This is Part 2 of Lauren’s Birth Story. Read Part 1 here.
After my three-hour-long caesarean, Gena, my pre-op and OR nurse, got me settled in recovery. My OB, Dr. D, stopped by and, although she didn’t go into much detail at that point, let me know that it was a serious caesarean and that my husband was with the baby in the NICU. “Violet is okay, but her breathing was a little fast, so they wanted to keep an eye on her.” She explained that had things gone smoothly for me they would have done this in the OR, but they needed the space. Dr. D’s visit was short, and she said she was going to get my husband and the baby.
While I waited for my husband and daughter to appear, I concentrated on trying to wiggle my toes. I was able to slightly raise my knees and move my left big toe. So this is what it must be like to be paralysed… I was brimming with anticipation when Gena cried, “Here they are!” and I saw my husband approaching with a small bundle in his arms.
Probably because of the narcotics I think I received when the spinal block began to wear off during the caesarean, I don’t have as clear a memory as I would like of the moment Violet was placed into my arms. I do remember the joyful relief of finally being able to hold her, of feeling distantly euphoric, and, true to my troubleshooting nature, immediately wanting to take steps to breastfeed—Violet was already more than two hours old by the time she was placed into my arms. I unwrapped her from her swaddle and held her against my bare chest. I reminded Gena that I wanted to see a lactation consultant ASAP.
I began to learn just how serious things had been in the OR. Gena told me that if I had delivered in a more rural setting, I could have died. She said I lost 3,600 ml of blood—a few ounces shy of a gallon, or the equivalent of five bottles of wine. I remember the look of restrained incredulity on her face. She said she was amazed by how well I was doing, that what I had been through “on paper” didn’t match the woman sitting up and smiling before her. I was triumphant. Fuck infertility and fuck the extended birth plan—Violet is healthy, I didn’t die, and I have my uterus. I brought this baby into the world against the odds and I survived!
Gena may have spoken a little too soon. By late afternoon, the full effect of the spinal block and narcotics had worn off, and even though I was on Percocet I was in so much pain I shook violently. Usually a mom is transferred to the maternity ward a few hours after a caesarean, but it was decided that I needed one-on-one care. When asked how much pain I was in on a scale from 0-10, I reluctantly said 9—because surely a 10 would be reserved for an amputation—but I was in so much pain I could barely breathe. I couldn’t cry out or even grit my teeth because they chattered with the adrenaline of being in so much pain. I felt like I’d been hit by a truck, and in a sense I had been: having someone’s hands, no matter how skilled, rummaging around in your abdomen for almost three hours really fucking hurts afterwards.
I was desperate to stay on top of my pain because I wanted to breastfeed and knew pain inhibits milk production. Gena paged Dr. A, the anaesthesiologist. Together, with my husband, they agreed that I would be given morphine via a Patient-Controlled Anaesthesia (PCA) pump. I could dose myself as frequently as every 20 minutes, just by pressing a button. It sounded like a fantastic plan.
Meanwhile, I was moved out of recovery to a private room on the delivery ward so I could receive one-on-one nursing care. Gena tried to help me transfer to a proper hospital bed, but I screamed with the pain of being moved and I hated the sensation of the catheter tapping against the inside of my bladder. I begged to stay on the recovery bed, so that’s what I slept on that night.
After getting settled in my new room, I was hooked up to the PCA pump. Gena threaded a tube under my nose. It looked like the kind that would deliver oxygen, but it had a little flap that covered my filtrum and bumped against my upper lip when I spoke. The flap measured my C02 output, because morphine can make you forget to breathe. If I stopped breathing, an alarm would be triggered. It was a clever device, but that little flap was really irritating.
The morphine kicked in, and a few seconds later I could feel my body relax with exhausted relief that the pain had stopped. I had a moment of lucidity before sinking into a haze that I had a baby who needed to be fed. I began to worry that my milk wouldn’t come in, so asked my husband to call my friend, E, who had generously offered me some of her pumped breast milk if I ran into problems and wanted to avoid formula-feeding V.
