Friday, June 3, 2011

From worry to wonderment: The birth of Sloan Elizabeth

This was not my first birth. Nor my second. I had two, lovely healthy, totally natural, unmedicated births prior to this one. So, with uber-confidence, I began making plans for a home birth. I consulted a midwife whom my husband and I trusted, and went forward with his support and the total freak-out of many others.

The pregnancy was normal - if you count desperate nausea every afternoon until bedtime at 7:58 p.m. as “normal.” I had two boys, who were three and five during the gestation of this little one, and I had a feeling that this might be the mythical girl baby for our family. At the 20 week ultrasound, our whole family piled into the tiny room and awaited the news of the baby's health and gender. We saw ten fingers, ten toes, the total wonder of a perfect spine and unquestionable evidence of the gender. She. Her. There she was. Our baby girl. She was beautiful, healthy and very busy. Tears of joy streamed down my face as we caught fleeting glimpses of her profile, saw her tiny fists punching and little feet kicking. We left confident and happy. Our baby had an identity: Sloan.

I floated in a little pink cloud for the next week, lingering in the girls' clothing section at Target, doing online shopping for impossibly small swimsuits. Then, the call came. I was in my office, and it was 9:00 on Monday morning. The perinatologist called with the results of a second trimester blood test that they had run. Everything was fine until she said, “The results for chromosomal abnormality are positive.” Positive? According to the bloodwork, my fetus was showing a 1/270 chance of an abnormality. They brought me in almost immediately for another ultrasound to do an anatomy/growth scan. There she was, tiny Sloan, bopping around with her gorgeous fingers, toes and perfect spine. But, her head circumference was small. So was she. These are soft-markers for Down Syndrome.

This began a 20 week period of Great Anxiety. In this time, I was writing, editing and turning in 100 pages of work for my final interviews before ordination as a United Methodist Elder. I’ve had more stressful times, but … actually, no. I haven’t. It was awful. I wasn’t sleeping well, wasn’t eating well, wasn’t resting well, wasn’t parenting well. I had good days and bad days, but mostly things blurred into a wintery haze of gloom. Every four weeks, they would bring me back in for an ultrasound. In February, her body and head were still measuring small. In March, her growth scale percentages went up a bit, but the concern for microcephaly remained. On Good Friday, of all days, we had another scan. Lo and behold, she had grown to 31% for weight (pre-emptive HALLELUJAH!), and though her head is still below 10%, she seemed just fine! I asked the perinatologist what might cause a small head, if not a chromosomal abnormality or something distressing.

He said, "If a parent has a similar constitution."
Me; "You mean, because I have a small head?"
Him: "I didn't want to say anything, but... yes."

May didn’t yield anything new, except an additional worry about low amniotic fluid. I had long since booted my hopes for a homebirth to the curb, and was proceeding with a midwife at a local hospital.

In the meantime, in between all of the ultrasounds and interviews, I was approved to be ordained on June 13. My due date was May 28. Both of my sons had been overdue (9 days and 5 days), so I wasn’t expecting her to tromp in two weeks early. My dearest friend had asked early in the pregnancy if she could be present for the delivery. I enthusiastically agreed (and so did my husband). The only catch was that she lives in St. Paul, Minnesota, a whopping 1,123 miles away. We gambled a bit on when she should arrive and chose June 2, 4 days after my due date.

My due date (a Friday) came and went without any stirring. I was uncomfortable, eating Tums for dinner, and enduring some whopping Braxton Hicks contractions, but that had been the case for 13 weeks or so. The baby was very low, very busy, and taking her sweet time.

The next day, the contractions seemed a little more regular and I lost my mucous plug. They took my attention away from other things (like barking at my children and watching TLC in peace. Wedding dress shopping is riveting!). I sent my friend a message, just to let her know how I was feeling. She sent back a kind response along the lines of, “KEEP THAT KID IN THERE FOR A FEW MORE DAYS!”

I obeyed.

Kara flew in, as planned, on Wednesday, June 2. Despite my attendance at a church kickball game (where I totally dropped a fly ball; I blame the belly), a Braves game and every last minute of office time that I could squeeze in, I was getting nothing more than very distracting preparatory contractions. So, we went for the gimmick: Scalini’s! My whole family, in our swanky new minivan, picked her up at the airport and drove north to Marietta where we had a tremendous Italian feast. I had every last bite of the Eggplant Parmesean, and we took crappy cell phone pictures to document the trip. I was overjoyed that Kara was here, and very ready.

That night, I felt uncomfortable but happy. The next morning, I lost all hope and joy. I suppose it was the pressure of having my friend here for a short time, and knowing that if the baby didn’t come soon, I would miss the opportunity to have her help. She was like a doula, but free. (Worst analogy ever.)

