how she entered the world, part two
For part one, read this.
I entered the artificially bright sterile room in nothing but one of those ill-fitting cotton gowns and something covering my feet and unwashed hair. Surely my ass was hanging out. I was accompanied by two nurses, who helped me onto the operating table.
My first thought was, wow, how different this is from the birth of our daughter Jaye. Worlds different. Couldn’t have been more different. Life contrasts.
My second thought was to try to relax. I had been in so many operating rooms before, for so many uterine surgeries. Though every procedure in the past 9.5 years was geared towards clearing the way for a baby, none of them were for such a happy occasion as a real live birth. That was a monumental thought, actually.
I tried to remember to b r e a t h e . . .
Two anesthesiologists worked to place a spinal in my lower back while I sat sideways on the table. First they had to get me in the right position. Then a local anesthetic, with a pinch and a sting. Then the big needle, which I didn’t really feel.
As I sat there focusing on my breath, I noticed the room was still filling up. Though I lost track at 12 — I counted to calm my nerves, as a distraction, to have something to report, out of sheer curiosity and disbelief — I think there were at least 14 people in the room besides me. Plus the NICU team had not yet arrived. Or Mac.
“Someone will get my husband when we’re ready, yes?”
“Of course,” a nurse replied. “He’ll be here in a minute. We’re almost there.”
They helped lift my legs, now growing heavy, on to the table.
Again, I focused on my breath. I am not a fan of anesthesia or needles. I just wanted that part to end. Not that I was a fan of really sharp knives either…
“Do you know what you’re having?” asked the old man doctor, whom I had met just twice before in the past 24 hours. Small talk, I thought. That, or he needed to know whether someone should call out gender.
“She’s a girl,” I answered. “Either a girl, or a boy with the tiniest penis ever.”
I caught him off guard and he laughed, as did a few of the others. Comic relief. My job here is done. Heh. Almost. Not yet.
I thought about when our daughter Jaye was born, how it was my job to announce whether she was a girl or boy. There were just a few of us in K’s dark cozy room early that morning, just after dawn, when I looked down and was barely able to say, through tears, “She’s a girl, a beautiful girl!”
They went to work. It was like a choreographed dance, their efforts to prepare.
Mac finally arrived and rushed to my side. Again, I sensed fear and concern in his eyes. I assured him I was OK. They ushered him around to my head and he took his place beside the anesthesiologists. I placed my arms on armrests in an unnaturally high position (which later caused soreness). Mac rested his hands on my arm and shoulder, and wherever they would let him hold me.
By now my legs felt rather heavy, as if they were trapped beneath something. I tried to move my toes. It felt like I could, but I could not. I could not move from the waist down.
They gave me oxygen through a nasal cannula, a small tube that wrapped around my head and into my nose. Again, I focused on my breath.
I could see the reflection in the round metal lights hanging from the ceiling as they prepared the incision site. Well this is sort of surreal, I thought, a long-distance view, a little distorted, but I would watch. But then the screen came up. Only it wasn’t a real screen — as you read about and see in movies — it was more of a surgical sheet pinned up to the surrounding equipment. As they raised it up near my face, I began to feel claustrophobic. I said so and someone moved it away a bit. Better.
Finally, they were ready.
As they began to work, I felt only pressure, but no pain. I had read accounts of women who felt pressure and tugging, and that’s exactly what I felt. It was bizarre to think that they were cutting me open, through muscle and fat, to reach this elusive baby, and who knew what else.
I wondered what else they would find, knowing that my last procedures before treatment were complicated by unexpected pelvic adhesions — i.e., one ovary had been twisted and stuck to the back of my uterus, and my colon was fused there too.
Now, if the placenta could not be easily delivered, they would remove my womb after the baby was born. This doctor would give it a try. They’d be looking for signs of placental embedding into other organs. They were ready for a complicated procedure, if necessary. They were prepared with several units of blood, in addition to a system that would capture and clean my own blood for immediate recycling.
Mac focused on me as they worked, rubbing my sore neck and shoulder. I focused on my breath.
I sent out one last strong wish to the universe to deliver this baby safely, to let no harm come to her. Or me.
We heard them talking as they worked.
“Here she is,” the chief resident said as she pulled her tiny body from mine. “She’s out!”
She held our daughter high for a brief moment, though I could barely see her. Somehow, Mac remembered his camera, and he captured this moment forever and shared it with me for a better view.
“That’s our daughter!” Mac said, through tears. “We made her!” I smiled and nodded in agreement. I couldn’t believe it either. It was a notion we had given up on long ago.
I had asked, begged really, for just a moment to see and touch her, if not hold her on my chest. They had said they would try, but at just 33 weeks and 3 days gestation, she would need immediate attention. Clearly it was not going to happen. (I would get my chance a few hours later.) She was passed to the NICU team — a team of six doctors, nurses and a respiratory technician — who whisked her away to be stabilized. They had to get her on a respirator. We could hear her wailing as they took her away. Mac laughed, relieved, and said something like, “sounds like there’s nothing wrong with those lungs!”