I wasn’t expecting to see them that evening, but E stopped by with her husband and their baby, bringing with them 100 ml of her breast milk and a giant bunch of pink and purple wildflowers. It’s hard to talk when you’re high on morphine. I was sluggish, irritated at having to repeat myself multiple times, such was my slurring, and hated the feeling of the C02 monitor, like a heavy feather stuck to my lip. But I was overcome with gratitude. I tried to thank E and remark on how much their baby had grown, but I was otherwise a passive listener to the conversation.
Morphine is a strange drug. In that darkened windowless hospital room, every moment felt like it was 1.00am. It was like I was having an out-of-body experience—present, but not really there—and it obliterated my memory except for the major discomforts.
The catheter sat uncomfortably in my bladder and against my thigh. I was so incoherent on morphine, no one really understood what I meant when I said my leg hurt, but the thick scab I had a few days later told me I’d been writhing in so much pain that the tubing had rubbed against my thigh and caused a deep blister. (Three months later, I could see its faint scar, a slight darkening of skin.)
But it was the itching that got me. It was like I’d swum in the ocean and let its saltwater dry on my back for days. Scratching only seemed to rub the “salt” deeper into my pores. Mika, the night nurse, appeared with a cool washcloth and wiped my back. (Morphine makes you sweat, and it irritates your pores.) I craved those cool washcloths as much as the water I begged to be allowed to drink. Later I was allowed sips of apple and orange juices in tiny cartons, but I gulped them down and asked for more. I also asked for food, but Mika said I needed to wait until breakfast.
I was aware that V also needed to eat and that my husband had to be the one to feed her. I wanted it to be me but gave in to the circumstances—namely, I was too high to hold her safely, and I was too high to be upset about this. We decided not to use E’s breast milk. Her gift took the pressure off me—but V had to be taught how to eat, which meant that temporarily using formula was more convenient. With his mom’s encouragement, my husband cradled our baby and held a syringe with two teaspoons of formula in one hand. He wore a glove on his other hand and put a finger in V’s mouth. When she sucked, he delivered a little formula via a thin tube that was pushed inside her mouth. This is how our daughter learnt to eat.
That night I kept awakening in pain, but the morphine kicked in quickly. I wouldn’t say I slept—an artificial coma is more apt—nor did my husband, albeit for entirely different reasons. He confessed to constantly checking to see if V was still breathing, and even took her into the brightly lit bathroom to prod her. It was, for him, a stressful night after a long and harrowing day.
The Next Day
By daybreak I was itching all over, had a parched mouth, and was ravenous. I agreed to be taken off the morphine as I needed to be transferred from the delivery ward to the postpartum ward after breakfast.
Moving from one bed to another was pretty ghastly. I raised my hips and inched my bottom to the edge of the bed. I grabbed the handrails for support and shifted my upper body over. Panting and shivering, I did it again to get right to the edge of the bed which was flush with my new bed. I didn’t care that my MIL was in full view of my vagina. Right then, I had one goal, and that was to get to the new bed, dammit. It was the shortest marathon I never trained for.
In my new bed and off the morphine, there was no better reward than to have V placed in my arms to breastfeed. I was given a silicone shield to help elongate my nipples and was transfixed by how this tiny creature rooted and latched. She sucked furiously and I could see that I was delivering colostrum. After nursing her, I pumped for the first time. I suddenly understood why colostrum is nicknamed liquid gold. I pumped a total of 5 ml and the nurse was impressed. I didn’t know then that a teaspoon of colostrum was a highly unusual amount to produce after losing so much blood. I never expected to be able to breastfeed, so one of the proudest moments of my life was to see that my body was able to produce food for my daughter.