We had nothing to do and time to kill, so I made haircut appointments for the boys and Kara. We drove into downtown Decatur and settled in to our respective salons. As we were walking uphill from the parking lot, I felt really rotten. Something didn’t seem right. When I got the boys settled, I went to the bathroom to find that I was spotting. In retrospect, if you’re 40 weeks, 6 days pregnant, that’s not spotting… it’s your baby trying to get out however she can. It was early labor, but the labor of the unsettling sort. I told Kara, who looked ravishing with her new ‘do, and Matt came to meet us since my head was exiting reality and entering into birth-consciousness (HUNGRY, BABY, HUNGRY, CRANKY, BAAAAAABBBBY!).

All things considered, it was a very calm way to go into labor. Since I was having contractions about every 8 minutes, nothing seemed imminent. We had plenty of time to feed the boys, drop them off with friends, make arrangements for them to get to t-ball practice and pack the car with hospital necessities. I managed to eat a little bit, and Kara and Matt were completely giddy with excitement at all of the physical pain I was settling in to endure. Wait, no. The baby. They were giddy about the baby.

We arrived at the hospital at 1:30 and were delivered to the L&D waiting room.

We got sent to an evaluation room where they monitored my contractions (all in my back, every 8 minutes for 90 seconds). I was 3-4 cm dilated, and progressing well enough for them to keep me. So, I was admitted around 2:30 p.m.. Apparently, my shoes were not. (Seriously, I wound up leaving the hospital with NO SHOES.) I sent cheerful updates to Facebook and settled in to wait for the baby to show up. My other labors had progressed speedily once I was in “active labor.” So, this one was throwing me for a loop. I thought third babies would hustle themselves along in a right speedy fashion, so I expected that the contractions would pick up and we’d meet her by dinner time. Then, we’d have huge bleu cheese burgers and invite the boys to come meet her.

That was my plan, anyway.

They asked me to totter around the ward to see if the contractions would pick up speed. They did not. I was progressing, but at a frustratingly slow pace. By 6 p.m., I was about 5-6 cm but ready to get the show on the road, so I asked the nurse to break my water. The contractions never moved to my abdomen, but stayed in my back. It was manageable, but very uncomfortable. After my water broke, they came more frequently, with greater intensity but lasted only about 45 seconds. Progress.

I was clear that I wanted a natural delivery, like the first two. The nurses were amazing and honored that request, but they insisted that I have a port put in my hand in case I needed a quick IV of something. I denied their request. But, they pushed it. I finally acquiesced and they jabbed it into my left hand. Because of the back labor, I wound up being most comfortable on a birthing ball. I was rocking the contractions, relaxing through them and breathing slowly. I was a freakin’ Bradley Birthing home video. When the RN checked me, I was at 8.5 cm. That was at 7:30. I was optimistic! Still time for burgers and boys!

At 8:30, my contractions were still consistent, intense and steady, but my progress stopped. According to everything I’ve ever read and experienced, once you’re in the 8-10 cm stretch, things whip by with a timeless sense of purpose. Not so much this time. I got stuck at 8.5 cm for nearly 2 hours, breathing as steadily and patiently as I could through each whopper contraction and hoping that I was making progress. I groaned to the doctor who came by to check and see if he needed to put on his catcher’s gear, “can’t something be done to help me dilate?” He responded, “I can give you a shot of pitocin to make the contractions stronger.” I demurred, “I DON’T NEED THE CONTRACTIONS TO BE ANY STRONGER.” As a bonus, in moving from the birthing ball to the bed to be checked, my line came out. The only way I could endure the contractions was to lift myself up on my balled-up fists and the line wriggled out of my vein. Darn.

Finally at 9:10, I felt something new. I felt like I might like to push, so I tried. There was no going back. Either I was expelling all of my internal organs, or this baby was going to come out. With the boys, I’d pushed for nearly 2 hours both times. With Cooper, I’d had lovely conversations with my midwife in between contractions. But, back labor changes things. I was in a near-constant state of agony, even in between the contractions. My back was tight and hot, muscles strained beyond reason. I pushed as hard as I could, encouragement and help all around. Finally, at 9:40, I pushed out her head. Kara filmed the whole blessed event in ways that mostly maintain my dignity, and I can hear her telling me, “Mandy! She’s beautiful! She’s got so much hair!” I shrieked out one last contraction and out she came… ten fingers, ten toes, perfect spine, perfect number of chromosomes.

Sloan Elizabeth was born at 9:41 p.m. on Thursday, June 3, 2010. She was welcomed by a proud mama, daddy and two very excited big brothers.

You can also read this story at Pregnancy and Newborn Magazine: