I keep sitting down, or rather, sitting up to write E’s birth story but then I just procrastinate until I’m sore and have to lay back down or get up. I’m just afraid I won’t be able to put the correct words together to adequately describe the birth and how it was for me.
My birth story has nothing to do with yours. Each story is different and unique. Because I had one thing in mind or feel a certain way about one thing or another does not have anything to do with another person’s birth choices. I really truly don’t care how you birth your babies UNLESS you felt bullied, tricked, raped, pressured, uninformed or like you didn’t matter. In that case my heart breaks for you and I wish you healing and empowerment.
I’ll start by telling you that everything I’ve done in this pregnancy has been to support E in the fullest way possible with the end goal being a natural vaginal birth for her health and safety as well as mine. Natural vaginal birth is the most ideal scenario if possible and E and I deserve nothing less than ideal!
The benefits of a vaginal birth over cesarean include the baby getting a boost to her immune system by the transfer of healthy bacteria she gets while passing through the birthing canal. The bacteria colonizes the baby’s intestines and helps inoculate against immediate and future germs and illness. There is an increase in white blood cells in babies born vaginally over cesarean. Vaginal delivery leads to a shorter hospital stay. Vaginal delivery triggers the production of a protein in the baby’s brain that is responsible for memory. Labor helps mature the baby’s lungs preparing her to breathe air; vaginal delivery helps clear the lungs of amniotic fluid.
Cesarean sections can lead to respiration problems, disrupted blood glucose levels and can lead to increased crying. Medications from a cesarean are transferred to the baby and can cause high blood pressure and agitation. Antibiotics administered during cesarean are transferred to the baby and can damage healthy bacteria necessary for fighting sickness and as with the baby not getting that initial boost of beneficial bacteria by going through the birth canal; it can have long term effects on the immune system.
Vaginal delivery also helps with bonding. While me bonding with E was not an issue as I am the surrogate and my goal is not to have a close bonded relationship with her like I do with my kids, one of the reasons I have always wanted Marce and Chris present for the delivery is because it is also a bonding experience for non-birthing parents. Just ask any dad who has witnessed the birth of their child.
For women vaginal births are safer. Death rates are much lower. Statistics vary greatly on this. It seems like maternal death rates should be easy to track but often deaths that occur after the delivery from hemorrhaging or infection go under reported in connection to birth. Regardless of the exact numbers, and considering that in all likelihood, under any method of birthing a woman is statistically unlikely to die, it is safer without a doubt to birth vaginally.
Cesareans have a higher risk of excessive bleeding and a risk of other organs being damaged during surgery. There is a lot of scar tissue with cesareans which can be a risk in future pregnancies. Cesareans carry the risk of infection, a much harder recovery, longer healing time, increased chances and severity of post postpartum depression and a longer and possibly harder time getting ones milk in and though it doesn’t apply to me since I’m pumping and not nursing, c-sections can complicate breastfeeding altogether making it more difficult.
The best way to prevent a cesarean is to be educated. Many, many, many c-sections can be avoided by a well-informed woman. Ways to prevent a cesarean include:
- Healthy diet
- Exercise before and throughout pregnancy
- A good healthcare provider who has the same goals as you
- BEING EDUCATED
- Birth plan
- Going into labor spontaneously
- Laboring at home as long as possible
- Walking, moving, changing positions during labor
- Having a loved one and/or doula present for support
- Avoiding interventions that are not medically necessary
- Avoiding being on your back
- Following your body’s urges to push
I had already woken Jason up by turning on lights and being loud and I told him it’s time. I called Marce and Chris before the fourth contraction and told them it was time and that it was going to go really really fast as evidenced by the strength of the contractions and since my water had just broke. They live about four hours away. Caitlin was born about three or four hours after my water broke and the contractions had not been as intense at the time my water broke with her.
The plan was to leave Anthony, our eleven year old, home as was his wish and to take Caitlin with us for Jodi to be with when she arrived. She wanted to be present and we had prepared her for what birth might look like. We had already gotten Anthony ready for this and even bought a frozen pizza just for him to have while we were gone. He still wanted to stay home and Caitlin still wanted to come. Jason packed up the car and got Caitlin situated. I grabbed my water, cell charger and a towel to sit on and got in the car. It was dark outside, the air was fresh and the world was peaceful. I was so excited, it was go time!
The nurse, Beth offered me a gown and asked me to hop in bed so they could monitor the contractions and the baby’s heart rate. I asked her if she’d read the birth plan I had given the front desk. She had not yet had time and Jason handed her a copy of it. I told her I prefer my own clothes and would like to be monitored intermittently. She still needed me to get hooked up for monitoring for an initial twenty minutes which I knew they would want to do. I let her know there was no way I could be in bed but I could stand by the bed while they monitored. She tried to wait between contractions to put on a belly band and hook up the two monitors, one to track the contractions and one for the baby’s hear rate.
