Lump n Bump

This is the messy part. Childbirth cannot be retold without the mention of blood and other fluids, so this is your trigger warning. I’ll tell it from my perspective, and for me it wasn’t too gory. Watching it happen was different, I’m sure.

I cling to the slick black bench of the Humvee with my right hand and mangle the lap belt with my left. I swear that safety strap will forever have creases that my first ironed in there. People have offered to me their hand while I labor with contractions. I have always declined (I almost wrote politely declined, but I’m certain it more accurately comes across as me rudely swatting their hand away; but I know that swat is far more polite than bruising their bones).

I assume we are headed to one of my two my chosen hospitals, one where my doctor practices, one where they have access to all of my medical records, one where there is a labor and delivery department. I hear them say “reroute to Kenmore Mercy Hospital” and I roar No into a contraction. Forty eight hours ago the OB literally told me straight faced with wide eyes do not go to Kenmore Mercy; they have no means to care for a pregnant mother or a fetus or a baby. I had no say in the Police’s course of action. I was trapped in a war relic in a blizzard that had already claimed several lives. Could I be two more?

I breathed. I exhaled. I buried my fear under the strength of millions of laboring mothers before me. The contractions centered me. There was no room for panic or distraction or anything beyond the lives I carried.

It took three times as long as a normal drive would have on a clear day. There were no cars on the roads, that wasn’t the issue. Thankfully our town has a street parking ordinance that bans cars from parking on the street overnight from November to April. This kept the armored vehicle from crashing with any cars, but the visibility was zero from the whipping snow. Frequently we had to stop and wait for any landmark to appear out of the whiteout to guide us forward. The experience was not unlike what was imagined in the 2004 movie “The Day After Tomorrow.”

We arrived. I estimate that it was close to 11am now. The stairs descend and I practically drop down them. Two police officers drag me into their arms and pull me to the emergency room doors. Police pry open the automatic doors and I heave with contractions.

A wheelchair is waiting for me six steps in. I sit crunched into a ball as small as my body can go. I am wheeled into a large room and the lights are bright. I am undressed by strangers’ hands and a hospital gown is pulled over my front. I clamber onto a narrow gurney and grip the rails on either side.

The effective moans with each exhale was disrupted by all this movement, I teeter on the edge of screaming again. The noises coming from me are a ragged rah-rah, opposite gasps gritted through my teeth. People are all around me. Gowned in yellow gauzy trauma aprons. Spinning, tense, anxious, panicked. This place supposedly has not seen the likes of me since the year 1980. They are not necessarily equipped for childbirth.

I keep hearing the nurses and doctors reference a kit, a labor and delivery kit or something. It seemed to me that there was a box of medical supplies designed for childbirth unpacked from the recesses of some dusty old medical supply closet. It even came with a large antique infant warmer. That busted old stainless steel thing looked like, and sounded like, it was made 30 years ago. It certainly had no sticker marking the date it was last serviced like what I see at the shiny new Oishei practice.

Dr. Jordan entered the room, gowned, gloved, and checked my cervix. 3-4cm. Doc had me push a little bit. Halfway effaced. I contracted again. His hand withdrew and he asked my name. I could only spit out Bri. Doc offers me some morphine, I dither for two seconds because of decision fatigue, and then I realize that this decision is easy. Yes, morphine, yes. He spoke confidently and transparently to his team and I. He wanted me out of his ER, I also wanted that. Between contractions I tell Dr. Jordan that I cannot promise to keep this baby in. We affirm that this is my second baby, my second vaginal delivery, so labor will go fast. Time and resources and weather are not on our side. If I’m getting out of here, many people have got to move mountains and work miracles fast.

My medi-port is accessed quickly. I get morphine. They find two more veins for backup access. I can’t imagine why the port access would fail and another peripheral vein would save my life, but I comply nonetheless. Its easier to find stillness with the morphine shielding me from the pain.

A short while passes, Jordan checks my progress. Still 4 cm. More discussion of the delivery kit contents. More contractions, I’m back to good laboring breaths. Morphine helps. Oh, it helps so much. I’m almost relaxed. I recall some moments between contractions when I felt so calm and light and tingly all over. I felt nice throughout my body. I remember wanting to find the right words to describe it here in writing, but now it feels like the details of a dream slipping away.