Breakfast arrived and I was ravenous after not eating anything for 32 hours. When I was finally allowed to eat and drink, there was no stopping me! It wasn’t the best food of my life, but I was reminded of the bowl of cornflakes I’d enjoyed in October 1996. The cornflakes were stale and the milk powdered but, after sailing through a Beaufort 10 storm in the Indian Ocean, that bowl of cereal eaten perched on the rigging of a Chinese junk is the most memorable breakfast of my life. Cramming bland hospital eggs and a Dole fruit cocktail cup into my mouth after weathering a different kind of storm comes a close second.
After breakfast it was time to move to the postpartum ward. The little Violet burrito, swaddled and in a hat, was placed in my arms, and we left. It was like being on the red carpet—everyone we passed stared and smiled at us. I held my baby close, at once fiercely protective and wanting to proudly show her off. So this is what being a Mama Bear feels like.
A couple of floors up was the ward where Violet and I would spend the next four days (healthy babies room in with their mothers at my hospital). I was disappointed to see that ours was a semi-private room—meaning I might have to share it with another family—but our day nurse, Emilie, said that she was going to try to keep it free for as long as she could. “After everything you’ve been through, you deserve a nice big room,” she said. True to her word, we had the room to ourselves for our entire stay, which meant my husband got to sleep in a proper bed every night.
Once settled, the focus shifted to breastfeeding and bonding. My MIL stayed with us, but my FIL excused himself because my breasts were constantly on display. There was a constant cycle of feeding: nursing supplemented with formula delivered via a syringe; pumping after nursing, making sure to get every last drop from the apparatus—even the drops from the bottle’s membranes were wiped off and onto my nipples to protect them; bottle-feeding the pumped colostrum; then my MIL or husband would wash up everything, just in time for the cycle to start over again. I held V to my chest, skin to skin, and took selfies.
I plucked up the courage to request that the catheter be removed. I knew this would mean I’d have to haul myself out of bed to go to the bathroom, but I also knew that the sooner I did it, the swifter my recovery would be. Once untethered, I got up for the first time half an hour after taking Percocet. I declined offers of help because others’ pulling felt too unpredictable for my battered body. Placing both hands behind one knee and then the other, I carefully bent my legs, raised my hips, and moved to the edge of the bed. I grabbed the handrail and pushed myself upright. Hands behind knees, I lowered my legs until I was sitting on the edge of the bed. I took a minute to catch my breath. I asked my husband to help me stand by pulling me up by my head. Standing, I was bent double and had to lean on my husband. My belly was on fire, and the area around my incision had a kind of tugging pain. It was only a few steps to the bathroom, but I made my way slowly. It took about a minute for me to reach the basin, another minute to pull down my mesh underwear, and another to lower myself onto the loo seat. When I got back into bed, I was triumphant and exhausted. I knew the first time would be the worst time, and I had done it.
Two days after V was born, Dr. D stopped by. She couldn’t believe how well I looked for someone who had had a pretty serious c-section, and was astonished to hear that breastfeeding was going well. She reiterated what others had said: that losing up to a litre (two pints) of blood during a c-section is normal; that up to two litres was unusual; but 3.6 litres was utterly unheard of. I was pleased: I wanted her to know that I felt well looked after in her hands and felt that seeing me bounce back was the proof.
Dr. D explained that the reason for my blood loss was placenta accreta. She quoted me from the prenatal visit where I said, With my habit of falling into tiny statistics, if anyone is going to have any surprises on the day, it’ll be me. The way she said it, it was like she was haunted by my premonition. The truth is, I had this feeling throughout my pregnancy that I had placenta accreta. I kept asking about it, complaining that my cervix didn’t feel right. Dr. D said, as she had done several times during my pregnancy, that my many ultrasounds had ruled it out, but my hunch proved correct. I was shocked to think my intuition trumped ultrasound technology and medical opinions, but not surprised at how in tune I am with my body.
