Loch one, Loch two, Loch Lomond

Surprise!  We're having a baby today(ish).

 On the morning of Wednesday, June 17th, I was standing in the kitchen minding my own business when my water broke.  I was 33 weeks pregnant, so this wasn't great.  All my babies have come early, but this was the earliest yet.  I'd been seeing a high-risk OB, but I'd just had an appointment on Monday and he declared that I was not showing signs of going into labor imminently, and I should go ahead and start planning my home birth for approximately four weeks hence.  With my last labor, exactly 90 minutes elapsed between my water breaking and holding a baby in my arms, so it appeared there wasn't a lot of time.  Aaron was working in Ballard and the boys were with me, so I called my brother-in-law who happened to be working nearby and asked if he could drive me to the hospital.  I hadn't had a single contraction yet, but I didn't want to risk delivering on the side of 405 while driving.  I hastily stuffed some clothes and a toothbrush into a bag, grabbed a snack and a stack of towels to sit on and got in the car.

At the hospital, an ultrasound confirmed that my water had broken and the baby was very much head-down.  Aaron and my cousin Shannon arrived soon afterward with snacks, and we settled in for whatever was in store.  I was still in the triage area at this point, and soon I had a few contractions.  When I told the nurse my labor history, she quickly got me into a room and got an IV going.  I was given a large dose of magnesium to stop the contractions, and a shot of steroids to help mature the baby's lungs.  I'd never had a magnesium drip before, and although the nurse tried to prepare me for how it would feel, words can't really do it justice.  Magnesium has a relaxing effect on smooth muscle tissue, including blood vessels.  In high doses, it causes rapid and intense flushing.  What it actually feels like is something I can only imagine is similar to being set on fire from the inside.  The nurse had filled a basin with icy water and washcloths prior to administering the magnesium, and I tried to lie very still and not panic while I directed Aaron to place cold washcloths on the parts of my body that felt most incendiary: "My feet, my feet!  Okay, now drape a couple across my calves.  Now my Adam's apple, wtf?!" It was a fun game for everyone.  Luckily, the most unpleasant sensations only lasted 25 minutes or so, then the dose tapered down to one third of the initial bolus.  My contractions stopped, I sent Shannon home until further notice, and gave Aaron a list of things to go buy(diapers, a car seat...).

I proceeded to have contractions slowly and sporadically, sometimes three hours apart, never closer together than 20 minutes.  They were mild, like bad period cramps, but came just often enough to keep me from sleeping at all that night.  I was also hooked up to a fetal heart rate monitor which kept slipping out of place every time I moved, so the alarm would start beeping and then my nurse would have to come in and try to re-position the monitor until it could read the baby again.  Magnesium slows the baby's heart rate and I was high-risk anyway, so taking off the super uncomfortable monitor wasn't an option.

The next morning, my OB's partner came in and checked me.  I'd had some bloody show, so it appeared that labor was still progressing albeit slower than my usual pace.  I was 4 cm dilated, so the doctor decided to keep the magnesium drip going in an effort to get a second dose of steroids into me(given twice, 24 hours apart).  Meanwhile, a neonatologist came down from the NICU to prep us for what we might expect once our as-yet-unnamed baby was born.  He told us that babies born at 33 weeks have very good survival rates with generally few complications, but they usually need to be in the hospital until they reach 38 weeks.  He went over the various forms of oxygen supplementation our son might need, and explained that some premies find touching too stimulating, so there was  chance we might not be able to hold him.  Upon his birth, there would be an immediate assessment and if he seemed stable enough, I could hold him for 20 minutes or so before he'd go upstairs to the NICU.  I told Aaron that if there was the slightest sign of trouble, I wanted him to baptize our son and made sure the doctors knew about this plan.  Then we waited.

And waited.

I made a labor playlist, and we discussed names.  I tried unsuccessfully to sleep, so instead I talked to the baby.  "Baby, mama needs a favor.  I know you're little, but I need you to be a fighter.  Daddy and I want you to be strong and healthy, and we want to take you home as soon as possible.  So I know you're not even supposed to be born yet and it's a lot to ask, but please, be our little warrior."

Around 9 p.m., I was still only have 2-3 contractions per hour, and I could still talk through them.  They felt slightly more intense than they had the day before, but didn't yet come all the way up to the top of my uterus.  However, I was beginning to feel surges of adrenaline in my legs, a feeling I recognized as transition.  I hit the call button and asked the nurse to check me.  She said they generally try to avoid stirring things up in women whose labors they are trying to stall.

