuse it and that it hurt like hell. The midwife told me that I was dilated at about four to five centimeters. That shocked and panicked me a bit. It was a long way to ten, so I thought. I know the IV went in at 1 am, because I remember thinking that I had until 1:20, a twenty minute wait, until the antibiotics were in and I could be disconnected from the apparatus. I was violently shaking.

As soon as the antibiotics were in and my IV taped down, I got in the warm bath. The contractions were coming fast with little to no time in between to get all "I am Woman / Hear me Roar." Frankly I remember thinking that there had to be a better way to give birth, one that involved less intensity. My midwife was alone with me and began to help me relax by stroking my arms, saying soothing words, and offering aromatherapy. Then my doula arrived. I needed her there. I was glad to realize that the IV, which I was worried would bother me because it was still taped to my arm, provided no major distraction.

Together with the soothing water and my doula's arrival I was finally able to "let go" and relax. Labor is all about letting go. Turning off the mind. Giving in to the muscles and liquids that make up your corporeal self. You must yield. Your instinct is to tighten, to flex for the fight. To control. To hold on to your dignity. The key is to relax, release, to submit, to discover the dignity of the flesh.

I remember one moment: darkened bath room, on my knees, fully bare, hands on the tub's edge, warm water streaming down my shoulders and back as I stretched up and moaned through a powerful contraction. That felt right. It felt powerful. It felt true.

I also remember feeling like I needed to vomit.

I remember looking down and seeing a dark spot ooze from my vagina and shouting out to my doula and midwife in concern. It turned out to be blood (and normal), but in the darkened room it was hard to identity.

Then I needed to push. How did I know? Your body knows. The nurses hustled me out of the tub. (Water births are not allowed at this hospital.)

I moved to the bed and climbed up on all fours. I pushed with my contractions probably about three times. And then he was almost there. The midwife instructed me to lie on my side, which felt awkward to me. I agreed to try it for one push. But one push was all it took. It was a mighty one. My midwife told me not to scream, and my doula instructed me to take that screaming energy and push it down inside, making more of a grunt. It worked. He passed through me and into the world. He was quickly covered in a blanket and set on my chest. They didn't even check the sex, just placed him on my chest while the placenta was delivered. So fast. So very fast. Yet no tears, no stitches needed. He latched on perfectly and didn't let go for two hours.

As I "finish" this entry, Leo is sleeping in the swing. He is three-and-a-half months old. His sister is out with their father shopping for a new car. I am sipping my jasmine green tea and waiting for him to wake up so that I can take him in my arms and breathe deeply again.

Truly I can hardly believe that this little guy, who is growing at a tremendous rate, is here. He arrived so very fast. And he is growing so very fast. And I can't believe I named him Lenard. I am sure that he will carry it well.

(finally posted on October 13th, 2009)


RĂ©ka Albert said...

Such a powerful story!

I hope the GBS issue was solved with the one dose of antibiotics and Leo did not need the extra procedures.

How did Izabella react to Leo? How is their relationship now?

J.K.Kelley said...

I did not get the dosage necessary before the birth. Leo had to have blood extracted for the test. It was negative.

It turned out the "extra" time in the hospital was okay. I got some alone time with Leo. Izabella handled the transition just fine thanks to our awesome nanny and her father.

These days she is still very much in love with "baby." I have heard that the conflicts might start when he becomes mobile (and can invade her space/toys).