Tornadoes

May 25, 2011 - Leave a Response

On the Missouri side, my mom rarely acknowledged storms. On the Kansas side–in a trailer park, no less–we sometimes turned up the TV in order to drown out the noise of sirens. Part of my mother’s family has lived in Missouri since the 1830’s and part of my father’s has lived in Kansas since at least the 1900’s. I guess something about drinking all that Midwest water is that you grow up inured to the danger of tornadoes.

My heart breaks for the people of Joplin. As much as I doubt a tornado would ever whip its way into the heat-sink surrounding Kansas City, I know that if it did, I might be one of those people who didn’t heed the sirens, who didn’t want to go down to the litter-box smelling basement to wait for the threat to pass. Of course, I have children now, so if the sirens went off and the weather people said to take shelter, I (grudgingly) would.

I’m praying for the people in Joplin and in Oklahoma. And I’m cleaning the litter in the basement, just in case.

Six Months Later

January 15, 2011 - 2 Responses

Every night for the past five months, I’ve showered, brushed my teeth and tucked myself in next to a cherub.  She’s usually been asleep for a couple hours at this point, snuggled in her swing or in her father’s arms, cheeks rosy from warm torpor, little mouth still sucking away at a breast that’s no longer there.  We call her Teagopottomus because of her hippo legs, but almost six months ago, we didn’t call her much all.  Mostly Hey You as in Hey You, get out of there and Hey You, it’s time to be born.

40 week belly

Eleven days before Teagan came

 

It’s hard to believe that it’s been almost six months since she was born—it feels like forever and yet no time at all.  Of course, after a child is born, it’s impossible to conceive of life without her.  How did I survive each day without one of her gummy grins?  Or her dark blue eyes?  Or without cleaning lint out of those deep crevices made by her fat rolls?

But, at the same time, it’s gone by way too fast.  She’s my last baby!  Why does she insist on learning to roll and sit up and wanting to do anything other than snuggle in my arms?

Ms. Claus

Who needs Mom?

I am extraordinarily lucky.  In lots of ways, her birth and early life was scary and dramatic and worthy of lots of dark, anxious feelings that I don’t have.  I am lucky, because for me, the roughness of her birth and the pain of her NICU stay, are eclipsed by the pinkish, giggling reality I get to cradle every day.  I am lucky because I have a protective, tender husband; a deeply giving mother-in-law and father-in-law; a father and his (now ex) girlfriend who’ve made themselves incredibly available; a mother and step-father who are falling in love over and over again with my children; and a long-distance aunt and a long-distance grandma who supplies us with help via text and Facebook when she can’t visit.  I have too many best friends to count, one of whom had a baby three weeks before Teagan, and still managed to find time to bake us entire meals, organize a meal registry so other people could make us meals, and watch Noah when we had our hands full with a newborn.  I have a best friend who hasn’t yet had children of her own and who’s adopted mine with abandon.  Leave her alone with a kid and you’ll come back five minutes later to a full-fledged photo shoot (I love it!).

And obviously, there’s Noah, who dares you not to smile or laugh, Noah of the spontaneous hugs and kisses and thick tousled hair.  Yes, I am lucky.

Noah Playing Play Doh

Noah not eating Play-Doh...for the moment

Not all women are so blessed.  Some are single mothers.  Some have family and friends, but miles away.  Some have to go to work or are sick or injured from birth.  Some women with an emergency c-section and subsequent NICU stay end up with post-partum depression.  Honestly, it’s a crapshoot who gets off the surgery table with hope for the future, who comes out the NICU with the warm fuzzies.

So lucky.

So recognizing that luck, I wanted to reflect back a little, now that it’s been six months and I’ve earned a little perspective.

First, the terrible horrible no good very bad parts of a CBAC:

The pain

The pain

The pain.

There were a couple reasons that the pain was so miserable, so beyond anything I’d experienced.  I think one was the long labor, and that my body had reached the second stage of labor before Teagan went into distress.  I think another (and probably most important reason) is that I didn’t rest after surgery.  With Noah, I laid in bed and made everyone bring me food, water, the hungry baby, etc.  With Teagan, starting four hours after her birth, I heaved my wounded, puffy body like a post-partum Shelob up to the NICU and then back down again.  After I moved onto the same floor, I trekked the quarter mile from my room to her little cubby.   I passed huge clots, some grapfruit sized, which the doctors didn’t seem concerned about.  Even on Naproxen and Loretab, tears would leak out of my eyes whenever I stood up or laid down or moved too suddenly.  It took six weeks for the pain to go away.  In fact, even though my cycle still hasn’t returned, I have painful cramping every two or three weeks or so.  And to add insult to injury, my paunchy mommy tummy is extra gross from the second c-section scar.  I have discovered girdles, let’s say.

Initially we struggled some with breast-feeding, but there was no lasting legacy of that.  I’d breastfed before, plus, if things hadn’t gotten better, I would have found professional help.  Breast-feeding is one of the most important things I do as a mother and I refused to be frightened away.

The good parts of Teagan’s birth:

Because I finally dilated to complete, so many of my doubts were laid to rest.  I can labor.  I can birth; if Teagan hadn’t had both fists up by her head, she would have been born vaginally.  No more scarlet “4 cm” on my chest.  No more “Failure to progress” tattooed on me.  Not to lay too much blame at the feet of a drooling infant, but, essentially, the c-section was because of Teagan’s realities.  Not mine.  Her distress was so apparent, so distinctive, that after the forceps attempt failed, I would have cut her out of my belly myself.  Having a c-section for a compellingly necessary reason?  A lot different than a c-section from a (basically) failed induction.

Bonding wasn’t a process—it was instant and as dreamy as falling in love.  We weren’t picnicking on a beach or gazing at stars, but we might as well have been.  Again, I’m very lucky.

Rocking Chair

Babymoon bliss

Would I do anything differently?

Absolutely not.  I felt comfortable with the amniotomy, since I would have had one that Monday (two days away) anyhow.  I loved my doulas, and I had three of them!  Swaying in my skirt, with Jill rubbing my back and Elizabeth holding my hands, was perfect.  Alyssa talking me through the wrenching Pitocin contractions was perfect.   My dark room with Josh kissing me was perfect.  And when I’d been stuck at five centimeters for several hours, writhing under the Pitocin, the epidural was perfect.  I briefly felt some shame about it—part of me wished I could have toughed it out to earn some stripes—but if I hadn’t had the epidural, I would have gone under general if Teagan had gone into distress.  I’m also fairly certain that the epidural helped me relax.  Three hours after I got it, I was complete and ready to push.  I don’t regret trying the forceps—if Dr. P had been able to pull her out, it would have been quicker than a c-section and I still would have had a vaginal birth.