Rich is assigned to watch over me. Other nurses volunteered to monitor me. I did not hear Rich speak up. In fact, his silence felt very loud once it was decided that he would stay in my room to time my contractions; he was the only nurse who didn’t have any other patients in the ER right now. I sense that he wished he did. Rich and I did great together though. Rich told me to tell him when contractions started and stopped, I nodded. He wore a navy blue sweat band to keep his hair back and a surgical mask to protect me. Rich told me to tell him if I felt an irresistible urge to push before pushing. I promised to make this a textbook delivery.

Dr. Jordan returns and checks my cervix. 6 cm. Doc leaves again he calls to update Nick and see about getting me transported anywhere else.

For Rich, time moves forward in increments of three minutes, sometimes ninety seconds, then closer and closer together. For me, time doesn’t exist. I rock my knees side to side, and I tilt my pelvis forward and back, willing my body to loosen up and make room for new life. I’m not scared until the pain creeps back.

I notice the anxiety after I hear my own laboring breaths come out as frightened little whines several octaves higher than the good low controlled moans. It was a brief out-of-body experience where I recognized the change in my head. I say out loud, I’m anxious again. I need– has it been any time since I got morphine? I haven’t outright asked for more pain relief, but this tentative question is progress for my personal growth. The Brianna I was a year ago could not have identified the rising anxiety. The version of myself three months ago also might have had a panic attack just contemplating the need to ask for morphine. The Brianna in counseling just one month ago learned that its okay to ask once and try asking again for the medical care that I need from the people who can provide it. Luckily, on this day, in this crisis, I only needed to mention pain relief to conquer this fear. Progress, people, this is self-improvement in advocating for my own care.

I get more morphine. I become detached again from the worst pain, and I resume my safe breathing. Dr. Jordan returns to check my cervix a third time and as he gloves up he tells me, I have the national guard almost ready to transport you. I gasp and shake my head. The water’s broken.

There was a huge gush between my thighs. There was no holding it back, it was a huge amount of fluid. Far more all at once than I ever experience laboring with George. I tell a nurse to my left, Rich is gone, she peeks under my gown, she goes rigid at the sight and lays the paper sheet back on my lap. I ask if its bloody. She confirms. I don’t know what blood means medically, but it definitely means I am delivering a baby in this room.

Dr. Jordan checks me again, yeah, she’s here, she’s crowning, I feel the head. Fully effaced, all dilated. We’re ready to push. I’m completely frightened now. Doc tells everyone in the room to grab her legs and– he pauses for the right directions —hoist them to my ears, I finish. My legs are held up, I’m flat on my back, I’m gripping the gurney hand rails because my life depends on it. Suddenly I pause the room, ask them to wait, I’m not ready, I’m anxious, I’m afraid. Its was futile pleading with the universe. And then another contraction came. I told them to get ready. I took a deep breath and pushed. Amniotic fluid and blood poured out fast.

I felt my daughter’s head nearly slide out. I felt her shoulders twisting inside of me. It was slippery and strange. I stopped pushing when the contraction ended. Everything paused. I caught my breath. I think Doc encouraged me to keep pushing. I ignored him, because I knew to push only with a contraction, otherwise you’re just burning energy.

At the beginning of the last contraction I inhaled. I warned the room, get ready, and my knees were hefted to my head as I bore down. It peaked just a second later, I felt her head, her chin and then her whole body immediately slip out.

I gasped, this was new to me. George had been different.

Dr. Jordan held Ellen Rose over my body just out of my reach. I kept insisting that I have her. Lay her on me, I need her. She was quiet, not crying, but moving. I only wanted to touch her, have her feel my breathing. I didn’t understand the delay, but I got her. She wiggled and slid against my skin, I held her tight and my daughter snuggled against my body. If you know the feeling, you know. If you don’t, you don’t.

Soon she was handed off to be wiped down and evaluated on the Apgar. Grimace, yes. Fingers and toes, yes. Breathing, yes. etc. etc. a nine! I listened intently and tried to watch. I didn’t have my glasses and people stood in my way. I closed my eyes and sank into the gurney. The placenta still had to come.