During Dr. D’s visit, I heard my husband recount his version of the events in the OR for the first time. I knew that it had been a horrific experience for him. I must have looked terrible with my eyes rolling back in their sockets, and two days later my skin was still a chalky white colour—but although it’s the closest I’ve ever come to death, I never thought I would die that day. But he couldn’t have known the conviction I felt. When he got to the part about being asked to leave the OR, his voice broke and he began to cry. Unable to reach over to him, I watched his face crumple as he apologised for the pause. Dr. D put her hand on his shoulder and reminded him of what she had said at our prenatal visit—that in some ways, being the support person in the OR is far more traumatic. She shared that her husband had been freaked out when their first daughter was born. Something about her birth required that she stay in the NICU overnight and she had a tube going into her scalp which her husband found very upsetting. I am very lucky that my OB is as compassionate as she is skilled.
Dr. C, our paediatrician, also stopped by on her way home from church. I was touched by this, because it meant that she had made a special trip in to check on us. Dr. C told us when we first met her that this was something she liked to do, but I began to get the impression that the story of V’s birth was making the rounds. You lost 3,600 ml and you seem to be recovering extremely well. And how amazing that you are breastfeeding! I found this consistent praise quite empowering. My genes may have failed me, but my body hadn’t.
It seemed that the next comment was always about V’s hair. A common refrain was Look at her hair! so I looked at her hair. It was a bit like the colour of earwax—orangey and golden. At first I was taken aback by the red, so unlike anything I’d seen in my genetic family. I thought of a story a schoolfriend shared about her birth—her dad sighed, “Oh no, she has red hair…” Perhaps his was, too? I wasn’t sure why anyone would have been disappointed to see her lovely red curls. I looked at my daughter’s little mop of messy hair and, foreign though it may have been to me, thought it was extremely pretty. But as Emilie showed us how to hold V and wash her hair under the faucet, I asked why everyone kept commenting on it. Emilie explained that most fair-haired babies are born with very sparse hair, if they have any at all. I was pleased. I’d been born with a full head of hair, too.
Monday was when I began feeling like myself again. I’d thought that pregnancy had pushed my body to its limit, but recovering from losing a gallon of blood during a three-hour-long caesarean tested me in other ways. Yet, if I had been physically able to, I’d have been bouncing off the walls in spite of the sleep deprivation. There’s something to be said for hormones. Oh, and coffee for the first time in almost two years probably helped. Being the ham I am, I took a goofy photo:
Learning to Breastfeed
Monday was also the day I met with a third lactation consultant, Carole. I was reliably producing colostrum at this point, but it was Carole who really put me on the path to exclusive breastfeeding. She showed me how to massage the hard knots of milk out of my breasts, and it was she who devised the feeding schedule: nurse with supplement formula in a syringe every three hours, then bottle-feed whatever I was able to pump from the end of the previous nursing session. How those first pumping sessions hurt, but how happy I was to see my efforts rewarded!
A few hours before we were discharged, Carole weighed V before, during, and after a feed to calculate how much colostrum I was producing. To her amazement, V had eaten 37 ml (1¼ oz) in one feeding session—an amount which twice appears in my medical records with a exclamation mark! I cocked my head and asked if I needed to supplement with as much formula. Carole’s response was to tear up the note card with my former breastfeeding instructions. Somehow, in spite of a history of IVF (the donor eggs part is irrelevant), chest surgery, being over 35, and, most critically, losing a massive amount of blood, I was exclusively breastfeeding on the day of discharge!
I dressed V for the first time: a white onesie with a blue cherry print. I sat in a wheelchair and our discharge nurse placed Violet in her car seat on my lap. I covered the car seat with a muslin cloth to protect her from germs in the elevator and from the bright sunshine outside. I thought about the last time I was wheeled out through the hospital’s sliding doors—after my D&C, flatter-bellied and with no baby—and was so thankful. I’m a mother. I’m alive. I’m a mother and I’m alive…
At my first postpartum checkup ten days after delivery, I thanked Dr. D for getting both V and me out the OR safely. She replied that she was glad she was there, that it was not something she would have wanted to hear about from someone else. I am reminded of how important it is to have a doctor whom you like and trust, and who likes and respects you as a patient.
At my second, six-week postpartum visit, Dr. D explained that the pathology report on my placenta diagnosed villitis, which can cause IUGR. If I get pregnant again, even with normal placenta presentation, it will be considered a high-risk pregnancy accompanied with frequent ultrasounds to make sure the baby is growing well. The most realistic scenario is that we do a FET, the pregnancy is closely monitored, and I deliver at 37 weeks via planned caesarean-hysterectomy.
I wished Dr. D happy holidays, but it wasn’t until after she’d left the room that I realized it would to be a while until I see her again. In fact, it’s the first time in over a year that I’m not seeing a doctor or nurse on a very regular basis. It was strange to be released from my RE, but stranger still to be released from my OB/Gyn. All this time spent getting and staying pregnant, the dozens of ultrasounds, injections, blood draws, the thousands of miles driven to and from appointments, the money, the soul-searching…it was over. Just like that.
Fourteen and a Half Months Later
Violet is now about fourteen and a half months old. She’s toddles around, babbling happily. She cuddles dolls, names objects in books, and plays by herself quite happily. She’s happy and healthy. Sleep is our main problem these days, and what a great problem to have! She has a vocabulary of around 20 words, 12 of which she uses consistently, and is able to communicate her wishes fairly well. She understands so much, it blows my mind. When she wants something, she points to it and cries, “Dat! Dat!” When she doesn’t want something, she shakes her hand and says, “No dat!” She eats almost everything from goat milk yoghurt to crab to broccoli, and is especially fond of raspberries, peanut butter, and meat. She has let me know that carrots are best fed to mama and that ratatouille is disgusting. In spite of the odds (which one lactation consultant put at one in a million), I exclusively breastfed Violet for the first seven months of her life. And almost 15 months later, I’m still breastfeeding (albeit only a few times a day). After miscarriage, infertility, and even learning that genetic children are not possible, being able to produce milk for my daughter has been incredibly healing. I have restored faith in my body.
My family says I’m a different person. Calmer and happier. Clearly, my daughter brings me so much joy. They’re not wrong, of course. But I think miscarriage and infertility have made me a better parent than I otherwise would have been. My struggles have taught me to be more patient. My frightening delivery has taught me that life is precious. I don’t sweat as much of the small stuff as much as I used to. I am stronger.
My daughter is strong, too. At her 12-month check up in early November, she was almost 32 in (81 cm) tall and weighed 25.5 lbs (11.5 kg). People regularly think she is two years old and when they find out she’s only 14 months old, they smile and say, “She’s going to be tall like her mama!” Maybe so. Though she won’t have inherited my tall genes, it’s very possible that, epigenetically, my height will influence hers. I’d like that. I doubt she will be as tall as I am [6 ft (184 cm)], but I have a feeling she’ll be tall, the same way I’ve always known she is a determined and plucky creature.
Because I’ve known my daughter is strong from the two pink lines that immediately darkened and brought tears to my eyes; because of the 28 eggs we inseminated, 21 fertilised; and of the 21 embryos, there were always two that were always slightly ahead of the rest. By the day of transfer, 14 embryos had survived 6 days in a petrie dish and had been biopsied for genetic testing. Ten came back normal. But it was Embryos 3 and 4—male and female, respectively—who were fully hatched and transferred to my womb. Embryo 3 didn’t make it, but his sister, Embryo 4, clung on for dear life.
Because I knew the day after transfer I was pregnant. Like I knew she was a girl the moment that I first saw her embryo heart beating inside me.
Because, despite the odds, Violet is here and, as she has done from the moment of her conception, she is thriving.