I labored by the bed for a while. My underwear was soaked with amniotic fluid and I saw the mucus plug on the pad I had worn to the hospital when I changed into a new pad using those super sexy netted underwear you get on the L&D wing – yes, you ladies know what I’m talking about. I asked for a birthing ball and sat on that a lot moving my hips. I remembered from my last birth that no matter how much I tried to move away from the pain I could not escape it (I know, such an epiphany) so I just rocked and moaned and focused on the vibration of my sound. Eventually I told Beth I was sure I had been there longer than twenty minutes and was ready to lose the monitoring. She said she was having a hard time getting consistent readings, a sentiment that would follow us for many hours. Apparently they had new monitoring devices that the nurses were not too happy about and my constant movement wasn’t helping much.
Once my nurse Beth realized what type of labor and delivery this was going to be (the back off type) she became real supportive. Because she couldn’t get good readings she sat and held the monitor often always doing her best not to disturb me as much as possible. She tried to apply pressure on my lower back when I commented that the pain had moved there and throughout my hips but I couldn’t have anyone touching me. I did accept a wet minty smelling wash cloth for my neck and face.
The nurse had some perfume on that was hard for me to be around but I did my best to focus on something else and it was okay. At one point Caitlin was eating some dried seaweed I had packed and I had to ask her not to eat in the room because the smell was making me sick. Fairly early on in labor around 3 a.m. and not in connection with the seaweed I did throw up which is something I have never done in labor. I hate throwing up more than anything and I was worried it wouldn’t stop but I only had to once though I clung to a puke bag for a long time after.
Beth did me a favor and called anesthesiology to let them know she hadn’t forgotten to call them down, that I was declining their interview which they do routinely. At my only good prenatal appointment with Kaiser the midwife told me I would have to do this. Beth was already my advocate.
Eventually we ditched the continuous monitoring. They had gotten enough data for their records and to establish that E was doing well. She commented on the strength of the contractions with genuine admiration that I was handling them saying something about me being an amazon warrior. I’ll take any reassurance I can get in labor!
Labor was so intense and I could feel sharp pain shooting through my hips and back. I told Jason he needed to get a hold of the boys because I really didn’t think they were going to make it in time. Their ETA was 5:15 a.m. and I just knew she’d be born within the hour. I needed to know in their absence since they would not be able to do skin to skin if they wanted me to nurse or if they wanted us to use the colostrum we brought.
Cell phone use was hit and miss in the hospital room which was very frustrating Jason kept leaving to get a call or text off. I think he finally called on the phone in the room because I needed him to find out what Marce and Chris wanted us to do if E was born before they arrived. Somehow I don’t think the question ever got asked/answered but I soon forgot anyway. I can only imagine the stress in Marce and Chris’ car with all these calls and texts, me insisting E was coming SOON.
My sister Jodi arrived about 3:30 a.m. I was too far in the zone to really even acknowledge she was there but I was glad she made it and could be with Caitlin who had been doing fantastic as far as I knew.
I went to the bathroom to go pee and labor on the toilet and it is there I had a slight urge to push. It was nice being on the toilet because I could just wipe and have someone flush when some poop came out. If you don’t already know this, everyone poops when they are having a baby. Think about it.
I was in so much pain, the contractions were coming fast. They were at the level that they reach right before the baby is born so I knew I could continue to handle it until she came since I knew she was coming soon. As much as I wanted Marce and Chris to make it for the delivery I just didn’t think they could. I must have told Jason five times to please make sure and record me because I was going to give birth soon. I just knew it and I wanted Marce and Chris to be able to watch the birth.
I told Beth I was going to push soon and she had the midwife, Janie come in. She asked if she could check me. I was glad for her too and she checked me in-between contractions as I sat on the toilet. I was astonished to hear that I was only 4 cm dilated but I told myself it was okay because I knew with this level of labor I would advance quickly.
I was starting to get exhausted with the non-stop contractions. By then I had established a pattern of two contractions in a row. I would breathe and moan through the first and direct my thoughts to all the other women who had labored before me and all those laboring with me. I moaned, deep and loud breathing in and out focusing still on the vibration my voice made in my head. As soon as the contraction seemed to be subsiding, the next one started. Each time for one second between the two I thought I would get a break but as soon as the second started immediately after the first I knew it was going to be harder than the one I had just had. The second contraction reached that level where I had to hold on to my sanity and just make it through each second. When the second one was finished I had a minute or two or thirty seconds, who knows as it felt like five seconds, until the set of two contractions began again. I asked for a blanket to be brought into the bathroom so I could lie down. I wanted to rest so much but just as soon as I would lie on my side or finally let my body relax, the contractions would start again.
I asked Beth to fill the bath tub for me and I got in the water for a few contractions. It felt good. I was so tired I rested my head on the side of the bathtub through a few contractions but I didn’t stay there long before I went to all fours in the water and then to my knees, trying to somehow lessen the pain. When I was in the tub it was just Jason me and the nurse and I and told them that I hated to say it out-loud, (one trick to natural birth is not to say it out-loud) but that I may want an epidural.
