Wednesday, May 9, 2012

Life, Love and the Importance of Lactation Consultants

On the heels of the Whoopi Goldberg comments regarding the breastfeeding initiative, I felt compelled to share my birth story.  I’m sure there were plenty of other problems that could’ve occurred, but to us at the time, it felt like just about everything that could’ve gone wrong did, indeed, go wrong.  I was quite resolved to nurse my daughter from the start, but those days in the hospital were far more trying than I anticipated.  Were it not for the support of the amazing lactation consultants at our hospital, I’m not sure we would’ve succeeded.

After 6 hours of contractions 2-3 minutes apart (from midnight to 6am) we went in to the hospital with our awesome doula.  I was completely heartbroken to find that I was only one centimeter!  They quickly determined that my uterus was in spasm, which meant that between the highs of the contractions, it was never fully relaxing. So every time I moved the slightest bit I'd have a mini or full contraction. I couldn't even get to and from the bathroom without 2 extra contractions. So nobody could massage me, I couldn't move and I stayed frozen and tense for the majority of my labor because of it. I remember yelling at my husband in a panic when he caressed my arm because I thought it was going to bring on a contraction. Because I was so tense they gave me a sedative at about 7am. It knocked me out but not for the contractions. So I'd be completely passed out, and every 1-2 minutes wake up screaming and clutching the bed rails, and promptly pass back out. It was the weirdest, almost nightmare dreamlike state ever. By noon I was maybe 2 cm, and I pretty much threw in the towel on my natural labor. I think I may have hung in there if I had been progressing and knew there was a light at the end of the tunnel becoming even remotely visible, but 12 hours of contractions 1-3 minutes apart (and more hours prior) was wearing me out with no progression, so I caved. Not to mention the fact that my spasming uterus was basically keeping me locked up like a popsicle and threw that entire labor I’d envisioned of using the hospital birthing tub, walking around, etc...out the window.  I’m sure plenty of you 30 and 40+ hour labor moms would probably laugh at that, but in the moment that’s where I was at – I needed some actual down time where I wasn’t tensed up thinking I couldn’t move for fear of the impending contraction that movement would cause.

From the moment our doula called the doctor, he was unfriendly to her and refused to speak to her even though I was in the middle of a contraction when she called.  This behavior continued once we arrived, but he was gone by 7am and replaced by a much more considerate doctor.  The nurse, however, had an equally frigid attitude towards our doula. Fortunately, at 11am she left her shift early and we were switched to the most wonderful nurse who was there for me until 11pm. But the first nurse would practically roll her eyes when I asked to turn over, because it meant she had to reposition the heart monitor. Amidst my weird sedated state, I would only ask about once every hour and a half if I could roll over to the other side because she made me feel bad about it.

So we arrived at 6am, epidural and pitocin started at noon, and by 4pm the downward spiral began. I got a fever, and my daughter’s heart rate was elevated. I had also passed meconium earlier and was Group B Strep positive, so the clock was ticking. They tried to give me something to bring my fever down, and said they'd give the baby some time to get her heart rate down. Nothing was working. The other main thing was we went in engaged at -1 with her in the perfect position, and then my daughter actually started to move BACKWARDS throughout labor. Before they cut me open you could see her curled up in a ball just beneath my rib cage. I didn't even know this was possible!

By the time the doctors switched at 7pm the new doc came in and was unbelievably pissed that nobody had called it and cut me open yet. At that point he insisted to do so, and when I told him I needed to talk it over with my doula and my husband, he stormed out in a fury. The nurse came back and said that he said if I didn't agree he was calling his lawyer. It was all very upsetting but we could kind of see it coming. My doula was getting uneasy about the snowballing problems, and ultimately, the main deciding factor was that my daughter was simply not coming out but actually moving backwards, and I was not progressing. But I wasn't progressing even before I got the epidural so I don't necessarily think that was it. Even my doula insisted that there was no other option.

Within 10 minutes of OK'ing the c-section I was being strapped to a table with my arms tied down like jesus on the cross. It was at this point they informed me (after telling me otherwise) that this same doctor wanted to cover his butt and because I had a fever they feared the baby might have an infection, so she'd be staying across the hospital in NICU for 2 days. Everything I'd hoped for went down the crapper in those 10 minutes. I tried to stop crying about it all and waited to see my daughter. I remember my husband having to wipe my running nose and tears because my arms were tied down.

They took her out and it was decided my husband would go with her. I am so thankful that our doula had sweet talked the nurses and docs into letting her come in when he left. She was able to stay with me for the majority of the surgery while they put me back together, and she also stayed with me in recovery. I don't know what I would've done if I was there alone because I was there for over 3 hours in a windowless room with no baby, no husband and just a nurse going in and out late at night after a LOOOOOONG day.

They also convinced our nurse to let me see my daughter that night (beyond the 60 seconds I got to see her after they took her out when they held her up to my face on the table). They told the nurse how long we tried to conceive and how many painful years I'd been waiting for this baby, and even though the doctors wanted us separated so I didn't infect her with my supposed infection (my temperature immediately returned to normal after the surgery!) she agreed. The nurse brought her down to me in recovery and I got to hold her for 10 minutes, but 10 minutes only.  She slept soundly the whole time.

The next morning I was on an epidural and couldn't leave my bed, and my daughter was across the hospital in NICU. I kept harassing the nurse to get me off the epidural so I could go see her. My husband was bringing video of her back to me in my bed, and it was difficult keeping grandparents away until I got to see my baby.