The only thing I would change—and this is going to sound silly—I would have drank more water. Dr. P and Dr. E felt that my amniotic fluid was low because I was a week and a half past my due date.  I’m not sure, but I do know that I wasn’t hydrating well enough in the hottest parts of summer.  In fact, I wasn’t hydrating very much at all.  I hate water and I hate drinking it.  It’s only after working at an office full of holistic practitioners that I’ve grudgingly admitted to myself that I need to drink more.  (I’m getting better.)  Maybe if I had been better hydrated, I would have had more fluid and Teagan wouldn’t have gotten stuck in a compound position.

I learned a lot from Teagan’s birth.  One thing is that a beauty and love can take a hundred different forms and that a woman with a labor full of interventions and obstetrics can feel just as much pleasure looking back as anyone else.  In that same vein, I can completely respect and encourage an (informed) decision to have an elective repeat c-section in a way that I couldn’t before I had Teagan.  Physically, an emergency CBAC after a trial of labor is downright terrible.  From what I understand, it’s easier to recover from a scheduled repeat than it is from a CBAC following a long labor.  Of course, a VBAC is the easiest to recover from of the three, and most women who attempt a VBAC get one.

Above all, I am overwhelmed by the magnitude and subjectivity and raw spirit of birth.

It’s impossible to idealize or stereotype or classify once you’ve truly been present.  I will always think it’s wrong to tell a woman that a healthy baby is all the matters.  But I’m blessed that when I bury my nose in Teagan’s head and kiss her little eyelids, her being, her chubby little existence, more than drowns out the panic and separation that happened in July.

I am lucky.

Beautiful Teagan

Are you in love yet?

No Nap Days

November 29, 2010 - One Response

Some days are good, some days are bad, and some days are from hell.  The hell days are the days when a confluence of different factors–work schedule, errands, a toddler outgrowing his nap–make it so that I miss my own nap in the afternoons.  This is bad.

You might know that I’m not currently on any medicine for my narcolepsy.  Crazy?  Yes.  Stupid?  Yes.  But with the drugs available for treatment being classified as l3 or l4 drugs–making them questionable to risky to breast-feed with–I feel like the choice is clear.  I can endure exhaustion for a year so that my daughter can have the best start at life.  But even if the choice is clear, it doesn’t make it easy.

If I miss a nap, my risk for sleep attacks increase.  This means whenever I sit down to nurse or read a book to my son, I doze off.  And given Noah’s rash cream debacle–we’re still trying to scrub the Desitin out of his hair–it’s clear that CONSTANT VIGILANCE  is required.  It also means that driving gets dicier; I’ve been in one sleep-related crash before.  I don’t want to do it again.

My mood deteriorates.  I get cranky, impatient with insignificant things.  The brain fog makes it difficult to play creatively with my son or even to interact meaningfully with my infant.  Coffee helps, but we’ve all done the stimulant to patch over exhaustion thing in college.  It leaves you feeling jittery and fried, which is why I hated the Ritalin so much in high school.

There’s not really a solution to my no-nap days, except that at some point after Teagan turns a year old, I’ll wean her, and some sleep doctor will come to work and find me scratching pitifully at the glass front doors.

“Provigil…please…” I’ll rasp.

We need a break

November 15, 2010 - One Response

Remember when we used to spend those long hours gazing into each other’s eyes? Remember all those times we stayed up late, sometimes chattering, sometimes just staring up at the ceiling fan, thinking? We were each other’s everything. But now… I don’t know anymore. It’s like you’ve changed. You don’t like the same books, the same food. We used to do everything together, but now it’s as if you want to do everything by yourself. Which would be fine, but then when I try to leave you, you get clingy and possessive. Your moodiness is astonishing. I don’t think I know who you are anymore. I love you, but let’s be honest: we need a break.

That is why Mommy is going out to the bar tonight with her friends. I love you very much, and hope you have a good night snuggling with Daddy.

Love, Mommy

Family Planning and the Narcoleptic

October 20, 2010 - 3 Responses

A couple weeks ago, my husband and I made the leap from thinking we were done having children to knowing we were done having children, thanks to a urologist and my husband’s unflappable temerity.  The means was largely my husband’s decision–many of the other officers he works with have done the same thing, plus the (small) fail rate for other forms of birth control was still too much of a risk for him, given how fertile we seem to be (four pregnancies in four years.)  Plus, a police officer and a would-be writer?  Maybe not able to support a family larger than four.

We’re both young.  We know that.  Even though life seems complete with our house and Josh’s career and our college educations and our two healthy babies, we know we’re young in the scheme of things.  But we’ve always done everything young: marriage, kids, home ownership…why not sterilization?

Anyway, Josh’s opinion and finances aside, the most important reason we’ve decided to limit our family is my narcolepsy.  On the spectrum of the disorder, I’m lucky.  I don’t have cataplexy for one thing, and, as long as I follow a napping and caffeine regimen, I can go unmedicated long enough to breast-feed my daughter, but as soon as she’s weaned, I’ll be racing to get that prescription.  Another child would mean another two or so years without medicine, taking in account pregnancy and a year-ish of breast-feeding.  And I don’t think I can do it.  It’s getting worse and I think it won’t be long before my nap and a cup of joe isn’t enough.

I know this all sounds faked or whiney or petty.  How can a nap be so important?  Hardly any parent, working otherwise, gets to catch up on sleep.  But if I don’t fight off that sleepiness, I’m a hazard to my kids.  It’s not safe to drive them (I’ve been in one sleep attack-related accident before), and it’s not safe to stay alone with them now that Noah can open doors and there’s a tiny infant to stomp on.

It’s hard to think this way, of myself as a hazard to my own children.  But the price is too high not to be realistic about my limitations.

Danger aside, there’s also the quality of time I spend with my children.  More days than I’d like to admit, I find myself encouraging Noah to color or read or do anything that involves us sitting because I’m too tired to move.  I use Teagan’s feedings as an excuse to slug on the couch, even though I know what Noah needs to be doing is running around in the last of the nice fall weather.  While I’m unmedicated, there are too many days when the babies only have half a mother: an exhausted, impatient half.

So we made the choice to stop.  I’m curious about other people.  Do/did you have a reason to limit your family size?  Because of a physical limitation?  An emotional one?  A financial one?

Dear Noah

September 22, 2010 - Leave a Response
You are two now.

You are the wildest, hardest and boyiest thing to ever happen to me.  You are also the best.

