Birth Story Round 2 - A Planned Cesarean
Around 2pm, triple taking the folded array of clothes laid out in front of me, I remembered the phone. I was untrusting of my ability to think of every possible weather scenario as I prepared my child’s things for the week at her grandparents. Toothbrush…sunscreen...rain jacket…Lovey…is my phone on do not disturb?
The following morning, I would admit myself to the family birth center for my scheduled cesarean. To date this had only filled me with resolve. The birth of my daughter, delivered via emergency cesarean on the heels of a long tumultuous labor and 10 hours of pushing effort, was physically and emotionally devastating. I could not endure that same outcome if I had another cesarean after a TOLAC (trial of labor after cesarean). My small rural hospital did not support VBAC (vaginal birth after cesarean) as an option, so I would have to have a home birth, or travel more than 2 hours to a larger hospital to attempt this. Neither of those scenarios settled well in me. Plus, this cesarean would be different, as expectation management is everything. I was prepared, equipped, healed, confident. I had curated my team of postpartum healing warriors; my village was stacked.
Yet staring at the sea of ponytail holders and tom’s toothpaste, I was suddenly overcome with doubt. This was surgery. Major surgery. They could injure the baby. I could clot, bleed out, or have nerve damage from the spinal. Holy shit, was I really ready for this? I was preparing to be cut open, sewed shut, and more frightening, to begin the healing process all over again. I had worked so hard, for 3 years, to mend my core and aching back. To find my way back to a body I could worship and no longer worry had failed me. This looming pre op phone call now dominated my attention as I grasped for straws of expectation. What time was check in? When did I have to stop eating and drinking? What was the order of operations? I scrutinized my packing list, unpacked, and repacked at least 2 more times. Finally, the phone rang. “Check in is at 5:30am.” “You will have a catheter placed.” “Your husband will wait in the waiting room while you are prepped in the operating room.” These were the most jarring pieces of information. Therefore, the only ones I can recall.
By the time I was wheeled into the operating room for my first cesarean, I was on the brink of life. Mostly figuratively. But I had reached a degree of fatigue that looked and felt like surrender. The rush of peppy nurses newly appointed to their shift, the fluorescent lights, the copious lines, the foley catheter, essentially went unnoticed. I had nothing left to give. I wanted, needed it to end. In all honesty, I was so destroyed that even the thought of my baby on my chest didn’t evoke emotion. I remember my doctor exclaiming “you are about to meet your daughter,” and it meant nothing. I just needed it to end.
I didn’t remember the separation from my partner. It was alarming to me that these memories were absent. What else had I forgotten? I zipped my daughter’s duffle as I hung up the phone. We dropped her off at my mom’s after school so we could have a quiet evening together and prepare for our early morning. Surgery was at 7:30 am, nothing per oral (NPO) after midnight. One more meal and I would meet my baby. I had recovered fully, grown to love my baby in the fiercest way imaginable. But now I was confronted with a procedure that had altered the course of my life, again, and this time on purpose. The sleep that night was not deep.
We arrived as instructed and entered through the emergency department doors. The halls were eerily discreet, something only noticeable in the absence of labor. I was greeted by familiar faces at the family birth center and escorted to a quiet room, on a quiet floor, with extraordinary views of the Collegiate Peaks. We made small talk with the nurses as they placed my first IV. My antibiotics were administered (standard for surgery, compounded by a positive group B strep test) as they took turns filling out a detailed health history and taking rounds of vitals. Then again, we were alone. My husband and I had time to unpack, settle into the room, even snuggle for 30 minutes. My anxiety had almost melted away. I knew this place. I trusted these people. We were about to meet our daughter.
This brief bliss was interrupted by the anesthesiologist who arrived to explain the procedure of my spinal injection, outlining that he would be monitoring my blood pressure and offering anti-nausea medication should I need it (I always need it). Then two new faces appeared who gently, though without clarification, prepared me for transport. It is surreal to be wheeled in a hospital bed when you are fully coherent, alert, well, and uninjured. I offered to walk. When we pulled into the surgical wing my husband was in fact separated from me. Alone, I was glided into the operating room, somewhere on the fringes of the time and space continuum. I was overwhelmed by the bright lights, blaring music, dance of bodies circling above me. As promised, the anesthesiologist began attaching leads to monitor my blood pressure, heart rate, and oxygen saturation. A nasal canula was donned to offer continuous oxygen as I was instructed to crouch over a pillow for administration of my spinal. The well-meaning nurse asked personal questions to soften the intensity, but I found myself muted by the tone of the room. I couldn’t find my air. One sharp poke for numbing. “Where are you from originally?” And another. “Is this your first delivery?” Then slowly returned to my vulnerable supine position. I felt the warm tingle of anesthesia flood my legs until I felt nothing. Then claustrophobia. There was no way out now. I watched as someone else’s swollen legs were lifted and rearranged over the knee pillow. They insisted they were my legs. Just then I was reunited with my husband who placed his warm hand on my left shoulder. He had changed into the button-down scrub top he fought for. Apparently, this was an unconventional request. However, we asserted that he needed to be able to have immediate skin to skin with our baby, as I would likely be unable to hold her. Why was this an accommodation and not standard practice? We would unpack that later.
Breathing through the heaviness of my confined body, my doctor initiated a “time out” and prepared the team for the procedure. I was relieved when I couldn’t feel the first puncture of the scalpel, now grateful my nerves went offline. The tugging and pulling were aggressive. My blood pressure dropped several times, a normal response to the medications. I stayed calm. When they reached my uterus, an elephant sat on my chest and a searing pain pierced my right shoulder. This was one of the most uncomfortable and suppressing moments – several moments – of my life. There was nothing I could do, nowhere to go. I had never felt so powerless. Why was I having surgery awake?! Then the nausea came (again, as it always does), and I began to dry heave until I tasted bile.
But briefly, the awareness of the discomfort was thwarted by joy and relief. The team, working quickly and calmly, rejoiced as they exclaimed “Hey, cutie!” and “Happy Birthday!!!” They gave my beautiful girl her bonified Simba moment as they held her in the air, dropped the curtain just enough, and revealed this beautiful being to us. We did it. She was ok. We could rest.
My nausea and crushing chest pain persisted through closure. Unable to quell the quivering of my arms, baby was placed on my husband’s chest, as predicted, and there she stayed until I was safely in the PACU and my trembling slowed. I loved her there. The nook of my husband’s chest is my safe place, and I knew it would now be hers. But the second she was placed on my naked chest, made her way to my nipple, and latched with exhilarating clarity and intent, I loved her even more deeply and immediately. She knew what she was doing. This time, as did I. We were soulmates. We got through it together. I felt something mend I hadn’t realized was cracked. That room of strangers were allies, all now woven into the fabric of my family. Now complete.