My placenta! I need that! Save it. For research, it must be preserved and sent off for testing for chemotherapy and cancer research. But I still had to deliver it. When I shouted out about the placenta I made a couple nurses jump. They were on it. It would be saved, they reassured.

Everything became very hazy at this time. I felt numb and empty. I touched my abdomen. It felt so sloshy and soft. Nothing was happening. No more contractions. Dr. Jordan had me push, all that accomplished was a wave of blood. And exhaustion. I stilled. Dr. Jordan was speaking to people reassuring them that all was needed was steady traction on the cord and placenta. My body was so heavy and pushing felt so futile.

I’ve no idea how long this lasted, but finally the placenta came with one little contraction. It was saved and stored away safely. I realized I had not torn at all. The inside of me felt cut up and bruised, but no stitches were done.

Nurse Kris, I had caught her name, was at my side frequently asking if I was okay. I kept snapping my eyes open and telling her yes, until I couldn’t open my eyes and sighed no. When prompted I said that my blood, my sugar feels low. I felt someone prick my middle finger and test for glucose. I never heard the result, but no one discussed it further.

I had given birth vaginally, without an epidural, at 35 weeks and 2 days’ gestation to a breathing daughter. My birth plan was almost complete. I just needed to make sure that I still survived. Doc had gone to update Nick on the phone. When he returned he was muttering about still hemorrhaging. How much blood loss? That’s a bit of blood. I wanted to feel scared at those words, and I was a little frightened, but emotions were just too heavy. Eyelids were too heavy. Arms were too heavy. And the room was very dark.

What had happened was I had simply lost a lot of blood. I felt woozy from blood loss. I knew I should be worried about it, but worry was too heavy, too.

Doc was in and out of the room, calling for the 5 minute Apgar score. Ten! I knew that wasn’t real, tens don’t exist in real life, only the textbook. But it was reassuring that these people were happy with my daughter’s vital signs. Dr. Jordan asked how I was doing. I couldn’t answer, a nurse said I was still pretty tacky. I know what that means; it means my heart’s rhythm is not right. I heard doc consider ordering blood transfusion because even though the placenta was gone, I still was bleeding quite freely. I nodded and managed to mutter that I had got one in October, yes please. He delayed the order because he was worried about a bad reaction. We had a saline drip and Pitocin hooked up instead. I felt a little better with the volume of my veins being puffed up with saline, and with my uterus working to stop bleeding. But I knew blood was important to get inside of me. What if chemo had damaged my ability to make blood? I readily agreed to the medical consent, and boy was I glad I did.

Thank you to everyone who has ever donated blood. Someone out there helped save my life, saved Ellen and George’s mother and Nick’s wife.

The next thing I knew it was close to 5 o’clock. Kris was sitting in the room with Ellen and I. We were waiting on word for transportation to a hospital with a maternity ward. Suddenly I remembered that I needed to get sertraline, Zoloft. I practically shouted it, I startled Kris, and she was on it. The order was placed and I got my medicine right at eight pm like usual. I also got dinner. Ziti with red sauce and ice cream and a dinner roll and ginger ale. They also hooked me up with snacks.

I was popular. The danger seemed to have passed, staff all wanted to see my daughter and congratulate me. I regret not holding her this entire time, but now, come to think of it, while I was still getting the blood transfusion, it was probably best.

Come nighttime the storm still raged outside, and Ellen needed sleeping arrangements. I did several clever things to help her and help myself. I got tons of pillows, and nested them on either side of me. I was cocooned on my back. I also had Kris invert the gurney just slightly so my feet were propped up, we also put pillows under my legs. Then I held Ellen on my chest all night. We slept and fed every three hours. My team of nurses made sure to bring Ellen a bottle of formula right on time. Ellen Rose Russell has an excellent suck, and latched on the bottle immediately.

I was delighted to be left alone with my daughter on my body that first night. I was very sad that Nick was missing out, and worried that George was still scared, but I bonded with my second child so intensely on Christmas Eve that I will not have any regrets about the circumstances.