Then they went to work again. This was the part I’d been warned about, when I’d begin to lose blood and they’d be working against the clock. They would try to deliver the placenta, and if they could not, they would remove the whole uterus and hope that nothing else was affected. For instance, was the placenta embedded into other organs such as the bladder? Would my ovaries and tubes detach easily from my womb? We thought they’d usher Mac out and put me under with general anesthesia for this part. But the doctor thought that might be unnecessary. So they worked fast.
I felt the tugging much stronger now, so much so that I wanted to say something. But I realized their goal was not to be gentle but swift. It felt as if someone was trying to pull something but it wasn’t moving. They were trying to deliver the placenta, but it was going nowhere. I would need a hysterectomy.
Meanwhile, I started to feel strong pressure on my lungs, as if they were collapsing. I tried breathing but it was hard. I couldn’t catch my breath. I said something and they pumped more oxygen.
Mac watched as my blood pressure plummeted. My normal pressure of about 120/65 dropped in half to about 60/30. Mac was terrified, but didn’t show it. He was gently rubbing my forehead but I had to redirect him to my neck and shoulder. I needed to breathe. I was light-headed. I felt claustrophobic. I couldn’t speak. Mac thought I was going to die.
B R E A T H E . . .
I had no idea how much blood I was losing. I’m still not completely sure of the total loss, since they recycle and re-infuse everything they can. Based on what we were told after, we think I lost about 3.5 liters of blood (there are about 5 liters in the human body). I was infused with four units of donated blood in addition to my own recycled blood. (Three days later, when I still felt lethargic and they were worried about my heart working too hard, I took their advice and got an additional two units in a transfusion that lasted 4 hours through the night.)
As soon as I felt the effect of the transfusion on the table, I felt better. The pressure on my lungs and chest lifted. They gave me more oxygen. I was able to breathe again. I could speak. Relief.
They were still hard at work, trying to gently separate my womb from other organs and stop the bleeding. We could hear them discussing what they were doing. My old uterus — that which had given me so much grief for over nine years, but had somehow finally given life — was taken, along with one (blocked) tube. But they left my ovaries, saving me from instant menopause, and no other organs were harmed.
But while they were still working, I started to feel movement in my toes.
“Um, should I be able to feel my toes right now?” I asked the anesthesiologists who were right by my head.
The spinal anesthetic was wearing off, to their surprise.
They explained that they were almost done, but still needed to stitch me up. They would need to use a general anesthetic with painkillers to finish the procedure. A nurse escorted Mac out and showed him to the NICU, where he could be with our baby.
The anesthesiologist applied an oxygen mask and told me to breathe deep. Cool oxygen. That’s the last thing I remember before waking up in recovery about two hours later. Truth be told, I barely remember recovery at all. I vaguely remember my bedside nurse telling me the baby was fine. Next I asked about my ovaries. They were fine too. Then I know she called the NICU to tell Mac that I was up, so he could come be with me.
Those first hours were a fog and all I remember is being really thirsty and wanting water. They gave me ice chips. I wanted more. They told me to slow down. They rationed the ice chips, then gave me little mouthfuls of water.
Finally, the nurse asked if I wanted to go see our daughter. That was all I really wanted. They wheeled me on the gurney to the NICU, accompanied by my IV, oxygen and catheter. Baby Z was in the most critical bay, in an isolette by the window. They made room for the gurney and pulled me up right alongside her. When I saw her there — beneath the heat lamps in that clear plastic box, with a respiratory mask and tubes on her tiny little face and wires attached to her little body — I couldn’t believe she was really there, or that she was really ours.
Here was this tiny little being, protected from the world upon entry, connected to life through huge beeping machines, here in this place where life was so precious and fragile.
By now she had been stable for a few hours. I reached my hand in, careful not to bang my IV against the isolette, to hold her little fingers and got a thrill when she grasped mine. The nurse asked if I wanted to hold her. We both had our oxygen — she with her CPAP unit and me with my tubes. I opened my gown and she laid our daughter on my chest, covering her with warm blankets. The skin to skin contact was both electric and grounding. I felt like I was melting at my core.
I felt her near weightless body on mine (she was barely 4 pounds 7 ounces at birth). With each rise of my chest, I breathed with her. I spoke to her, for the first time outside. “Mama’s here, baby.” I took a deep breath and cried a few satisfying tears. Relief. Joy. Gratitude. Mac thought to snap a few photos.
I glanced out the window and admired the magnificent view. It was a panorama of San Francisco looking across Golden Gate Park towards the Bay and Pacific Ocean, with tips of the Golden Gate Bridge in the distance, peering out from the late summer fog. I could see hills and the headlands beyond that, and to the right the distinctive skyline. Picture postcard perfect.
Yet here on my chest was the most remarkable sight and sensation. This tiny little girl — who marked the completion of our family — had somehow found her way to us. She did it in her own time, in her own rhythm, with a life force so strong I never could have even imagined her.
And that is how our little Z entered the world.