By noon I was finally able to get into a wheelchair to see her, after incessantly pestering the worst nurse ever. Later, this same nurse returned to tend to my beeping machine a few hours after taking me to the bathroom for the first time after the epidural.  I told her I was relieved because I needed to pee again.  She replied, “You don’t need to buzz me for help if you have to pee, that was just for the first time.” So at less than 18 hours post c-section, she told me this and stood there and watched as I struggled like a turtle on my back trying to get out of bed, and continued to watch me hobble over to the bathroom and go by myself. 
When this nurse finally got everything in place so I could be removed from my epidural and do all the things I needed to see my daughter, I got wheeled a long distance across the hospital.  Obviously they were giving her formula, but they were very supportive of my breastfeeding. I was so doped up on percocet I could barely keep my eyes open, and people had to practically help me hold her the first time I got to really meet her. I still cry when I look at how out of it I was in those pictures. The first time I nursed her was behind a screen in NICU, with the stiffest hospital pillow on my lap, and it was really difficult to position her and lean forward with the c-section.

When I went back to my room I kept trying to pump and was completely unsuccessful.  Not a single drop would come. They say you need a baby for the hormonal response, so in desperation I put on the newborn channel on the hospital TV in some pathetic attempt to get a response. My husband spent the majority of those first two days with our daughter, which was what we both wanted. I had seen several lactation consultants at this point who showed me how to use the pump and watched me nurse, but FINALLY one came in on the second day and got me bigger flanges for the pump so my nipple wasn't rubbing against the edges when it pulled in and out, and...SUCCESS! I remember shuffling out to the nurse’s station with my measly ounce of milk and being so proud!  If it weren’t for the help of that LC, I’m not sure if I had it in me to keep trying to pump without my baby there - especially when it was hurting so much because the flanges were too small. 

After the first meeting I would deliberately NOT take my pain pills when I knew I was going to see my daughter, but it made holding her and trying to nurse her excruciating. I had dreamt of this being such a beautiful experience for us, and there I was under fluorescent lights with a stranger’s family on the other side of the screen, grimacing while I tried to sit in an uncomfortable chair with that damn stiff, awkward pillow on my lap nursing her.  At least she had an excellent latch. The lactation consultants were phenomenal and checked on me often and came with me to the NICU multiple times to help.  They were so supportive, and I can remember one coming into my room first thing when she arrived for her shift, because she wanted to see how I was doing right away after meeting me the day before.  She said she’d thought of me often overnight and hoped we were doing well.  She encouraged my husband and I to do as much skin to skin contact as possible with our daughter, and she was so pleased to see that despite our rough start being across the hospital from one another, I was still trying.

When they finally gave her to us in our room after those first 48 hours, they said she was getting jaundiced and we had to overfeed her. At this point, as first time parents hearing threats of taking her away to go under the lights, we were willing to do just about anything they said and didn’t give it a second thought. We had her pounding formula and nursing ‘round the clock. Less than 12 hours after she was in our room with us, they said she didn't look good and suspected that the results of the blood test they just took were going to be bad and she'd have to stay under the lights and not in our room.  They said they’d probably be back in a few minutes to take her away as soon as the test results came back, and that she probably wouldn't be going home with us if it was as they suspected. I instantaneously lost it and was in complete hysterics until 20 minutes later when they came back and said she just squeaked by on her blood test! They had just given her to me and they were going to take her away again? And factor in postpartum hormones? HOLY! Thankfully everything went OK from that point on until our release from the arctic hospital, into a 105 degree summer day.

I still can't really tell the story verbally to anyone without crying, and every time I see that triumphant moment in a movie where the baby is handed to the mom to nurse it I get choked up. To this day, I haven’t been able to get through reading “On the Day You Were Born” without sobbing. I think it would've been a lot easier to swallow if she had been in my room waiting for me after recovery and we could've gone from there.  In the months that followed people asked about my “giving birth,” and I never felt like I gave birth to her.  I felt like they took her from me, in more ways than one.  I guess I still feel that hesitation whenever “giving birth” to her comes up, because it feels misleading.

But despite it all, despite spending those first few weeks home lamenting about the bonding we missed that I had played out in my head over and over....a friend of mine who is an amazing midwife said it best – “Birth is about separation, not bonding. It is probably the most literal example of separation. You have a lifetime to bond, and you and your baby are already connected.”
She was right. Upon returning home, we nursed exclusively for the first 7 months, and continue to do so today. We have shared a bed every night, and at nearly two years old, I still wear her occasionally, despite her enormous size. Others may have their own means of bonding, but for me those things helped tremendously. I can proudly assert that everyone who meets her says she is the happiest baby/toddler they've ever seen, and not the traumatized little baby I anticipated because of our separation at birth. We are so, so close, and yet, she is independent as can be and often running away from me down the street! She is a social butterfly at parties and could care less if I’m around in those situations. Yes, that rocky start is painful to think about, but in the long run, it sounds crazy to say but it didn't really matter. What mattered was things like the  lasting relationship the LC's helped me establish, not the separation.  No matter what type of birth you have, that love and intimacy can still be cultivated, even if you are denied it immediately following the birth.  She’s happy as can be, and we have an undeniable bond…and we always will.

Thank you for taking the time to read my story!


Post a Comment