"I know, and I appreciate that, but I have two concerns: one is that I'm still 4 cm and contracting just often enough to prevent sleep, and I'm coming up on 40 hours without sleep.  If I'm still 4 cm, I want an epidural so I can actually rest before having to birth a baby.  My other concern, the one I suspect is more likely the case, is that my lame contractions are, in fact, accomplishing something and I'm further along than anyone suspects."

She agreed to check me.  I was 7-8 cm.  Sneaky uterus.  The on-call OB came in and said "You don't want an epidural; you're going to deliver this baby within the next four hours, and your recovery will be so much better without one." (spoiler alert: he was right)

 My doctor arrived around 11 p.m., and we talked birth plan.  He wasn't on call that night and had already worked a full day at another hospital, but he'd promised me that he would come to my birth no matter what.  I love him.

Chatting, like you do.

 After a while, I felt the urge to push but my contractions were still so-so.  When I did push, I could feel the baby ramming into my pubic bone.  After a few pushes I declared that I felt like I was being hoisted by my own petard; the harder I worked, the worse it felt.  It was 11:45 p.m., and we all wondered if this baby was coming on the 18th or the 19th.  Then my contractions stopped.  Just disappeared.

"I need a chair," I said.

"For what?" my nurse asked.

"For lunges," I replied.  "I'm going to do lunges and get this baby under my pubic bone."

I actually said the words "Pants-off Dance-off!"

 The comparison was too obvious.  "Got a little captain in you?" I said.  I did, in fact, have a little captain in me, and I wanted him out.  The fact that I had not yet lost my sense of humor was an indication to me that labor was not yet fully underway.  So I did lunges for a while, then tried getting on all fours on the bed, then asked for and was brought a birthing stool(which, inexplicably, was bright purple and had actual glitter in it).  After a while I decided to just lie down again.  My doctor offered Pitocin, which I declined at first but after realizing that the magnesium was hamstringing my uterus I agreed.

 And then s*** got real.  Not as real as my other labors, but real enough to make a little progress.  I told my doctor that my contractions still felt pretty ineffective, so he asked if he could put his hand on my stomach for the next one.  The next day, he told me that he'd seen women have stronger Braxton Hicks than the contractions he felt in me.  I pushed, but I wasn't in a good place mentally.  I actively felt ambivalent about getting this baby out, knowing that my body was the safest place for him and that if I did succeed in getting him out, he was going to be taken from me.  Labor wasn't painful enough for me to want it to be over, and my contractions weren't really helping.  I decided to just get it over with, and started pushing hard.

That was a mistake.

I should've waited for the Pitocin to kick in more, because once I got the baby's head approximately halfway out, I ran out of steam and didn't have contractions to help me.  So the baby just paused there, head halfway out, not moving.

And that's when the screaming started.

With Jack, I remember grunting a lot during the pushing phase.

With Matteas, I was quiet and focused and barely made any noise at all.

With this baby, I felt like I was going to lose my mind if I didn't getsome relief from the terrible burning that felt like my entire body was being ripped open with a dull butter knife.

"Don't push," my doctor said.

"Then cut me open and get him the f*** out!!" I screamed.  "I can't not push, I need him OUT!"

 And then he was.  Pink and screaming, with the cord wrapped once around his neck, he arrived at 1:26 a.m. on June 19th.  He weighed in at 5 lbs. 1 oz., and his apgar scores were 8 and 9.  I don't remember Aaron cutting the cord, I just remember being so happy that he was screaming(functioning lungs!) and out of me.

World's Best Doctor.  Seriously.  He was so calm even when I swore at him, and went above and beyond so I could have continuity of care during a very stressful pregnancy.

Other than needing a few weeks to figure out how to eat, our baby didn't have any issues.  He never needed any oxygen support or meds, maintained his temperature consistently and gained weight well.  Every doctor who looked at him declared him mature for his age.  After 18 days in the NICU, we brought him home.

We named him Lochlan Rafael.  Lochlan means "warrior," and Rafael means "God has healed."

