Monday, July 22, 2013

Magpie's birth story, part I - the prequel

I've never posted the story of my labor with Magpie and her birth. At first, I was too shell-shocked to process it, let alone write it down, and then I was too sleep-deprived, and then I kept putting it off, and then I returned to work and didn't have a second free anymore...and well, somehow nine months have passed. Ms. Magpie has now been on the "outside" as long as she was on the inside. And it is time to write about how that came to happen.

I was induced for my labor at 39 weeks and 2 days. This is not what I had wanted. During my pregnancy, I had quietly completed a Hynobabies course, with Will at my side; I had ponied up the money to hire an experienced doula; I was going to go through Magpie's labor unmedicated if I could, in a fully equipped hospital but with as little intervention as possible. After so very much intervention to create Ms. Magpie, and so much intervention during the pregnancy itself between the monthly IVIG infusions and the weekly ultrasounds, etcetera, I think I was just done. I was ready for something to go right - without a hitch - and without a thousand medical interventions to make it possible.

Then I was diagnosed with gestational diabetes during my 27th week of pregnancy. It quickly became apparent that I couldn't control my fasting glucose numbers no matter how carefully I watched my diet. My post-prandial numbers were lovely...but my fasting numbers in the morning were creeping steadily upward. I became so afraid of having a "large for gestational age" baby, and therefore so strict with my diet, that I didn't gain a single pound past my 27th week, only gaining 18 pounds the entire pregnancy, despite the recommendation to gain 25-35 pounds as a woman of normal weight at the beginning of pregnancy. When I look back on it, it all seems a bit crazy, but I was determined to try to do the best for this very wanted girl, whom I pictured swimming in sugar, and growing - I was repeatedly warned - ever larger because of it. Because of the rising fasting numbers, I was put on insulin at night, and then when that didn't do the trick, more insulin at night. I started doing twice a week non-stress tests at 30 weeks, soon adding growth scans to the mix once a week. They all looked good, but between the insulin-controlled gestational diabetes, my age of 40, my treatment with lovenox throughout my pregnancy (switched to heparin at the end), and my abysmal reproductive history of six consecutive losses, I was told that waiting to deliver without induction was a no-go.

"All babies are priceless and irreplaceable, but this baby is really priceless and irreplaceable," my OB said to me again and again. And she was right.

I was told that the placenta can start to break down at the end of pregnancy and that this happens faster in women with gestational diabetes. I was told that the risk of stillbirth goes up past 39 weeks for women with insulin controlled gestational diabetes. I was told not to risk it. That as soon as it was safe to deliver, we were delivering. My OB offered me an elective C-section a few times. "You're a primipara; your cervix is long and closed and posterior; this may not go well for you and may be a rough road to delivery."

But I was adamant. I was not going to have a scheduled C-section. I was going to try to do this unmedicated. I was going to give birth vaginally. Surely my body could do something "right." Looking back, it seems that I believed that if I was determined enough, I could make the birth itself turn out the way I wanted. A ridiculous level of persistence and determination had brought me through 7 IVFs and gotten me this far; in my mind it stood to reason that I could persist through a few hours of labor and have the birth I wanted.

So we proceeded ahead with the induction plan. My long and closed and posterior cervix ("not even a fingertip dilated") would be prepped with cervadil and then after 12 hours of cervical ripening, we'd move on to pitocin.

Although cervadil is usually placed at night, I asked to be admitted and have it placed in the morning so that the timing of the pitocin administration would allow me to overlap with the beginning of my OB's call schedule. And so I was admitted on a Monday morning at 10AM. An IV was put in, which stunk, because my veins are a wreck from having chemotherapy in my twenties, and so I tend to have a lot of pain with IVs. And then the cervadil was placed. Apparently they can't lubricate it and they try to place it as high as possible, tucking it behind the neck of the cervix. I'll be honest - it was a bit uncomfortable, but it was in. I was strapped up to all the electronic fetal monitoring equipment. And told to rest. This was impossible, of course, given my adrenalin levels, excitement, and nervousness. On the physical side, the IV, that electronic fetal monitoring equipment (which alarms every time you move), the scratchy gown, and the cruddy delivery room bed whose sheets wouldn't stay on leaving me repeatedly sticking against the vinyl mattress were not exactly conducive to sleep either. I was most definitely awake, but tried to rest.

We were on our way!! Or were we?

To be honest, I didn't feel really much of anything going on.

***To be continued***


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Tuesday, July 2, 2013

Two teeth

Here is my beautiful girl at 8 months and change. She's growing up, moment by moment.

I am not entirely comfortable in this blog space but will try to keep posting. Thank you for your thoughts and comments on my previous post. They all helped and I am working to just tolerate the feeling of reduced safety that I have now. And also to be mindful of what I write, to realize that I have a wider audience than I imagined.

I have much to say, about parenting, about trying to balance life as an academic and clinician with being a mom, about what it is like to be here in the world of parenting and babies after being so long in the world of infertility and loss - so long there that I thought getting out of it was impossible.

Much to say on how deeply I desire to do right by this little girl, this oh-so-wanted little girl, and how I often feel completely de-skilled by her, disarmed, at a loss to possibly measure up to the ideals I have for myself ("If only I can get out the other side of these many losses, of this infertility, I will..."). Much to say on how each moment comes and goes so fast (how can this be true already?) that I want to hold on to each one, be mindful, be present - physically and emotionally. How already I sometimes glimpse the little girl emerging from the little baby I gave birth to. And much to say about those times when she looks up now and sees me and smiles, looks at me and her entire being lights up, and I feel so moved to be my best self for her, to be deserving of the trust and faith she has in me.

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