Wednesday, October 29, 2014

Luca Baby! (Or There's a Reason it's called Labour)

Luca (who began his journey into this world on Diwali) was born last Friday, October 24, in Room 603 at 11:11 am, weighing 7 lbs 7 oz, on the third day of my thirty ninth week of pregnancy - and he is just magical - a pure gift from the universe. I would not describe the means I brought him into this world in this way. In fact, I would say it was exactly the opposite. But he is worth every sweaty, shaky, screaming second of it.

Everyone tells you to have a labour plan. I'm not discounting that you should figure out what you want and hopefully for your case you will be fortunate to be able to labour and deliver according to your chosen gospel, but in my case, the raised eyebrow of all medical professionals to my assertions of wanting a natural childbirth that accompanied their too prescient warning that the baby has its own plan and that quite possibly it may all go out the window, proved too true.

I opted to have my birth in hospital, although I would have preferred a birthing centre connected to a hospital (ie in the same building), not been so keen on a house birth in the knowledge that the number one cause of death for women until recently has been childbirth. I did however want to make the experience as natural as I could and enjoy the mystery of giving life. I had yoga poses and stretches all worked out and had dragged my partner earlier to a yoga message workshop so he would know how to help me labour through the contractions. I envisioned squatting, walking, stretching, labouring in the child's pose, in the shower (as our room would not have a bath), to the tune of Sanskrit chants, Tibetan bells and my hypno tape. Having experienced much pain in my life due to many broken bones and ligaments as well as a quick and dirty affair with amoebas, I thought I had it all down pat.

My confidence only increased when I started to get nightly contractions in week 37. These contractions dilated me by week 39 to 2 cm. They bloody hurt, but I could certainly deal with them. In fact, two days before I gave birth, I was working to finalize a motion I had to file late into the night through my contractions.

As always happens in my life, the universe took a turn to deflate my expanding head.

Week 39, Day 2, I had my usual ultrasound to check my little boy's kidneys. My husband and I ran in a mad rush to the appointment, having slept in, both of us up cramming against deadlines (I had just finished what I needed to do in order to give myself six weeks off and I wonder whether my son was being considerate enough to wait until this point to come into the world). We never found out about his kidneys that day as the sonographer took one look at my amniotic fluid, went pallid and said she was calling in the doctor to speak to us, without even waiting to finish the rest of the ultrasound. We waited in agony for the doctor to return and were surprised she came in with what seemed an indecently wide smile in the circumstances. "Today is the day!" she jovially said. She explained my fluid had dropped from 11 to 4 and in particular considering my son's possible hydronephrosis, there was no reason to delay. They were going to induce me right away. I asked to speak to my OB, in shock, not prepared to start labouring that day. I didn't even have my hypno tape!

Rather than induce me right then, I was sent home for the sole reason that the maternity ward was overflowing, with the warning that I should gather my things and return within the next couple of hours. My husband and I rushed home and scrambled to finalize my hospital bag, leading me to fall into tears because I could not find my Sanskrit chants nor my hypno tape. After I calmed down, my main concern was going to the bathroom, more worried about pooping in front of medical staff and my husband (as I have heard is quite common in labour) than the pain awaiting me. What a fool I was. Once the pain kicked in, I did not care in the slightest in front of whom I was bleeding, peeing or pooping. Later I found out that I did poo a little bit during the pushing and I was in too much pain to even notice. My husband assured me he was so freaked out about the deluge of blood that was coming out of me and more enraptured by seeing his son arriving (even though I had warned him to keep his gaze only north of the belly button!) to even care.

When we arrived at the maternity ward around 4 pm, it was an overflowing madhouse. There was a low pressure system over the city and the evening would see a solar eclipse. Whatever you may think about the influence of the stars upon our actions, it certainly seemed to have an effect on many a uterus in New York that day. We had to wait outside of the maternity ward as triage was overflowing and I took the opportunity to walk, naively trying to start a natural labour and avoid an induction. As I walked back and forth I saw a few women sweating and nearly screaming in pain as they entered active labour - a little foreshadowing of what lay in store for me- and were cruelly confined to the waiting room chairs. The staff kept coming out to apologize explaining they had no rooms nor even medical staff to deal with all the contracting uteri and that they were doing their best to the tune of heightened grunts and screams as I continued to pace.

Lovely M came with sustenance and an encouraging smile. They had ordered me not to eat but I snuck in food anyway as it looked likely that they would not even see me for hours in triage. Once in triage, they hooked me up to my prison of monitors and provided me with the most painful IV I had ever experienced - three hours and a bruised bump later I begged them to reinsert it. My contractions confused them- instead of a pattern, they appeared to come in sets, one overflowing into another and then a pause of sometimes nearly ten minutes before another series tried to conquer my sanity. I was then even more confident I could handle the pain as it was again confirmed that I was feeling the pain of actual contractions and able to walk and squat through them. This was going to be a cinch.

