Tuesday, October 2, 2012

Last but not least

The girl of my dreams
When Hemdiya was about a year old, I had a dream about my baby girl...and she was not Teneya.  I wasn't ready at that moment, but I knew she would come when I would be.  You see, Hemdiya is worth about three children in the amount of time and energy is takes to lovingly parent him.  But enough about the other kids, this post is about that baby girl in my dream.

In her first week of life, I saw the movie What to Expect When You're Expecting.  I felt like Wendy this pregnancy; all the way from the "where is my glow?" to the "no dear, the baby farted."

I'm not gonna lie, it was tough.  And though it was the fourth time, there were a lot of firsts.  It was that first time that I was...
  • working full time through the whole pregnancy
  • making it through the last trimester in the middle of summer
  • "single" parenting for six weeks while my husband was in Central America
  • experiencing premature contractions
  • induced with pitocin

Pitocin is so nasty.  And I discovered that most doctors don't really know how to use it...at least most of the ones at the hospital in Tzfat.

After a pregnancy that seemed to drag on for years, I had another (surprise!) breech baby.  She was head-down the whole time until 39 weeks.  I went in for a check-up and the doctor saw that my placenta was also very low and may even be blocking the exit path.  She referred me to the hospital where two doctors, three midwives and a couple of nurses crowded around to see such an usual case.

They weren't used to the request for ECV (turning the baby from the outside) which I knew about from having it done with Hemdiya at 38 weeks.  In fact, a neighbor who gave birth in Tzfat a few years ago was sent straight away for a c-section because her doctor said that ECV is "dangerous" (and surgery isn't?!).  There were a few differences this time though:
  • with him, I had too much water which meant plenty of space to turn
  • with her, my water was very low and they didn't think it would work
  • with him, I went to Hadassah Ein Kerem Hospital in Jerusalem which is one of the best in the world and had several doctors who could do the procedure
  • with her, I went to Ziv Hospital in Tzfat where one doctor who was only there on Tuesdays could do the procedure

It was Thursday, so they sent me home.

Tuesday finally came after what seemed like a few more years.  I was sent around to so many desks to get this letter, and get that stamped, and see this person who sends you to next.  Israeli bureaucracy strikes again.  Despite arriving at eight o'clock in the morning, I didn't get the pre-ECV ultrasound until over four hours later.  At some point, between checking in and lunchtime, my baby had flipped head-down again.  Ultrasound showed that the low-lying placenta wouldn't be in the way.  Hurray!

Because ECV could only be done on Tuesdays, plus the fact that I had passed my due date and had very little water left (2.7), the medical staff were all in agreement that I should be induced and get the baby out while she's still head-down.  The thought of a c-section had been hanging over my head since the week before and threatened its ugly head again if she turned bottom-down and I went into labor on any other day of the week.  Let's get this baby outta here, I thought, and went along with the plan.

So, the very first thing they did was hook me up to pitocin.  BAD IDEA.  Aside from my incredible need to walk during labor, plus the fact that all the delivery rooms in the usually sleepy hospital were full because the Klezmer Festival was in town, tying me into the wall with tubes in a tiny pre-delivery room was a bad idea for medical reasons too.

After five hours of absolutely nothing happening, I was practically clawing at the walls and insisted on stopping the induction.  Because we had already started inducing labor, they didn't want to let me go home and said I should get some sleep and we'd try again in the morning.  I needed the sleep.

In the meantime, I read up on the drug online.  Apparently, it's well-published (in English anyways) that synthetic oxytocin (aka pitocin) will aid in the onset of labor ONLY if the cervix is already ripe.  In the morning, after being told that I would be given pitocin again, I found a really nice Arab doctor who took the time to answer my questions and brainstorm for alternatives.  Aside from the prostoglandin hormone cream, there is a small balloon (like this one) that can be inserted and filled with water to open the cervix.  It also slightly, gently separates the amniotic sac from the cervix which stimulates the production of prostoglandins.  At the end of the day I made it to 3.5 cm, but the next morning was back to 2 cm and the new doctors on duty were only interested in pushing pitocin.  My plug came out that morning and contractions were coming every 20 minutes, but I knew my body wasn't going to plunge into labor...even with hormonal help.