This year you learned to walk, talk, jump, eat with a fork, climb your dresser, take off your diaper and love a little sister.  That’s a tall order for someone who sleeps with a thing called Crib Bear and still dabbles in eating crayons.  The rate at which you’re learning astounds me.  Just this week, we were swinging, and I asked you to count to five with me, and instead you counted to ten, and then put your binky back in, like it was no big deal.

But it is!  Because I didn’t teach you to count to ten.  Just like Daddy didn’t teach you that bad word, but you still learned it after watching him hit his finger with the hammer.  (In all fairness, you could have learned it from me while I drove in rush hour traffic.)  You’re picking up all the little nuances of life, like wiping your mouth with a napkin or locking a door.  We no longer have to relentlessly coach you to learn something.  You watch, you imitate, you move on.  It’s alive, Dr. Frankenstein might say.

You became obsessed with belly buttons, which for reasons unknown, you called “mites.”  You had to inspect everyone’s mite upon seeing them, sometimes several times a visit.  No keys are safe around you.  Phones fare slightly better, but only slightly.  We can’t get you to sit through Elmo’s World, but you’ll watch a twelve year old Bollywood clip over and over and over again.  (Chaiyya Chaiyya…)

Your favorite books were Goodnight Moon, Big Red Barn, Are You My Mother?, and your pop-up castle book.  If you are the only kid in Sunday School who knows what a portcullis is, I know I’ve done my job right.

You moved into a big boy bed–a mattress on the floor.  You cried the first night, then fell asleep on the floor, resting your head on the mattress.  Most nights after that, your daddy and I woke up at three to hear the thunk-thunk-thunk of your footie-pajama-clad feet coming down the hallway.  More than once, we wouldn’t be able to see your head because your arms would be full of stuffed animals–Crib Bear, Clifford, Myrtle Beach Turtle and maybe a penguin or two.  The entire menagerie came to snuggle with us.  Lately, whenever we put you to bed, you ask “Night night too?” wanting us to lay with you.  To me, you demand, “Glasses off,” knowing I’ll probably fall asleep next to you if I don’t have my glasses on.  To Daddy, you say, “Blankie on Daddy?” trying to lure him into cuddling with you. We can’t resist you.

You and your Grammy are best friends, just like my grandma and I were close.  You love your Pepas (all three of them!) and your uncle Jerry.  I’m guessing you love your aunt Stephanie too, but chasing her with a dead cicada shell is no way to show it.  You got to meet your uncle Jason and aunt Heather, and play with your cousin Jake.  I can’t wait until you two are old enough to get in trouble together.

Most importantly, you met your baby sister this year.  You didn’t sleep very well when we first brought her home, and you had a rough couple of weeks, but now you’re the best big brother anyone could hope for.  You want to make sure she has a blankie and a binky (even if she doesn’t want it) and when I’m holding her, you remind me that she needs “Tummy? Time?” and then lay on your tummy next to her.  When she cries, you tell her, “Don’t cry, baby.”  I know that these little moments are sowing seeds for big moments later on.  You’ll be the one to teach her all sorts of cool tricks, drive her to places we forbade her from going, beat up boyfriends you disapprove of.  In the near future, I can’t wait for the nights when we hear two pairs of padded feet on the wood floors, and I can snuggle both of you (and all your stuffed animals.)

I feel bad for you, Noah, because you’ll always be my learning baby.  You taught me how to mother an infant, and now you’re teaching me how to mother a toddler.  Sometimes I worry that you got the worst parts of my personality, but then you’ll give me such a Josh look with a quirked eyebrow and o, rly? expression that I know you’ll be alright.  At least fifty percent of you is sane, intelligent and level-minded.  Did I mention that you are as handsome as your father?  Hazel eyes, thick, thick hair and loooong lashes.  Handsome like Josh, mercurial like me–girls are going to go crazy over you someday.

Thank you for this year.  I’m sorry for the times I cried while making your waffle because I was so tired (I was pregnant with your sister) and I’m sorry that we didn’t discover Deanna Rose sooner.  Next year will be better.

Love,
Mommy

Breast-feeding in NICUland

September 15, 2010 - Leave a Response

NICUland is staffed by some of the warmest, smartest people I’ve ever met. Those NICU nurses fight constantly against death and sickness, and still manage to find various ways for parents to be involved and vital in their child’s care. But, in any hospital department, policies and realities can make individual experiences difficult.
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Teagan was born at 9:14 a.m. At 1:52 p.m., I finally got to hold her and nurse her. She was listless about breast-feeding; she nibbled and licked for a while before she latched on. She stayed on for a few minutes, then fell asleep. The nurse assured me that she was getting everything she needed through her IV line, so there was no need to fuss about my milk coming in.

Down in my room, they brought in The Pump. There were several of these Pumps floating around the NICU for lactating mothers, so that they could pump and spend time with their baby. They even gave you free accessory kits, with the tubes and shields and whatnot, in addition to unlimited sterile bottles to express into. Despite the helpfulness and the fact that I had pumped for ten months with Noah, I found the whole array foreign and intimidating. I had dreamed for months (years?) of this blissful skin-to-skin breast-feeding heaven after her birth, where she’d latch on right after my awesome unmedicated VBAC, room in with me, and snuggle in my arms for days. Instead, I had The Pump, which, on its stainless steel rig, looked like it belonged aboard the Nebuchadnezzar in The Matrix. The top of it looked like the sleep-medicine machine from Inception. It had WHEELS, for crying out loud. Instead of my soft baby in my arms whenever I wanted, I got to hook up to the thing with wheels that the nurse wiped down with sterile wipes beforehand. Yay. (side note: I’m grateful for the breast pump as a tool–and it is a fantastic tool, especially in the NICU, but also for working and studying mothers.)

The second time we went up to see Teagan, the nurse laid down the law. We were allowed to sit with her as much as we liked, as long as we liked, but she was only supposed to nurse every three hours, and only for thirty minutes at a time. I’ve never had a baby not room in with me and I’ve certainly never breast-fed on a schedule (mostly because I’m too disorganized to put *myself* on a schedule) so I was a little taken aback. What if she got hungry in between feeding times? If I was holding her and she started rooting, was I supposed to ignore it? And with such an iffy latch, was I really supposed to pull her off if she was having a great nursing session? Everything about it was antithetical to my mothering instincts. But the nurse was firm: sick babies can’t nurse too much. It wastes their energy. Plus, they’re getting everything they need from the IV. Nursing is really more of a recreational sport at this point.

On the way down to our room, Josh shook his head. “You’d think sick babies would need their mommies more, not less.”

Why didn’t I fight this? After fighting off a c-section for 17 hours, you’d think this would be cake. But I don’t know. I was exhausted from the long labor and no sleep, emotionally numb from my failed VBAC and Teagan’s NICU admission, not to mention fogged out on drugs for pain. My gumption was gone. My energy to advocate was sapped. I just wanted everything to be easy and conflict-free.