They were both quiet for a minute. The nurse said, “I’m okay with that if you’re okay with that.” I remembered that if I got an epidural I had to be tied to the bed, continuously monitored, likely on my back hooked up to an IV. I said, “Never-mind, I can do this.” She asked me if I’d like to be checked again. I said yes please, knowing that it would help me so much to be able to know there was an end in sight especially since I was going on the fact that I was only at 4 centimeters last they checked. The water got cold real quick and I got out. I was shivering and so cold and getting weary. I tried to lie on the blanket on the floor and Jason and the nurse brought me towels and a blanket to cover with but there was no time to lie down. I used a smaller birthing ball they had brought me earlier so I could be on my knees and rest my head and arms on the ball.
Marce and Chris and Marce’s dad from Israel arrived at about 4:30 a.m. while I was in the bathroom. I knew they were there but was I was beyond caring about anything around me. I was just surviving and managing the contractions. At one point I finally left the bathroom in-between contractions, said “Hi Guys” and then something like “G** Dammit, Fuck” and then felt bad for half a second since Marces dad was there just as another contraction was coming and I moaned through it and the one following.
Kristina my doula arrived at about 5 a.m. She quickly came next to me and moaned and breathed through the contractions with me. She mentioned hip compression or something of the sort and Jason and the nurse quickly told her I didn’t care to be touched. I had purposed ahead of time with this birth to try and allow someone to try something like pressure on my back because I figured it must help but any time anyone put a finger on my back or neck or body I told them to stop. I allowed them to keep fiddling with their monitors because I knew they needed their data and to check E’s heart-rate and I was okay with that. Beth and I had a respectful relationship and I knew she was doing her best to support me.
It helped to have Kristina there and affirmed that I was doing it right. She encouraged me to relax and let my body melt in-between. They were once again trying to get the monitor to get some solid data on the state of baby’s heart rate. In hind sight I think I thought the monitors were the problem but it could have been because the data on E’s heart rate was inconsistent. I honestly don’t know but I think it was just a monitoring issue.
I sat on the birthing ball and sometimes stood leaning on the bed. I wondered if I wasn’t letting E come because of the fear of the pain of her coming out. I wondered if somehow I was subconsciously holding on for her parents to make it. I told myself to let go, it was okay to have E now. Everyone was there. By then Janie had come in to check my cervix. She checked me while I squatted next to the bed. There was no way in hell I could have laid down to be checked. About two hours after I had been at a four I was found to be at a five. I had expected to be at least at an eight or nine. I would have said ten but I hadn’t had another urge to push.
The contractions were reaching a certain level of crazy. I remembered there is often a time in labor that usually directly precedes the birth when you think you will die but I knew then that I was not directly preceding birth. Rushes were still coming in twos, the second always reaching a higher level than the first. I thought I would have already had E by then. I was laboring on the labor ball by the bed when I announced mostly to Marce and Chris, “I’m sorry but I think I want an epidural.” The sorry part was because if it affected anyone it would affect their daughter but I did not regret saying it. In fact as soon as I said it I had a sense of peace. I felt like I should be conflicted but I wasn’t. While I knew I COULD have managed as many women all over the world have and do without access to epidurals or choosing not to use them, I didn’t think this was going how it should and I didn’t want to suffer a longer ride.
I felt like I should have already had E and didn’t care to manage that level of labor indefinitely. I didn’t know why she wasn’t coming. I had done this before and I thought, I guess just based on my experiences, with this many hours of labor at the level it was at my body should have dilated fully and been working E out of me. It was after six in the morning. I had been laboring hard for over five hours to get to a dilation of five with one centimeter of progress in the past two hours which had been exceptionally hard. When I had had Caitlin I don’t remember exactly but I was at least a four or five by the time I even arrived at The Birthing Inn and the contractions just then started getting as intense as the ones I was having just an hour into this labor. They did reach the same level with Caitlin just not until the labor was very well underway.
Beth and another nurse started preparing me for an epidural. After they got the heplock and IV in me and after anesthesiology arrive they had everyone leave the room except Jason. I had to sit on the bed. I wasn’t sure how I could possibly do that but I was able to breathe through the contractions, leaning on Jason and somehow holding still long enough for the anesthesiologist to administer the needle. He was good. He was respectful and told me what he was doing the whole time. It took a while for the meds to kick in all the way but each contraction I knew would be felt less and less intensely.
Everyone came back in the room and the atmosphere completely changed. The sun was coming up outside and I wondered how it was day already. I was able to see everyone though I generally kept my focus within a few feet of myself. Everyone looked tired! Caitlin fell asleep on a chair finally. My nurse and I agreed that I’d have E before she went off work at 7:30. Contractions didn’t let up and I was still thought E would be born soon. Since I couldn’t feel the strength of the contractions I had to make a conscious effort to focus on my body and try as best as I could to stay connected with E.
It took a long, long time to dilate to ten. My nurse’s shift came and went. I asked her to request a good nurse for me and she said she would pick someone she knew would work well with me. I had a new midwife, Veronica whom I had had a couple negative office visits with during my pregnancy. She came to check on me in the beginning and somehow we got on the topic of the size of the baby (since I could talk and interact with those around me having had the epidural) and she said there is no way this baby was nine pounds. We had a good laugh after she left because she was one of my harshest critics about me measuring big during the prenatal visits.