What a Girl Wants

When people found out I was pregnant with Jack, I received a broad range of responses.  Most of them were polite-if-reserved congratulations, some were wildly optimistic and supportive, and an unfortunate few were judgmental and cruel.  Some people seemed to feel a pressing need to let me know just how disappointed they were in me, and how very much they disapproved of my choices. This may come as a huge shock to those who offered them, but not a single one of those critical moral sermons was helpful. When I look back at the hard parts of that period in my life(and oh, it was hard), there was never one time when I thought "You know what would be a huge help?  If people were more judgmental."  

Why is it that we feel we have permission to offer moral commentary on the lives of people we see as sinners, when we don't do the same to the people we see as morally upright?  Never once in my entire married life has someone come up to me and said "Hey, I think it's really great that you and Aaron have sex.  Just so you know, you've got my approval." I know the circumstances are different, but I can't help but notice how context-dependent some people's responses have been to my first vs. my third pregnancies.  Without exception, everyone I've told has expressed excitement and support of this pregnancy.  Excitement and support were the exception with Jack.  What it highlights is not that people feel differently about this baby, but that they feel differently about me.  It strikes me as singularly anti pro-life to be kind and gracious to a married pregnant woman, but shaming and critical to an unmarried pregnant girl.  Isn't the baby the same?  (Spoiler alert: yes, the baby is the same.)

I think part of the challenge to practicing compassion is that we like a good old-fashioned conversion story, one with a clear Rescuer and a clear Convert.  We're comfortable with the story of the Wayward Girl who sleeps around, gets pregnant, meets a kindly priest or warm-hearted housewife and is rescued from the clutches of Planned Parenthood and her own ignorance.  The main plot point of that story is one of ignorance or misinformation: she didn't know better.  Now that we've set her straight, she can live a life of virtue and holiness.

What tends to make people uncomfortable is when the pregnant girl doesn't need rescuing, informing or converting.  I was, and still am, a practicing Catholic when I got pregnant with Jack.  Conversion wasn't an option, so the only path left that would ensure I knew I'd done wrong was to shame me.  I think what simply didn't occur to most people was that I was not wildly thrilled to be in my position, but no one asked me how I felt about it.  No one asked me much of anything, I was simply told.  I was told, among other things, that I most certainly had to give the baby up for adoption, that I had humiliated my family, that I clearly didn't have the sense to feel ashamed of myself, and, when I asked for discretion, that I didn't have the right to ask anyone to keep my "dirty little secret." By the way, these were all super helpful things to hear and brought me a sense of hope and encouragement in my darker moments.  

This is a great article that brilliantly illustrates the hierarchy of feelings in a trauma situation.  While not ever pregnancy is traumatic, every pregnancy requires hard work and every pregnant woman deserves support, period.

The whole experience has served as an overwhelming affirmation of my desire to become a doula.  I've experienced a wide array of circumstances and feelings surrounding pregnancy throughout my childbearing years, all of them helpful in cultivating the empathy and non-judgment that make a good doula.  Without my own suffering, I wouldn't understand as deeply the need for compassionate, non-judgmental support. I realize now that judgment has nothing to do with what you want for the other person, and everything to do with what you want for yourself.  If you're not the one who's pregnant, your personal feelings on the matter are neither central to the situation nor helpful to the woman actually experiencing the pregnancy.  Your negative feelings or righteous judgment will not serve her.  Your kindness will.  Be really honest with yourself about what your goal is: to let her know how wrong you think she is, or to help her move toward the best possible outcome?  Responding to her, not demanding that she respond to your feelings, is the only productive path. 

Thankfully, there were more people in my life who offered loving support than criticism, and I am forever grateful for them.  The thing that set them apart from the neutral or non-helpful responses was that they each extended their own version of the question my midwives ask me at each appointment: how can I best support you?

I want to issue an unconditional invitation: if you are pregnant and find yourself in need of support for any reason, please come sit on my couch and have tea with me.  I don't care if you're married, divorced, single, religious, or vegan; I want you to know that you deserve good things, that you are beautiful and loved, and that there is support available to you.  If you come sit on my couch with me I will most likely be in my pajamas, there will be a few dirty dishes in my sink, and my kids will have at least three fights while we're talking, but I will welcome you with open arms, whoever you are.   

Time to write that novel...