Nursing was further derailed by the night nurse. Josh rolled me up to breast-feed, and Teagan was alone in her little booth (this was normal–since she wasn’t all that sick, her nurse usually had one or two other low-priority babies.) Josh, wanting to hold his less-than-a-day-old daughter, scooped her up from the warmer. One of the leads pulled loose. The night nurse, hearing the alarm, came in and literally TOOK TEAGAN OUT OF JOSH’S ARMS, snapping, “You can’t pick her up unless I am here!” With all the noise and jostling, Teagan started crying. The nurse gave Josh a disgusted look. “See? She’s crying now.” That nurse watched us like a hawk. If thirty minutes had passed, even if twenty-seven of those minutes was trying to coax a latch and only three were actual breast-feeding, she took Teagan away and put her back in the warmer.

It was true that it helped to have a nurse around when I tried to breast-feed. All the other nurses were much more lenient and compassionate about us handling Teagan (as in, we were allowed to.) But only the nurses seemed comfortable maneuvering her with the IVs and PIC lines and endless leads. Breast-feeding a newborn is hard enough, trying to find all the right places to support their heads and bodies and your own breasts. Juggling all this while trying not to strain or pull the lines was frustrating. It was easiest when I could sit with my Boppy and have someone hand her to me. One day, I went to hand her back to the nurse and saw blood all over her legs. The PIC line itself snapped, leaving blood to trickle out the ruptured tube.

By the second day, her latch wasn’t improving (although a wandering LC managed to get her on. Murphy’s Law of breast-feeding help: whenever an Lactation Consultant is there, they can get the baby to latch on fine. As soon as they leave, it all goes to pot again.) People started pestering me about my milk coming in. It was a good four or five days with Noah, so I knew it would be a while with Teagan. I also knew that colostrum was plenty for tiny babies. But it became a subject of concern and pity when people would ask and find out that I still didn’t have mature milk in. Still! And it’s day three already! Gasp!

It didn’t help that I wasn’t pumping anything. Even the NASA grade Inception-Matrix-Medela contraption couldn’t coax any colostrum out, which started getting discouraging. I might get one viscous little dribble, which by the time it worked its way down the shield, through the flange and down the side of the bottle, wasn’t even enough to suck up in a syringe. I hated the obligation of pumping, the necessity of stimulating my supply because my baby wasn’t nursing enough because of their stupid schedule. By the time I went up to nurse Teags, got back down, double-pumped for twenty minutes, I had about an hour to sleep before I did it all over again.

Also on the second day, the nurse practitioner raised the possibility that Teagan might be able to go home the following day or, at least, move into the step-down nursery. But in order to do that, she had to keep her temperature without her warmer and produce so many grams of wet diaper without being hooked up to the IV fluids. We had a choice at that point: supplement with formula on the chance that she might be able to leave the NICU and come home with us sooner, thus freeing us from the restraints on nursing and cuddling OR we could leave her hooked up to the line and delay homecoming. We chose formula supplementation. This is something I go back and forth on in retrospect. I wish I would have talked with the neonatologist and maybe a lactation consultant before we agreed, just to make sure that those really were our only two options. At the time, the prospect of bringing her home put stars in our eyes. It was all we saw.

Cups and syringes weren’t allowed feeding methods in the NICU, and I didn’t think to ask about finger feeding, so it was going to have to be the bottle. Teagan’s first bottle experience wasn’t pretty. She turned her head away from the rubber nipple over and over again, making this disgusted face. The nurse grasped her by the neck in one hand and used the other to force the nipple into her mouth. Teagan gagged and sputtered, formula running down her cheeks and chin, fussing and squirming to get away. The nurse just adjusted her grip on Teagan’s neck. “Sometimes they just need to get a taste of it to learn it’s yummy food,” she told us cheerfully.

Unkind words ran through my mind.

After that, I tried to be the one to give her the bottle as much as possible (although, if I liked the nurse on duty, I’d let them do it so I could pump while I watched and potentially get more time to sleep.) There’s no reason that bottle-feeding can’t be a gentle and loving activity, and how much longer would it really take to allow a baby to “latch” onto the bottle themselves and drink at their own pace? Even when Teagan would turn her head away and cry when the bottle was put in her mouth–clearly done eating for the time–some nurses would force her to finish the full two ounces of formula. Why couldn’t they just let her eat to hunger? More things I wish I would have challenged… And, after a full day of bottle-feeding, nipple preference set in.

Hard.

Teagan only had to feel my nipple touch her lips to start shying away. This dead look of existential despair would appear on her face and she’d press her lips shut, as if waiting to die. Death would be better than have that awful fleshy thing that was so much *work* in her mouth. Even the LCs couldn’t work their magic. But as soon as she got that bottle, she’d chug the whole thing in no time. (Also, by this time, it was clear that she was staying the full week, so I didn’t think I had the option of banning the bottle altogether.)

At least my milk came in (four and a half days postpartum), so we could supplement with MamaJuice, but I didn’t want to be doomed to be an exclusive pumper. I wanted to breast-feed her normally! Early on, with her iffy latch, I’d been thinking about a nipple shield to help get her on the breat more. The LC who’d been working with me had been holding back on the shield, treating it like it was a freaking missile code or something. But the other LC gave me one straight away. And guess what? After shooting a little syringe of expressed milk on the silicone, Teagan was able to latch on long enough to get a let-down. With my newly minted supply, the let-down was a like a beer bong. Her eyes widened in surprise, but then she hunkered her body closer to mine, furrowed her brows and got to work.

The syringe of milk onto the nipple shield was Nurse Awesome’s idea. Just like Molly the LC was the reason I kept breast-feeding Noah, L the Awesome Nurse was the reason Teagan and I could shed so much NICU baggage. She was the first nurse to actually read the doctor’s orders regarding Teagan’s feeding. I was putting Teagan back in her warmer and telling L that I’d be back in three hours, when she bit her lip and started rifling through papers. “Dr. S wrote on here that you could breast-feed ad lib,” she said. I stared at her. She explained, “That means you can feed her whenever you want, as often as you want.”

Oh.

“And,” she continued, looking through the nurses’ notes, “I can see that you’ve been able to pump several ounces after each feeding? There’s no need to keep supplementing. Even if you weren’t pumping a lot, I’d still say let’s stop supplementing and see how her wet diapers are now that your milk is in.”