The trouble with the monitoring was still ongoing and at some point E’s heart rate started to dip. I honestly wasn’t paying attention to the heart rate all along which unless there is a problem I think is the best way to labor. I cannot say when the heart rate became an issue. I would like to obtain the birthing records and see exactly when the heart rate started to drop and how directly it was related to the epidural assuming they did have good enough data from the intermittent monitoring to compare pre and post epidural numbers. This was the first of the side effects that was likely a direct result of having obtained an epidural.
I still continued to be confused why E hadn’t come yet. Eventually Kristina convinced me to let go of what I had expected and just embrace that each of my labor and delivery experiences were going to be completely different from each other.
The next check was around 7:30 am. I was at a seven. I found that I was still able to move around in the bed freely and I spent a lot of time on my knees with arms over the back of the bed to try and help aid E down.
Veronica, the new midwife and I made peace real quickly. I saw that she was clearly there to support me. I knew she had concerns over the heart rate and the fact that I wasn’t advancing but she only ever tried to find solutions like switching positions. They kept messing with the monitors and finally Veronica asked if I would be open to using an internal fetal monitor that is directly attached to the baby’s head. I cringed at the thought but I was so sick of them messing with the monitor and it was unnerving for them to keep searching for a heart rate as a few times I was really worried that there was no heart rate.
This was an easy decision for me because it had only to do with E so I simply deferred to Marce and Chris. I’m sure they were concerned too and they agreed to the internal heart rate monitor. They placed that through my vagina onto E’s head and taped the attached cords to my thigh. From then on we had a much clearer picture of E’s heart rate which was frequently unsettling. It would dip very low at times yet it always came back up and the variability was good. There were certain positions that would cause more problems and Veronica was sure something was pushing on the umbilical cord.
I eventually dilated to ten centimeters probably around eleven in the morning. We waited for a long time for the urge to push to come but I just kept not feeling like I needed to push. I spent most of my time trying to find positions that kept E’s heart rate the steadiest. It seemed to be the best lying on my left side, left leg strait, right leg over the left with my knee toward my chest propped on a pillow although even then there were problems. Whenever I’d change positions to encourage her to drop we ran into more heart rate decreases, some as low as 60 (120 is ideal and it is normal to drop but not that low and not for long and not after contractions, mostly during).
Finally Veronica suggested we try pushing regardless of the urge. Time just kept dragging on and I was definitely ready to see some progress. It felt completely un-organic. I waited until I could feel a contraction starting and looked over at the screen to confirm it was coming. Veronica put her fingers just inside my vagina having asked me if I’d like her to do so, so I could focus my energy there. Kristina held one leg back and Jason the other, at my request because my legs felt too heavy for me to hold alone. I reached my hands underneath my legs, took a deep breath and pushed and pushed and pushed trying to pull my legs toward me and push E out of me. Even though I couldn’t feel E descending very much I just knew I could push her out. There were a few successful times that I felt her a little lower and once they even saw her head for a moment but she always went right back up and there were many more unproductive pushes than productive ones. We pushed through each contraction for some time with no progress. E was not dropping and I was not able to push her further down into the birth canal. We tried again with me squatting over the bed holding onto a pole they had attached to the bed. There was no success with that either and her heart rate dipped more.
Veronica asked if I would be open to using Pitocin to help pick up the frequency and strength of the contractions. I didn’t want to stress E out and thought the Pitocin might do that but I was all for helping pick things up. Since I had dilated to a ten, the contractions had spaced much further out to about every five minutes. I asked her about trying nipple stimulation first and Veronica was supportive.
I was surprised they had a protocol for that. Apparently too much nipple stimulation can lead to a more or less constant contraction which can be too much for the baby to handle and probably especially in our situation where her heart rate was already frequently dipping. I went ahead and tried to express more colostrum. As soon I would start to express a contraction did begin and Lisa, our nurse asked me to stop as soon as a contraction started. Then I had to wait five minutes to stim again. It worked to get things going but having to wait five minutes in between was sort of self-defeating since my contractions has already been spaced at that level. Eventually I would stim every two or three minutes. I could always get a contraction started but it didn’t bring on any urge to push. As much as I just wanted to get the contractions to come hard and fast and force her out we had to go slow.
Eventually I asked everyone to leave the room for a little just so I could feel less like a watched duck. I think it was Kristina who mentioned it might help and also Jason and I could be alone and maybe even do some kissing comfortably (which we did a little bit) which also helps labor. I’m guessing it was nice for everyone to go clear their head a little anyway but I don’t really know. It did seem to help things pick up and but it wasn’t sustained.