Hours later, my whole body shaking, bleeding down both my legs and crying, all I could handle was sitting, my confidence ruptured. At 10 pm they had inserted cervidil inside me. The insertion itself was really painful. They told me to lie still for 2 hours and get some rest as nothing would happen for 12 hours and then all the work would begin. Ha! As I needed to pee desperately, my son edging up against my exhausted bladder, my husband and I watched two episodes of Twin Peaks until I was allowed to pee. Then we said goodnight and settled in for much needed sleep before The Big Day. Less than one hour later, before I had a chance to take one wink of sleep, I was experiencing seismic pain rushing through me, my groans waking up my husband who had fallen into a deep, restful sleep and The Big Night began. 12 hours my arse. In two hours, I had started bleeding everywhere and was having one contraction after another, without break. My husband asked if I wanted the yoga massages, if I wanted to squat or do other poses or stretches with his help, if I wanted my chants on and all I could say through clenched teeth was that I didn't want him to touch me, that I wanted darkness and silence and didn't know what I wanted. I believe I kept murmuring I didn't know what I wanted as I sat in different positions, curled up, suffocated in my own surging pain. My bewildered husband didn't know how to help. I told him just holding my hand helped. Not knowing the strength of my grip, at one point, he politely told me that while he could handle my grip, if I kept pulling back his thumb, I would dislocate it.

Some time during this madness, my IV fell out and my husband grew pallid and called the nurse. "My wife's IV dropped out" he said shakily, "there's blood everywhere." I didn't care - I had been bleeding with each contraction down my legs, my husband at first scurrying to clean the floor until I growled at him that he should be more worried about me than the floor. At that point, my previous fear of doing dirty deeds in public had flown out the window. I would not have cared had I had diarrhea and it was all filmed and put on Youtube. All I could concentrate on, through the constant shaking and bleeding, was the pain. Each swell a tsunami of shattered nerves, hitting my pelvis, my abdomen and my back, which felt as if it were on fire(back labour - another gift of experience from the universe). The nurses intermittently came in to ask me if I wanted an epidural and I kept refusing. They constantly readjusted the monitors, which kept falling off. I asked if I could labour in the shower and they very nearly laughed at me. I could not be off the monitors for one second.

Hours later a new nurse came in and checked my contraction chart, her eyes growing wide. She said she would be back with the doctor in a minute. The overworked doctor came in, viewed the chart and immediately told me she was taking out the cervidil, which was another painful experience, causing me to bleed more.

By sunrise, I was defeated, near to collapse and crying. I gave in. I told my husband I had no more energy and would take an epidural. I was worried that if I didn't, I would have no strength to push. As we watched the sunrise over the Brooklyn Bridge in front of our window, I clenched my teeth through the pain, shaking so uncontrollably that I could not stand. "Isn't it beautiful?" my husband asked me. I nodded, having lost the strength to talk. It was as beautiful, brute moment of tortured sanity. I saved my last verbal effort to look my husband in the eye and sternly ask "where the fuck is this anesthesiologist? Call the nurse!"

I always read everything I sign. I'm an attorney. It's second nature to me. When the anesthesiologist came with her paperwork, I only looked at the signature line. She told me my contractions were too quick for her to wait for a pause and I would have to lie very still. I nodded. Just give me the drugs! The relief was almost instant. My nurse smiled at me. "There" she said, patting my shoulder. "Much more civilized now."

We later learnt that I was the only one that hadn't taken an epidural that night. My husband nodded, comprehending why I was the only one that people could hear on that floor. "They were probably all taking bets when you would give in" he laughed. I smiled stupidly at him, the drugs released into my system. I still felt the constant pressure, but no pain. He could have said he had an affair with a ewe and I would still have smiled up at him.

As against the epidural as I was, I believe it saved me from the C. From 8 am until half past 10 , when I began pushing, I could not sleep due to the constant pressure, but I could rest. My husband slept soundly by me, energized to be my chief cheerleader during the Big Push. By the time the doctor came in and said I was plus 3 (which I also wonder whether I would have reached had I not relaxed by taking the epidural, as the body clenches during pain) and ready to go, I had regained some of my energy. And boy did I need it. Pushing took all my strength and by the time he was out, I was out of it, screaming through my last three pushes.

I was confused when my boy came out silent. My husband was pallid and immediately left my side. I started to cry, not knowing what happened. My husband later explained that his shoulders had got stuck and that they had to resuscitate him, which explained all my tears. In a second, Luca was on my chest, looking up at me serenely with his enchanting eyes. It was one of the most amazing moments of my life - to have carried him and felt him squirming, hiccuping and kicking inside me, to have him so serenely looking up at me on my chest.