She peeked in the trash and shook her head at all the used bottles of expressed milk and formula. In the NICU, they had two kinds of nipples that were both technically newborn nipples, but were from different manufacturers. L always gives her breast babies the one with a single small hole, so that they have to work at the nipple like they do at the breast. The other nurses had been giving Teagan the other nipple–one with two larger holes. “The milk just pours out of those nipples,” L said. “No wonder she got nipple confusion.”

L was only Teagan’s nurse for twelve hours. In those twelve hours I got Teagan back on the breast, stopped supplementing and discovered the cause of her intense nipple confusion. Another bonus? After five days of scheduled feedings and aggressive formula supplementation, Teagan weighed one ounce under birth weight. After twelve hours of unrestricted, on-demand breast-feeding with no supplementation? She had gained four ounces. The nurse on the shift after L’s couldn’t believe it. He weighed Teagan three times to make sure the scale wasn’t malfunctioning.

Things were much better after that. It took about a week after we got home to wean off the nipple shield, but we took it slowly, and I let Teagan dictate the pace. I did get some plugged ducts and mastitis, probably because of the shield use in addition to my tendency toward oversupply, but we got over that too. She wisely rejected a pacifier, and decided that first week home would be all about building my supply. I sat in my glider for hours at a time. We had bottles and bottles of milk pumped in the NICU–Josh would have to cup feed her expressed milk just so I could take a shower. She ate constantly.

And here we are, two months later, no worse for the wear. Even though everything is fine now, looking back, there are a few things that I wish I would have done differently.

1) Most importantly, I wish I would have asked more questions about the mandated schedule. I knew Teagan wasn’t very sick, and I also knew that it was my right as a parent to question anything that felt wrong to me. It turns out that I could have breast-fed on demand her entire NICU stay, and those five days of scheduled feedings and headaches are days I’ll never get back. That she’ll never get back.

2) I wish I would have made sure there was no other options than formula or more NICU time (she ended up having to stay longer anyway…bad gamble on our part.) I also wish I would have remembered to ask about finger-feeding. I would have been willing to take the time to do it, and it might have prevented the nipple confusion and thus the shield and thus the mastitis later on.

3) I wish I would have spoken up about some of the more aggressive bottle-feedings. One nurse tried to get Teagan to eat four ounces in a setting so that she’d go FOUR hours in between feedings instead of three. I was so unhappy about it–why didn’t I speak up?

Teagan was only in the NICU for a week. I can’t imagine all those brave mamas who struggle through all the necessary and unnecessary concessions to NICUland for weeks or even months to continue nursing. Of course, we all know it’s more than worth it; breastmilk is even more vital to vulnerable preemies. But sometimes that fact is cold comfort when you’re pumping alone at three in the morning, staring blearily at your baby in her web of leads and tubes. All nursing mothers should be celebrated, but NICU mothers deserve something more. Praise. Limitless admiration. A nap, perhaps.

Life in NICUland, Part Two

September 7, 2010 - 4 Responses

It got easier. Leaving her and going to another room on another floor got easier. It helped that I was heavily medicated for pain, that I was exhausted, and that Josh and I at least had each other. We’d go to the NICU and breast-feed and cuddle, then back downstairs where we slept. Rarely did we go back to our room and not sleep.

Initial bloodwork–routine for babies born as traumatically as Teagan–showed that her white blood cell count was elevated, along with another marker for infection. Coupled with my long labor with ruptured membranes and my GBS + status, the neonatologist recommended a three day course of antibiotics to treat a possible infection. Even though her blood culture eventually came back negative, he later recommended an additional four days of antibiotics since a) her white blood cell levels were declining, but very slowly, too slowly if the levels were due only to a rough delivery and b) there was no indication that her levels weren’t declining because of the treatment, in which case it was important to continue in order to eradicate the infection entirely.

That’s the long-winded way to say that we were there for seven days, but that she wasn’t very ill. She didn’t act ill at all; she ate fine, she wasn’t lethargic (not any more so than your normal newborn), she peed and pooped fine. Because of this, because she wasn’t really sick, because she was full-term, I felt out of place in the NICU.

I felt like some ancient Greek sailor washed ashore some strange, sad island.

While I nursed Teagan, while we brought in an outfit to take her home in, parents around us were learning how to use feeding tubes, bringing in pictures and blankets to cheer up the lonely isolettes. The parents didn’t talk much. The parent resource room was a stopping-by place to eat and drink, and not much more. Moms pumped next to the warmers or isolettes, dads dozed in the recliners next to them. I’d nod and smile to other moms if I passed by, bonded by our aching postpartum bodies and empty arms, but we were all so wrapped up in our own intense struggles that the effort to strike up casual conversation was too much. The only thing on our minds was our babies’ health, but that’s not the easiest way to break the ice: “So I heard the respiratory therapist had to come in three times last night for your kid?”

The NICU is full of contradictions, though, and despite the fact that I never talked with the other parents, I felt strangely bonded to all the babies on Teagan’s row. It’s unavoidable that, spending hours by your baby’s bedside, you will hear every agonizing and joyful detail of the journeys around you. The hospital even requires all parents to sign a HIPAA form for this reason.

Which is why I won’t write any of their names or conditions, even though their names and tiny faces, as I could see them through all the wires and tubes, are burned into my brain. Sometimes at night, when I’d drag my body into the hospital bed, I’d find myself praying for some of those other babies before I prayed for Teagan. Teagan had me there in the hospital. Those other babies had parents an hour away or teenage parents or a mom in the ICU. They were prayer magnets.

After I was discharged, I managed to snag a brand new room in the new NICU wing to board in while Teagan finished her treatment. The room was gorgeous, fantastic, and was even equipped with all the gizmos in the patient part of the NICU so that potentially your baby could room in with you (Teagan couldn’t). But compared to the constant noise of the NICU, with the monitors constantly alarming and the cries and the constant hum of chatter among the nurses, my room was uncomfortably quiet. Josh was at home with Noah, and I was alone. I ended up spending a lot of time napping in the recliner next to Teagan’s bed.

Time warped in strange ways. Sometimes my head would barely seem to hit the pillow before they called me back to nurse and sometimes I’d stare at the clock in the corner of her booth and swear that someone slowed it down. I’d forget to eat some days. Nights were interminable, pumping next to the warmer while I listened to the baby across the hall go bradycardic over and over again.

And I missed Noah. I missed his giant, tousled head, and his squeals, and falling asleep with his head resting in the crook of my arm. I just wanted to be home, where we could all be together for good.

Life in NICUland, Part 1

September 3, 2010 - 2 Responses

Imagine you woke up one morning unable to breathe. And you looked over across the room, and there were your lungs, sitting in a plastic box. You’d panic, of course, because how are you supposed to breathe without your lungs? And how are your lungs going to function without your body and blood? Now imagine that when you went over to the box, someone stepped in between you and the box and told you that you couldn’t have them right now, that your lungs were sick. But they’re my lungs, they belong with me, you’d want to say.