I knew when I first became a surrogate that my preference was for the parents to be present for labor and delivery if that is what they wanted. I knew that I would be ultimately asking strangers to come in on one of the most intimate things you can do as a woman, labor and birth. All along I just tried not to think about the details like that this couple whom I love but am not that close with would see me naked, see my vagina my poop, my hemorrhoids (which developed quite nicely during labor), the varicose vein in my labia, me stimulating my nipples and on and on. I didn’t care because I knew that for one I would be so engrossed in labor that I wouldn’t be focusing on it and two I know Marce and Chris had one concern and one concern only and that was their daughter. I knew they couldn’t care less about the rest. Besides, Chris is a nurse so I already knew there is absolutely nothing in this world that can shock him and that they are grownups and could leave at any time if they felt uncomfortable.
The staff at Kaiser did such an amazing job at helping protect my dignity and privacy despite the fact that we had such a large birthing team. Even knowing they would watch the birth, they still asked me if we should close the curtain that separated me from the sitting area in the room during exams and things like the one time when I was trying to urinate over a pan to try and avoid the catheter being put back in. That was unsuccessful so the nurse ended up just using the catheter to relive me and then leaving it out. It couldn’t be in when I was pushing but I was pushing or going to push for so long that I couldn’t go without the catheter the whole time. The catheter of course was because I had the epidural.
Lisa the nurse even asked if it was okay for everyone to be present for pushing. Of course I expected the pushing to end in the grand entry of Marce and Chris’ baby girl E and I had no problem with them being present which was the whole point! I feel like I was pretty unaware of what Marce and Chris, Marces dad, Jodi and Caitlin were doing most of the time.
Caitlin and Jodi were in and out of the room and ended up leaving when my pushing and all the hands in and on my vagina started to bother her. I am so grateful Jodi was there to debrief her and take her out when it was time. Kristina and Jason were next to me often and I was present with them but I think I was able to tune everything else out.
|Jason going on zero sleep and Caitlin my little angel who apparently doesn’t need sleep.|
I did not feel obligated to have Marce and Chris present and it might have been different with another couple depending too on what their comfort level was but I wanted them to be there so they could tell E about her birth and so they could see how hard E worked to come meet them.
We tried everything. We tried every position. I pushed with all my might only to further clear my bowels. My sweet sister and Lisa took turns discretely cleaning me up.
After the nipple stimulation failed to produce a baby I agreed as did Marce and Chris to start a Pitocin drip. They started it slow as I requested but kept turning it up. It was producing strong contractions just a little closer together. They were so strong I had to breathe through them though the pain was absolutely not comparable to contractions without an epidural. E’s heart rate continued to drop sometimes with no explanation as low as 60 and at times dipping for as long as 90 seconds. I started to realize that every time Veronica came in likely E’s hear rate had just plummeted. At one point she called someone to bring in some Terbutaline but canceled the order as E’s heart rate went back up. I didn’t know until later that that is a drug given to try and stop or slow labor. After another hour or so I went ahead and tried pushing again. Veronica asked an attending doctor to come in to assess the situation. No one was visibly overly panicked or stressed and no one had said anything about a cesarean but we all knew things needed to change.
|This is my lovely doula, Kristina.|
I tried and tried to push E out with the doctor feeling her head way up in me. They asked how I would feel about the use of a vacuum extractor and Marce and Chris and I asked questions. The vacuum extractor makes me so nervous since even though it’s rare, it can cause severe side effects including brain damage to the baby. I asked why we wouldn’t try forceps first and the doctor said she was not low enough to be able to use forceps. Finally the doctor said he thought we she go for a cesarean section. He could not rotate or move E to try and help her decent past my pelvic bones even low enough to use the vacuum extractor. We tried one more push. I wanted to and did push while squatting just not believing that I couldn’t force her down by opening my pelvis as wide as I could and pushing as hard as I could but it was no use.
I agreed to a cesarean with no further ado as did Marce and Chris and I think every single person in attendance let out a sigh of relief.
The bustle of preparing began instantly. I lay down on my back, knowing that the position I was in no longer mattered. I wanted to say, just let me try one more thing, a little longer, a different position just not understanding how it was possible for E not to be born when my cervix was wide open for her. But we had already tried everything. I knew the staff had let me go longer than a lot of places would have. Later when the first midwife I had, Janie came to visit me in the hospital she told me they would have likely started the cesarean discussion sooner if it had been my first labor but everyone knew my pelvis was “proven.” (I hate that phrase, “proven pelvis”). They all knew I had birthed two large kids before this and we all knew there was no logistical reason why I shouldn’t be able to deliver E.
I came into Kaiser in the wee hours of the morning with very little confidence in them. All but one prenatal visit with Kaiser during the whole pregnancy was miserable. They were overly focused on interventions and possible problems. They never stopped to listen to me as a human and an experienced mother. They were fixated on testing, vaccinating and finding problems. Not once did they inquire about the broader picture like how I eat, exercise or live my life. Even the way they have the pregnant women (except me because I refused) pee in a cup in the public restroom connected to the lobby of the entire facility which is way more than the OBGYN’s office, was dehumanizing. Imagine what the aim accuracy into a tiny cup by a pregnant woman who cannot see her urine stream is. I’ll tell you, you have huge odds of missing the cup. It’s gross. You know women are touching doors and faucets with hands that were just peed on and besides it’s embarrassing to carry your urine in a brown paper bag through all the various waiting rooms. I did it once only and then they found a bathroom back by the exam rooms for me to use. Kaiser up to the L&D part had a big fat F in my book. I was not impressed.