At the end of my third day in the hospital, I had enough.  The staff on that Thursday were particularly green and unhelpful.  Pitocin, pitocin, pitocin--it was like a mantra for them.  I missed my kids.  I missed my home.  I signed out again doctor's advice and went home for Shabbat, promising to come back afterwards for a check-up and monitoring.

It was honestly more nerve-racking than I though it would be, stepping away from the baby monitors for those two days.  I had a spinning sometimes-breech baby with low water over 40 weeks and in the middle of being induced.  It was hard to sleep.  Contractions came randomly; three in an hour, then none for three hours.  At one point, I hadn't felt movement for some hours and started to panic.  Even laying down on my left side or playing with my belly didn't stimulate anything.  I was about to run back to the hospital when she finally kicked Aaron's ear and he listened for signs of life.

By the time Sunday came around the corner, my gut was screaming get this baby out NOW!  The staff on duty that day were so much better than a few days before and I had made it 4 cm on my own over the weekend.  I agreed to go ahead with pitocin this time.

Like I said earlier, pitocin is nasty.  It actually made me have contractions on this try, but they were so unnatural.  I was used to the way that contractions start gradually and increase in intensity while getting slowly closer together.  A little while in, I was having contractions every two minutes but--even though they were so close that I felt like I should have been at 9 cm and almost ready to push--I had only made it to 4.5 cm after five hours.

Hearing that news broke my willpower.  I don't know if I have ever felt so close to my end.  They'll have to cut me open anyways now to get this baby out, I thought, I just can't go on.

I, the natural-birthing-doesn't-even-take-painkiller-for-headaches-or-PMS lady, asked for an epidural.  In the meantime, I said, get me off this stupid pitocin until the anesthesiologist arrives.

I got up to stretch my legs and use the bathroom.  The contractions didn't stop once I was unhooked, but became stronger.  After half an hour, right before the doctor showed up, the midwife checked me again.  Seven centimeters.  That's when I got my second wind.  I also got laughing gas.

Nitrous oxide is a beautiful thing.  It's like being drunk, but kicks in quicker and will wear off just as fast if you need it to.  In between contractions, which were now completely being made by my body and become longer and more effective, I kept the mask on and breathed in the delightful gusts of intoxicating air.

Nine hours after labor began, I was a new mother all over again.  Yet another pair of bright, blue eyes was staring up at me as feelings of pride and joy flooded my entire being.

I roomed with two other new mothers, one of whom had an epidural.  Overheard her asking the doctor about how long the residual back pain would last.  Maybe a week or more, she said, could take a month even.  They should really warn you of that possibility before giving it to you.

Another woman down the hall had been induced with pitocin after her water broke a day before.  She finally begged for an epidural after hours of the same terrible contractions.  Thirty minutes of sweet relief were followed by contractions again.  The needle wasn't placed well and had slipped out of the right spot.  She ended up with a c-section and developed an infection requiring IV antibiotics.

Thank G-d I missed out on the epidural, I thought after hearing and reading more.  My whole pregnancy, I had felt so tired and weak.  I worried about if I would be able to push another baby out.  I'm not 19 anymore, I told my husband while I was on bed rest at 26 weeks.  But afterwards, I realized how incredibly empowering it is to have accomplished a natural birth.  I felt sad thinking about how some women may enter motherhood without this belief in themselves, that they are strong enough to bring a baby into the world.  This is one of the pitfalls of a so-called gender equality where being like a man is what it takes to make a women not feel inferior.  After all, I don't believe that a man could endure childbirth without being drugged up.  No offense guys, you just don't have what it takes...and that's ok, you've got other things going for you.

My feelings of inadequacy and weakness were replaced by a new inspiration to conquer my fears and achieve whatever I set my mind to. And as all mothers know, we need a lot of physical and mental stamina to survive what our kids will end up putting us through.