“Well,” the person would reply. “You can have your lungs back. But only for thirty minutes every three hours.”

Can I preface this by saying that the NICU is an incredible place staffed by incredible people? That the compassion and wisdom of the staff, from the neonatologists to the nursing assistants, still astounds me, even in my memory? And can I also say that I think NICU parents are allowed to have more than one emotion about their experience? Teagan’s stay was short and pretty uneventful, but the bundles of joy, hurt, loneliness, regret and longing are heaped in piles higher than I can see.

They wheeled me up to see Teagan over three hours after she was born. Nothing had hurt more than seeing her rolled away in the isolette after only one caress of her cheek. Nothing hurt more, except maybe having to give her back after we were finally reunited. I missed her first few hours, her first meeting with her grandparents, her daddy and her brother. That still makes my eyes sting–I missed the moment when Josh held Noah up to see her and he said her name. And now, when I finally got to hold her and try to nurse, after a few minutes of her apathetically nibbling and licking (Josh said in the hour right after birth, she was like a little bird, mouth open and searching for mama), now I had to give her back. The nurse tucked her back in her plastic box, and I went downstairs again.

The second visit was the hardest. Because this time, she latched on and nursed like a pro. This time, I was less groggy from drugs. This time, I unwrapped her from her never ending swaddle and explored all of her silky, tiny body. She was so little in my arms, with these sad wrinkles on her legs and arms. She had perfect lips, like a rosebud, and eyes a dark, dark blue.

Only the parents were allowed to hold her, and I was glad. I wanted to be selfish with her and hold her forever.

Friends and family started piling in to see us and her. I already had my parents and a friend in the booth with me, then several more people arrived at my postpartum room down stairs. The nurse came in and murmured noises about checking Teagan. I knew I had to leave, but as soon as I eased her into the nurse’s arms, I started sobbing. Not crying, where tears sort of leak out, but the sobbing where you can’t breathe (and yes, you make those awful sounds) and there’s snot and did I mention the sounds?

I felt like I was being cut open again, like my baby was being stolen from me, and that her being packed away in the box was the most unnatural and depraved thing that the universe could inflict.

Then my mom said to the nurse, “She’s just emotional, you know, being hormonal.”

I could have spit, I was so mad. Here I was, completely undone (and I don’t get emotional very often…the last time I cried in front of an audience was in 2006 at Krista’s funeral), and my own mother was dismissing my very real pain. I kept crying as Josh wheeled me back down to our room, where the visitors were waiting, and it was all I could do to keep those sounds at bay while everyone talked. I just wanted to hold her again, press my lips to her chest in thanks, thanks, thanks that she was alive and breathing through those little rosebud lips.

Tristan, Teagan and the rest

August 29, 2010 - 5 Responses

I wrote this as an essay for my non-fiction creative writing class last semester, and I thought I’d post here, since it clarifies some of the things obliquely referenced in Teagan’s birth story.

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I imagine God in the ceiling.  Sometimes on the roof.  I look up when I pray my helpless, hapless prayers and imagine an infinitely small, infinitely bright point of light and the smell of fresh, wet leaves and the sound of rain.  At my confirmation–the taste of boxed wine bitter in my mouth–and at my wedding, I remember looking up at the ceiling right before the priest said his final words, grasping for that final puzzle piece of divine assurance before I took the plunge.

God was not in the ceiling September 23, 2008.  I scanned the ceiling tiles in the operating room over and over again, trying to ignore the quiet bustle of the surgical nurses preparing the tools, the occasional comments from the anesthesiologist–okay, this will feel like cold water on your back…now you may feel like you can’t breathe, that’s normal.

My doctor arrived, there was a lot of pricking and poking to make sure I was numb from the chest down, and then my husband crept in.  My blood pressure dropped from the increased anesthesia and I started shaking violently, tears running out of the corners of my eyes.  I was shivering.  The lights were blinding.  My husband was almost unrecognizable from all the surgical garb.

“Time to meet your baby,” the doctor said.  A nurse gave me a smile through her mask.

More cold feeling on your back, the anesthesiologist said.

Intense pressure.  Pressure so great that I thought the table would crack underneath me and the floor under that, and I’d go plunging into the basement.  I stared up at the empty ceiling, waiting for hope, waiting for strength, waiting for any other feeling than cold and pressure.

There was a strangled cry and my son was hoisted over the curtain for me to see.
I thought my lips would go blue from cold.

The year my son was born, 32% of American women gave birth via cesarean section.


A year and a half later, I’m sitting across a desk from a wide-eyed woman with dark hair. Next to me is another wide-eyed woman. I’ve hired them to be my doulas–labor assistants–for my next birth. They have soft voices and long eyelashes, like Victorian paintings. They have soft names too: J***. E*********.

“We’ll do everything we can to help you have a natural birth,” J***says. When she’s not doula-ing, she’s a chiropractor and an acupuncturist.  She got her pre-med degree from a small Mormon university in Iowa. When she listens, she stares at me with this intense look, hands clasped together on the desk, like a priest.

“I’m just worried it won’t happen.  That something will go wrong like last time.”  This is only a partial confession.  The rest feels too stupid and embarrassing to say out loud.  That I’m worried that since my mother had a c-section with me, then I’m doomed to have all my babies the same way.  Or that I secretly believe that my body is a Murphy’s Law of all things that can go wrong with a gravid vessel.  Or that I’m also worried that the hospital and my midwife and the nurses and my insurance will all come together in some giant conspiracy to force me back onto the operating table and into another four-week Darvocet-riddled hell of recovery.
E********, who could have been a Maxfield Parrish painting, picks up on this last worry.  “We won’t let the hospital or the doctors force you into anything.  We’ll stand up for you.”
They list the things they can do for me–acupressure, aromatherapy, massage, visualization, position changes.  They’ll stall for me when nurses want me to do something I don’t want to do, feed me a secret supply of Powerade and granola, they’ll make sure that every procedure is explained in careful detail so I can accept or decline in a position of informed consent.
The things that a husband or a sister or a mother might do for a woman, except my sister lives in Virginia, my mother is bipolar and dying of cancer, and my husband–a police officer who routinely photographs corpses and attends autopsies–grows faint at the sight of needles and blood and at the idea of his child being extruded into our world.
“Remember that sixty to eighty percent of women trying for a vaginal birth after a cesarean get one,” J*** says.  “And since only sixty seven percent of women overall achieve a normal birth, I’d say those are good, good odds.”
I leave the meeting quietly positive.