But during my labor the nurses, midwives and doctors never treated me with disrespect. They respected my birth plan and did an excellent job of keeping the environment stress free despite the obvious fact very early on that the delivery was not progressing quickly. They not once shut down an idea from me or Kristina about how we could help E become more engaged or better positioned unless there was an actual concern like for instance toward the end when I would stimulate my nipples after the Pitocin was going Veronica said she thought it was too much so I stopped. They asked rather than told. I didn’t once feel bullied. I didn’t feel like anyone was trying to hype up the feeling of emanate danger in order to push for an intervention they wanted. Okay maybe my second nurse, Lisa was a little dramatic at times but I was older than her so she didn’t scare me much and I liked her anyway. I think Beth requested her because she had a strong personality like me. :) They told it to me strait like I was capable of making my own decisions.
By the time we reached the cesarean section conversation I felt like everyone was one big vested team all with the same goals and perspective. I think it was as hard for my midwife to call as it was for me. She had kept a close eye on everything the whole time, kept things safe and moving but in the end to keep trying to get E in the right position when she was continuing to have a hard time, was no longer working for anyone including me. It was time to get her out.
I will never know how this would have gone at home or in a birthing center. Would I have been part of the 2% of women who transfer to a hospital? I have a hard time believing that would be the case. Would I have just labored naturally without the use of an epidural and would that have been enough to keep E’s heart rate where it should be to give her all the time she needed to get positioned correctly.
We later were told E’s head was posterior, so her nose was facing my belly button and her chin was also up. She was also holding onto her umbilical cord which was probably less of an issue. Head anterior, so nose to spine, and chin tucked is ideal for vaginal birth. While I don’t doubt that E’s head was likely not positioned well from the beginning I have to acknowledge that an epidural quadruples the chances of the head being posterior in the latter stages of labor.
I know my labor was not exceptionally long at about thirteen or fourteen hours. We definitely could have gone longer if only E was tolerating it better.
Then there is the question of the intensity of pain and exhaustion. What would I/we have done for that had I been in a birthing center? Had I not had the option to quit laboring naturally would it have been more sustainable? What about the fatigue? How long can the body do that? I know, it’s been done before. Women are fucking amazing creatures and have done the unbearable millions and millions of times over.
I thought about the following and the lactation specialist who visited with me the last day I was at the hospital eluded to this: How much did my tolerance for the pain and fatigue and my decision to ask for an epidural have to do with this being a surrogacy? Was I lacking some primal instinct that I might have had if it had been my child? I’ve never taken care of E any less than my kids or felt any less protective. In fact this pregnancy was my healthiest and I was so purposeful with every aspect of it. I don’t feel like my biological connection to E was a factor but I’m trying to be honest and look at every possibility. I had an epidural with my first child and I thought I would never ever again have one.
Were we in trouble from the beginning based on E’s positioning which may have caused my water to break so early on more or less sticking her in that position without the cushion of the water sack to help her move around and down in to an ideal position like is normally done during early labor? I don’t know.
In this case there was no early labor. How much did that matter? It certainly seems like it would matter in the positioning aspect. I’ll never know. None of us will know these answers. What I do know is that I made decisions based on the information and situation I had at the time. If I had the answers to my questions ahead of time I could have made decisions based on those answers. But I didn’t know and therefore wanted and chose an epidural and in the end without knowing the what-if’s I was more comfortable getting a C-section than lingering longer. I did the best that I could at the time with what I knew and somehow I have a level of peace about that.
I was instantly okay with a cesarean but also instantly covered my face with my hands and started sobbing. Jason, Kristina and even Veronica were right there to offer comfort. Veronica asked what the tears were about and I just said this has been a failure. It’s not supposed to happen like this. I didn’t want E to have to be born like this.
Marce and Chris came over to me and they were crying as well. I don’t remember the words exchanged but they knew this isn’t how I wanted it to happen and neither did they. All along my only concern about having them present was that they would become overly worried and contribute to a stressful environment but truly they were only a support. Looking at pictures in hind sight they were clearly concerned just like Jason from the pictures from when our children were being born but they took everything in stride and just quietly waited for their daughter weighing in when decisions needed to be made.
I soon asked about getting more than one person to be able to come back for the cesarean since the midwife in a prior office visit had made it very clear that they only let one person back and that it’s ultimately up to anesthesiology. Bless her soul Veronica went right away to personally talk to the doctor who would be operating and the anesthesiologist to get permission for more than one attendant. They both agreed that two could come back and I wanted Marce and Chris to see their daughter be born more than anything. That is what this was all about. They would be the ones telling E about the day she entered the world, not Jason and not me. Jason was okay with that too. I was grateful they were going let them both come and I didn’t and don’t take that exception to policy for granted.