So everything was going along swimmingly until my 20 week ultrasound, which showed some premature shortening of my cervix.  This is likely something that happened with my two previous pregnancies, and is probably the reason I had both boys so early(Jack at 34 weeks, Matteas at 36).  While it wasn't a huge shock given my penchant for preterm labor, it's disappointing because now I have to be one of those careful pregnant ladies.  My prenatal care has been transferred from my beloved midwives to a wonderful OB/GYN who is taking excellent care of me, but what this means is that if I go into labor too early, I won't be able to have a home birth like I'd planned.  Jack was born in the hospital, Matteas at the birth center, so I was really looking forward to rounding out my birthing resume with a home birth.  If I make it to 35 weeks(and my doctor thinks I will), I will resume being a midwifery patient and carry on as planned.

In the meantime, I'm on a carefully crafted medication regimen and I see my OB once a week for ultrasounds.  While not on strict bed rest(which hasn't been shown to improve the outcomes for women with cervical shortening), I'm on a "couch potato light" program and for the time being am not supposed to indulge in so much as a walk around the block.  I can go about my daily business, just nothing extra.  Good thing I already chopped down the freaky stumps in our backyard during my last pregnancy, because anything involving an ax is on the no-no list.

It's been interesting to observe how I've absorbed this information.  At first, I was devastated.  I drove home from the ultrasound and crawled into bed, where I proceeded to cry and nap alternately for the next few hours.  I've been anxious about a lot of things in my life, but never anything related to pregnancy or childbirth.  Those were things my body knew how to do on its own, and I could trust my body to do those things largely unsupervised.  Now I can't.  It's an odd sensation, to feel betrayed by one's own body.  It's also sort of frustrating to not know why; there are a number of things that can contribute to cervical insufficiency(the medical term for what my cervix is doing), but I haven't had any of them.

I was pretty depressed about the whole situation for a while, but this week it occurred to me that I finally had a reason to do the kind of low-energy projects I usually find myself putting off, mostly because I told myself I didn't have the time.  Now, all I've got is time.  Four months of it.  I got some drawing books from the library, and dusted off my sketchbook and art supplies.  I'm currently reading and loving Ruth Reichl's Tender at the Bone, and am currently taking suggestions for books I should read next.  Nothing scary, sad, sinister or stupid, but I also don't want to have to work too hard for my entertainment; I want it to scoop me up in its nonjudgmental arms and suddenly it's two hours later.  I've mostly recovered my taste for food, so now seems like as good a time as any to finally perfect a sticky bun recipe.  They never come out chewy enough for me.  Got any good recipes?  I made Smitten Kitchen's sticky buns last night(minus pecans, which Jack can't have) and they were tasty but they failed to knock my socks off.  I want a sticky bun the texture of a doughnut, with a dark, toasty caramel that you pour between the layers before rolling, not just soak the bottom half of the roll in(which I did, and I have no regrets about that part).  For my next batch, I'm going to use a dough recipe I found for actual doughnuts and omit the honey in the caramel sauce.  And then I'm going to gain 100 pounds because I'm cooking again and not exercising.  YOLO.  If I can maintain four weeks of "cervical stability," my OB says I can go back to yoga.  If my yoga pants still fit by then.

If anyone needs me, I'll be lying on the couch reading and eating leftover sticky buns.

What My Baby Wants, My Baby Gets

I've been using that line a lot lately as an explanation for why my eating habits have been so weird lately. Aaron and Damien think I'm just being picky, but I swear this kid's preferences change daily. Yesterday I craved cream of mushroom soup, which is very odd because when I'm not pregnant it usually grosses me out. Today I wanted a hamburger from Dick's. I go to the store and stock up on things that appeal to me, but a day or two later I can't even look at the stuff I bought. It's really challenging to stay full when no single food consistently appeals to me. So far there has been fruit, cereal, hot dogs, soup, and fast food; I can't wait to see what this baby will be in the mood for tomorrow...

Miracle or Placebo?

So I'm not sure what's working: the bracelets, the B6, or the crackers, but something worked because I feel fabulous today. I felt a little queasy when I first woke up, but I had some crackers(actually that's a lie; they were dry Kix because I forgot to buy crackers) by the bed so I ate some and then lay there for 20 minutes or so before I got up. I have a pretty bad cold right now, so it's hard to tell what's the cold and what's from pregnancy, but I sat on the couch and drank some orange juice and just took things slow. About an hour after I got up I had a waffle and some milk, and since then I've felt almost completely normal. I read a review of the acupressure bracelets and one study suggested that their success in pregnant women was probably a placebo effect, but I don't really care because I don't feel nauseous anymore. I'm a little nervous that I'm celebrating prematurely and maybe in the evening I'll feel yucky again, but I really hope not.