In the 1970’s, boosted by improved surgical techniques and effective, available antibiotics, the cesarean rate began to rise.  More doctors chose cesareans over using a forceps when birth got tricky.  The new continuous fetal monitoring systems–monitors which gave a constant, live read out of the baby’s heartbeat–led to more surgeries since the data was, and still is, vastly open to interpretation.  And when something’s open to interpretation in obstetrics, that means liability, which means a cesarean.

The c-section rate rose from about 5% in 1970 to 25% by the end of the 1980’s.  Alarmed, public health officials called for a decline in the number of c-sections.  Doctors listened and allowed women with the so-called bikini cuts–incisions made from side to side, rather than up and down–to attempt a trial of labor for their next pregnancy, rather than scheduling a repeat c-section.  By and large, they found that it was safe, and the national c-section rate began to dip.

Unfortunately, the careful attitude of the first generation of VBAC (Vaginal Birth After Cesarean) doctors had grown lax.  By the mid-nineties, obstetricians treated VBACing women the same as their other clients, and started inducing them with prostaglandins (medications that ripen the cervix) and augmenting them with Pitocin (a synthetic and stronger version of the hormone oxytocin.)  Consequently, the rate of uterine ruptures, where the uterus tears along the old c-section scar causing hemorrhage and the possibility of fetal demise, began to rise.
Something like controlled medical panic ensued, and rather than stop administering prostaglandins and Pitocin to women attempting a VBAC, the doctors and hospitals began to back off VBACs altogether.  Which brings us to today, when ninety-two percent of women who’ve had a c-section have repeat c-sections and only eight percent will deliver their next child vaginally.

My midwife is a Certified Nurse-Midwife, which basically means that she’s a nurse with a Master’s in midwifery and that she has an office and delivers in a hospital, just like an obstetrician. She is blond, and she hugs me at the end of every prenatal visit.

Right now, I’m trying not to cry.

She scooches closer to me on her stool. “Your operative report says that your previous cesarean was for ‘failure to progress.’ I’ll be honest with you. Women who try for a VBAC who’ve failed to progress in past labors…they don’t have the best odds. Only about sixty percent.”

“Which means a forty percent chance of having a c-section?” I ask.

“Yes.” She leans forward. “I want you to know that if you decide to schedule a repeat c-section, I’ll still provide all your prenatal care and I’ll be right there with you in the operating room.”

I think back to the cold, the shaking, the empty ceiling.

“But…” I hate being in conflict with authority figures. This dates back to my years at Catholic school. “Isn’t a forty percent chance of a c-section better than a one hundred percent chance? And just because I have less of a chance of succeeding, the rupture rate won’t change, right? It will still be just as safe?”

“Well, yes, it’s still as safe. But I have to tell you that my supervising obstetricians want to make sure that I’m only taking the best VBAC candidates. And, realistically speaking, you’re a poor candidate.”

The 2004 Landon Study was the largest study done on contemporary VBACing women.  It included women being induced or augmented with prostaglandins and Pitocin, and it showed a 0.7% risk of uterine rupture.  Of the 0.7% women who ruptured, about ten percent of those babies died or suffered brain damage.  Put another way, a woman attempting a VBAC has a 99.93% chance of delivering a healthy baby.

My mother calls my step-father’s ex-girlfriend from the ’70’s. Yes, this is strange, but Cee is an old friend. She’s also been a midwife for decades, a midwife of the herbal tea and homebirth order, and has personally delivered countless VBAC babies in beds, bathtubs and on living room floors with no adverse outcomes.

“Is her midwife right?” Mom asks. “About this poor candidate business?”

Cee snorts. At least, my mother tells me she snorted. “All a failure to progress diagnosis means is that a doctor failed to wait.”

My last labor gives women like Cee nightmares. My water broke, I checked into the hospital, was immediately told my contractions weren’t strong enough, and was summarily hooked up to Pitocin. They had me lay in bed for fourteen hours–I got the epidural after the first eight–cranking the stuff up to try to get me to dilate. In all fairness, the doctor waited plenty. But my son’s head was cocked sideways, and while this wouldn’t be a big deal for a client of Cee’s who would be up and moving and swaying, in the hospital, trapped motionless in the bed, the kid couldn’t find his way out.

Mom asks, “Have you ever delivered a woman who had her c-section for failure to progress?”

“Absolutely,” Cee declares. “The truth is that women need to be upright and moving and left alone during labor.” She pauses. “The other truth is that they were never planning on giving your daughter a vaginal birth. The first excuse they can find, and this ‘poor candidate’ thing is just the first in a long line, they will use to force her into a c-section. I know that hospital and I know those supervising obstetricians…they’ve written her off as a c-section from the very beginning.”

The average vaginal delivery can take anywhere from six to twenty-four hours of labor.  A c-section takes less than sixty minutes.  The physician’s fee for a vaginal delivery is about $1500.  The fee for a cesarean is about $600 more.  If something tragic happens to mom or baby during labor/delivery, a physician is much more likely to be sued for a cesarean that he didn’t do rather than than an a unnecessary one.  Fear of liability was the number one reason cited for performing a c-section in a recent anonymous survey done within the ranks of the American  Congress of Obstetricians and Gynecologists.

My midwife consents to attend my trial of labor on the condition that I meet with one of her supervising obstetricians and discuss my poor candidate status with him.

My husband offers to go with. “This sounds like it will be a cesarean high-pressure sales meeting.”

It is. The first thing Dr. M does after looking at my chart is roll his eyes.

Red flushes up my husband’s neck, turns the tips of his ears the color of blood.

“So you’re here to talk about a VBAC?”

I affirm that yes, this is the case.

“The first thing I want you to know is that there are huge benefits to having a second c-section. If you never give birth vaginally–and a vaginal birth is a traumatic, traumatic thing, I can tell you–then your pelvic floor will stay perfectly preserved.” He winks at my husband in a see, buddy, I’m looking out for you way that makes my husband’s ears practically glow radioactive orange.

“The second thing I’ll say is that the rate of your uterus rupturing is about one percent. That doesn’t sound like a lot, but if you got on a plane today with ninety-nine other people, and one of those people is a terrorist, well, you wouldn’t like those odds, would you? Plus, pretty much every baby whose mom suffers a ruptured uterus dies.” He shakes his head sadly; the light catches the bald spot below the clusters of hair gel.

My husband clears his throat. “We read a survey that showed much lower numbers, risk wise.”

Dr. M bristles at this. “You know, I sit on the board at this hospital, and I can assure you, the risks are much higher than the studies show.”