The pitocin was stopped; a dose of Terbutaline was administered via a shot in the back of my arm to slow labor. Anesthesia came to discuss everything and start the medications which they administered through the epidural that would keep me from feeling the cesarean. The doctor came to explain exactly what they would be doing and get my consent. I didn’t care about any of it, what the doctor or anesthesiologist had to say. I just nodded my head and breathed deeply.
I did care when the nurse said she had to shave my pubic hair. She shaved down to the top of my labia and that was humiliating for me, not because anyone was there, they had once again pulled the curtain, just because they were shaving my pubic hair.
Kristina leaned in and told me what to expect. She said the room would be cold because they have to keep it cold to keep bacteria down but to ask for blankets. She said to tell them anything I wanted like if I needed them to not chat during the procedure or to tell me what’s going on. She said more but I forget it all. It helped knowing she knew exactly what I was in for since she had had a cesarean with one of her three children.
They brought scrubs for Marce and Chris and everyone just tried to figure out where to go or be before during and after the surgery. Marce and Chris would wait in the room we were in until I was prepped. I told Marce who was there for the embryo transfer that E’s entrance into the world was looking a lot like her beginning since Marce was also in scrubs watching from a distance as the embryo that would grow to be this stunning baby waiting to come out was implanted in my uterus nine months earlier. Jason waited with them and then in the lobby and then in the recovery room waiting for me to come back. He was there when I was brought back after the surgery. Kristina had booked a room at a close by hotel to try and grab a few hours of sleep. There was nothing she could do at that point and nowhere for her to be until she came back after it was all over to check in with me.
We were all tired. When I had called Marce and Chris and Kristina at one in the morning none of them had yet been to sleep for the night. Jodi was able to slip out for a nap at home with Caitlin at one point during the labor but she came into the birth already being sleep deprived from the night prior. Jason was dead tired. I had had two hours of sleep prior to labor.
They wheeled the bed out and I covered my face with a blanket. I didn’t want to be a spectacle to any onlookers. I had no sense of direction or where we were going. I kept my eyes closed.
They pushed me into the brightest room I’d ever been in. I would have thought I had made it to heaven if I knew I hadn’t just been wheeled into an operating room. People continued to tell me what was going on but I continued to not really care. I was able to scoot from my bed onto the super narrow operating table instead of them lifting me. I asked them what they do with very large people; it’s a really narrow stainless steel table. The medication was causing me to shake uncontrollably. I was very cold. They pulled out supports for my arms and extended them out like I was Jesus being mounted on a cross. For a minute I thought they were actually going to tie me to the supports. I was so relieved when they didn’t although later I wished they had since it was brutal work trying to keep my arms still with the intense shaking.
I felt a little nauseous and they gave me a barf bag and I’m sure some medication to help with that. I had had an oxygen mask on pretty much off and on throughout the day as is typical once you start an epidural. I was worried about making it to the bag in my position with an oxygen mask on if I did indeed have to throw up.
It took about thirty minutes I’m guessing to get me situated, confirm I couldn’t feel anything, clean me and bring Marce and Chris back. There was a moment during the prep time that I thought they were going to start without Marce and Chris because E’s heart rate dropped so low for a period of time. The entire room stopped until it came back. When Marce and Chris arrived I pulled my oxygen mask down and told them to please not be concerned for me as this was the best day of their life. I didn’t want the cesarean to overshadow the magic we were about to behold. But I think they were already just focused on seeing their daughter and of course concerned that everything would go smoothly.
They began the surgery. I could only feel tugging and pulling which Kristina and the anesthesiologist had warned me about. I had grabbed a hold of the bar that was holding a curtain between me, Marce and Chris and the surgical team because it helped steady the shaking in that arm a little. The bar on the other side was out of my reach unfortunately. Marce put his hand on mine which was not only affirming but also helped warm my freezing cold hand.
It didn’t take long at all for E to be born. For nine months I’d anticipated E coming into this world. I’d fantasized and imagined how it would be. Every day for the last month I asked her if she wanted to come today and for the previous fourteen hours I actively tried to birth her. I had lost a level of connection with her between the epidural, the continued failure to get her out and the bustle of getting ready for surgery and her imminent arrival was almost not a reality to me.
At 3:30 p.m. two days past thirty nine weeks E was born. When they first brought her out of me she immediately cried and it shocked me and I just started crying and smiling. Fourteen and a half hours after my labor had begun E was finally earth side. She was alive and well and crying. A real human baby girl, E was here at last!
The first moment of the first second of the most anticipated cry in the world changed everything. Every bit of tension, concern and sadness melted to nothing as elation filled the room. I saw them bring her to the warmer. I was able to see everything as Marce and Chris met her there. She was the most adorable naked little baby alive. She had a round face with chubby little round shoulders and arms, a round belly, little chubby legs that were no longer confined to my uterus and a head full of dark hair! The nurse wiped her a bit and checked her over. It really looked like the nurse did nothing but clean her a little as she continued to cry off and on. E was totally healthy and well. Marce trimmed her umbilical cord and very quickly Chris held her. They brought her over for me to see close up. She was so precious words cannot describe it.
Despite the face masks the guys were wearing, despite the fact they hadn’t slept in in well over 24 hours I could see they were more alive than I had ever seen them before. Their eyes were bright and happy and content. Those first moments after E was born caused every single ache, hassle, pain, stress, worry, fatigue etc… from the last two years in the pursuit of E, the past nine months, the fourteen hours fade into absolutely nothing. It was one of the happiest moments of my life watching E with her ecstatic dads finally begin their earth-side journey together. E was more precious than I had even imagined. This ladies and gentleman is what it’s all about.
For as quickly as they had gotten E out, they made up for their speed in removing my placenta and putting me back together. Of course this is the sort of thing I prefer them to take their time on. I made sure before the surgery that they stitch the uterus separate from the skin tissue and they do. (You wouldn’t believe it but some doctors stitch the uterus and skin all at the same time.) I would have liked nothing more than to have dozed during the rest of the surgery but I was shaking so bad it took all my energy to keep my arms on the arm supports. My muscles were sore and tired from the shaking. It took about another hour and a half for them to finish and it was a very miserable time. I just felt like crud in general.
When the surgery was over they lifted me onto a bed and wheeled me into the post-op recovery room where I would be monitored for the next two hours. Jason was waiting for me. I was pretty miserable and just wanted to stop shaking, warm up and rest. It took about thirty minutes I’d say for me to stop shaking. I finally kicked Jason out to go relive Jodi and get him and the kids some sleep. It was my nephew, Jodi’s son’s birthday and I had stolen her from him the entire day. I really wanted Jason to just take care of him and the kids as all I had to do from then out was sleep and recover.
Even though I don’t let him rub my back in hard labor and there wasn’t a ton for him to do all the time and this wasn’t his child I was birthing, Jason stayed by my side the whole time. I absolutely could not have done any of it without him. Jason is the one person in the world I want near me when I’m hurting. His hand holding, kisses, back patting (once I had had the epidural), his being near me was absolutely crucial to my sanity and strength. This whole surrogacy he has been a good sport about every single part of it and I didn’t realize ahead of time just how much my being pregnant absolutely could not not affect his life. He has picked up my slack without complaining once. When I whined about being tired or swollen or achy he was sympathetic and he never pointed out that I asked for this! I went looking for it! I chose to be pregnant with someone else’s baby. Every time Jason left the room at the hospital I was aware of his absence.
At that point though in recovery, the hard part was over (haha, I’ll get to this in a later post) and all either of us needed at the moment was sleep. He left around 5:30 p.m. and relived Jodi to go back to her son, Lemont. She made it back home in time to take him to dinner. I dozed for probably a half an hour and then visited for a long time with the same nurse who had been taking care of me the whole day, Lisa. I think we are best friends now but I forgot to get her phone number.
Before taking me upstairs to the postpartum wing my nurse wheeled my bed into Marce, Chris and E’s room. E had had her bath by then and her first feeding of some of the colostrum I brought from what I had expressed at home. Her first two meals were two weeks worth of expressing. I was so glad she could get started at least with some colostrum as were Marce and Chris. E was swaddled in a white blanket peacefully sleeping. She took my breath away again, her skin so, so soft and delicate, her face so round and strong and sweet. Her lips had so much expression in them. I was told and got to witness the next day – she would be able to get anything she ever wanted via the little quiver her bottom lip produces! I got to hold E and was just in awe at her preciousness.
Marce and Chris were clearly operating on a second wind! Chris’ mom and sister were there and Marce’s dad. Everyone was so full of happiness. Little E was perfect. Absolutely perfect. We got a few pictures with everyone there with Marce and his dad and Chris and his mom and sister all crowded around my hospital bed in the middle of the room while I held E for the first time. She is such a doll, an absolute perfect doll.
E had a blood sugar level just high enough after her delivery to warrant further monitoring but everything checked out to be just fine without intervention. They also kept an eye on her because I had one temperature reading just after surgery that was high. If the temperature spike would have been during surgery it could have indicate something bad (the nurse explained it to me when I asked the next day but I let it go in and out at the same moment) but everything checked out just fine and Marce and Chris were able to take E home the next evening. E was born at 8lb 4oz, 20.5 inches long and totally healthy!
Just a side note, E’s weight would have put her close to nine or nine plus pounds if she had waited to come when my kids did around 41 weeks. My kids weighed nine and nine and a half pounds when they were born. No one can say I’m not consistent at least in the size and beauty of the children I birth though I only get to take credit for E’s rolls, not her beauty since there is no genetic connection. :)
E was born on Monday and I was able to go home two days later on Wednesday afternoon. I had a good (but fucking horrible just because of what is was- no one understands how bad C-sections are) recovery and was treated really really well by everyone. All my nurses knew my goal was to get home as soon as possible and they absolutely helped me to get where I needed to be to do just that.
Every moment of every part of this surrogacy journey has been worth it and I would do it a million times over to get to see this beautiful life that was created from the love of her parents. Nothing is more important than this. We all love you little E. It was a pleasure to carry you in my womb and a pleasure to watch your parents take over your care with all the love they have in the world to give you.