“What about the risks of a repeat c-section?” I ask. I’m thinking of higher NICU admission rates for c-section babies, higher rates of respiratory distress, correlating high risks of asthma and autoimmune disorders. The fact that last year, the CDC released a report saying that c-sections, performed for any reason, carried a three-fold increase in mortality for newborns.

He waves a hand. “Just your standard surgical complications. And those are all for the mothers–a small chance of hemorrhage, blood clots, infection, hysterectomy.” He makes a face that might be concessionary. “There is a higher chance that you will die.”

He counters himself quickly. “But then you have to ask yourself, are you the kind of woman who would rather die or rather have her baby die?”

After years of calmly taking abuse at the hands of pissed civilians, my husband is clearly having trouble not throttling this man.

I try again. “But I thought I heard that c-section babies are at more risk ultimately too, like with breathing–”

He cuts me off. “They have trouble breathing because they have a little extra fluid in their lungs. What would you rather have, a little fluid or a dead baby?”

My husband stands up. “We have to go,” he tells Dr. M. “All we need to know is if you’re going to let us try this or not.”

Dr. M is surprised. I don’t think he has many patients reject his dead baby speech. “Nothing about you is technically contraindicated for a VBAC,” he says slowly. “It’s just that, if it were me, I’d choose the c-section.”

If it were you? But that’s the point, isn’t it? That it’s never going to be you. You’re never going to have to hobble around the house, in more pain than the narcotics can kill, trying to cook dinner because your husband had to go back to work. You’re never going to have to try and breast-feed after a c-section, when any pressure on your stomach makes you cry and all the Pitocin and bodily trauma have delayed your milk coming in. And you’re never going to have to bite down guilt every time a new study comes out showing increased allergies or asthma or autism or whatever with c-section babies–knowing that because your body failed to do what mammals have done for millions of years, you put your precious baby at risk.  Of course, I say none of this. Authority issues, remember? I slide off the patient table, ready to leave.

“Let me ask you this,” Dr. M says. “Why is this so important to you?”

I glance up at the ceiling. “Lots of reasons.”

2007
My husband and I were married for two years when I found out I was pregnant again.  The year before, in 2006, we’d gotten accidentally pregnant and then miscarried a few weeks later.  This time, we were (a little) older, more ready, more excited.  We knew we wanted to start a family right away, before my narcolepsy got worse.
We bought little clothes and shoes, and, after we made it past those perilous initial twelve weeks, we picked a name.  Tristan if it was a boy.  Teagan if it was a girl.
Then, at sixteen weeks, there was something wrong on the ultrasound.  I still don’t understand what.  A nurse called from my doctor’s office: they scheduled me to see a perinatologist during the next week.
I cried all weekend.
That Monday morning, I laid down on the table at the perinatologist’s office for the ultrasound.  He pressed the transducer against my stomach and swept it back and forth, sometimes digging it deeper into my skin, frowning, frowning.  I could see the outline of the baby on the screen.  What was he frowning about?
“You see this?” he asked, tapping the screen.  “That’s where the baby’s heartbeat should be.  There’s nothing.”
“What do you mean?” I whispered.
He looks genuinely remorseful, which I was grateful for, since he didn’t know me.  “There’s no heartbeat.  Do you see how tightly the baby’s body is curled in on itself?  That means your baby has died.  Probably been dead for two or three days now.”

I have never wanted to be out of my own skin, disavow myself from every physical cellular atom of myself, so badly.  How could my own baby die, and be dead (curled up, a husk) in my body for days and I didn’t know it?

When you’re in your second trimester, dead babies present complications outside the realm of normal obstetrics, so I was sent off to the abortion clinic.  My husband clutched my hand as we were walked through consent forms and processes geared for someone ending their pregnancy deliberately.
Let me say this: I have always voted pro-choice.  Because I believe that whatever my own inclinations are, everybody should have the right to decide for themselves.  But at that moment, when the confused nurse congratulated me on choosing the right thing, that the abortion stigma was a thing of the past, assuming I was there to stop Teagan or Tristan’s heart from beating–at that moment, I wished with every ounce of my heart that that building would burn to the ground.
They made my husband leave, then had me lay back on the table.  Faded posters were tacked to the ceiling, all of the inspirational classroom kind.  Kittens hung from clotheslines, a mountain climber was perched on some remote crag, a cluster of hot air balloons rose among the clouds.
The doctor pulled a faded sheet off a machine in the corner.  I asked what it was, but she had already turned it on.  It was so loud that no one could be heard over it.  She motioned for me to place my feet in the stirrups.

The machine connected to something she inserted inside of me.  There was pain and a sudden lightness in my head and pain and I threw up.  The nurse patted my hair.

The doctor turned off the machine.  “I just broke your water,” she said, then showed me several white tubes.  “This is something called laminaria.  It’s sterile seaweed.  It will dilate your cervix completely overnight, then tomorrow morning we’ll get this thing out of you.”
This thing.  My baby.  After the laminaria was inserted, they had me sit up.  I fainted for the first and last time so far in my life.

No one told me it would hurt, having your cervix forcibly dilated by seaweed, but it did.  All night long, I paced and moaned and rocked on my heels like a woman in labor, forbidden from even ibuprofen because they wanted me to have an empty stomach for the anesthesia.  At six the next morning, we checked into the hospital.

And for the first time in my life, I laid down on an operating table and a stranger pulled my baby out of my body.  I can’t remember if the ceiling was empty or not, since they knocked me out as soon as I laid down, but I do remember the cold.  And a feeling of blank detachment when the doctor told us in recovery that it had been a little boy.
Tristan.
One year later, I laid down on another table.  Noah was pulled out, alive, full-term, healthy.  But once again, I was a passive carrier.  An inert host with a body too broken to birth.

2010

The windows are open and it’s raining.  I just got off the phone with my mother, diagnosed last month with Stage IV breast cancer.  She wanted to know how the meeting with Dr. M went.  Somehow, talking about how I don’t want a medicalized birth and then having her compare it to how she doesn’t want a medicalized death is too much.  I tell her I love her, then hang up.

There is a story about the prophet Elijah, that when told to wait for the coming of God, he was faced with a great wind and an earthquake and a roaring fire.  But none of those incredible things were the presence of God.  Instead, it was a still, small voice in the aftermath.

I think about the fights fought and the fights left to fight.  That God hovers outside of the c-sections and stillbirths and cancers, and instead whispers to us in summer rain and tall thick trees and breezes so warm you want to sleep outside.

Thunder threatens miles away, and the restless girl in my womb, Teagan, kicks and thumps.  No matter how she is born, no matter if her grandmother is alive to see it, no matter how many babies I’ve lost…at this moment, God is on my roof, painting the sky with wet leaves and the smell of far away wind and hope.