After my son was born, I had to push the placenta out and was surprised at how it looked - massive bulbous, iridescent. My attention was only diverted by the doctor preparing a massive syringe. "What's that for?" I croaked. "Nothing" she gently said. I nodded, not caring, looking enchanted at my son. "There's been an abrasion and some tears" she explained. I nodded and looked back at my son, my husband and I both crying with an outpour of insurmountable joy.

Nothing had happened the way I planned. Even the doctor on call, it being Friday, was the one doctor in my OB practice that I was not comfortable with - and yet, she was amazing - and it was right that the universe showed me once again that I was too quick to judge. Nothing in the end mattered but the fact that a new soul, part me, part my husband, born of our love, was looking up at me, lying on my chest and is now soundly asleep as I type away. I can't wait until it's feeding time again to pick him up in my arms and cuddle him. He is my other beating heart.








Saturday, October 18, 2014

Kidney Blues

When we had our 36 week ultrasound, we thought it would be a breeze. We were going to see how big our little guy was and considering the immense fortress of my stomach and that my husband was 9lbs 3 oz (4.167 kg) when he was born, we didn't think small. So we were not astounded that he was on the big size - measuring nearly 6 lbs (5 lbs 14 oz) at 36 weeks and nearly 8 lbs at 38 weeks (7lbs 10 oz) - we both felt the force of his kicks!

We however were very unpleasantly surprised to find out that all the organs of his urinary system showed dilation. The most gut wrenching part of our ordeal was when the sonographer, who had up to that point been very chirpy and garrulous, widened her eyes and became taciturn in response to me asking for her to check whether she could see two healthy kidneys. For the next half hour as she pursed her lips and looked stoically at the screen, we thought the worst. Before I had asked her to check the kidneys, she was checking his blood and we were both embroiled in stygian thoughts that our son had kidney failure or an issue with his blood. I tried to be calm and not cry, as it moved my belly and affected her exam, but they welled up and gushed out. My little guy! How could this be happening to him? And, why? I immediately started to wonder whether it was something that I did. Did I not drink enough water? Was it because I drank coffee and wine at times in my pregnancy? Was it because I had too much acid in my diet? Too much potassium? Was it because I exercised too much? Was it because I slept on my right side as often as my left? What kind of mother was I, that I hurt my son before he even came out of the womb!

I understand - particularly as an attorney- that the sonographer cannot voice their opinion and that you must wait for the doctor's assessment but the ordeal of waiting is agonizing, particularly as you can see the panic and concern on their face and so you think the worst and ask - are his kidneys OK? Is his blood OK? And the learnt response - "the doctor will be here shortly to explain everything to you" - that strikes at your heart with a bitter blade.

When the doctor finally came to explain what had caught the sonographer's eye and stunted her in a brooding silence, it was much better than we expected. He had moderate dilation of his bladder, both kidneys and ureters. The doctor explained that the organs were healthy and whatever obstruction he may have was not preventing him from peeing as my amniotic fluid was at a healthy level. However, he did warn that there appeared to be some obstruction and that either it would go away after he first peed out of the womb, he would need antibiotics or he would need surgery. He reassured me they caught it in time to avoid kidney failure. On further research, I found the odds were on his side. My doctor made me feel a lot better when she said patients that were dilated up to 20 mm (he was at 11) were fine after their first pee. In any case, I am going to watch his pee like a hawk and take him to the pediatric urologist to err on the side of caution. My (not so) little one!

We've been having weekly ultrasounds since then and so far his condition is stable. I have been trying to employ the art of biofeedback, visualising his urinary system working like clockwork, but I am not sure whether biofeedback transfers from the mother to her baby in utero. It can't hurt.

Once we knew his condition was stable, we looked at the tragic humour of it all. I had just finished writing the first draft of my novel, which centers around a spontaneously sentient kidney and a girl dying from polycystic kidney disease. It had to be his kidneys....I did briefly wonder whether my research and writing on kidneys, kidney diseases and their trafficking somehow was at fault - oh, the cruel caprice and connivance of the cosmos!

I suppose worrying is part of the package of being a mum and I've already started to metamorphosize into the worry bean. My center of gravity has also shifted (physically as well as emotionally). Yesterday I craved an iced coffee from a particular cafe and walked there only to spot their cleansing juices. I knew this was better for my son, so in I went with a tooth for coffee and out I left with a citrus ginger blast (which is also yummy). En route, I spotted earrings that I wanted to buy and went inside the shop ready to indulge myself, not having bought myself anything for a long time -apart from maternity wear- and left without earrings and with an elephant onesie instead. I didn't want to splurge on both, so without thinking, once I saw an outfit for him, I instinctively lost the desire for my little indulgence and indulged in the bigger happiness of buying something for him - I can't wait to dress him up in it! So that's the instinct of motherhood and how a girl becomes a protective and caring mama bear.




Friday, October 17, 2014

Water baby!

I only found out about water exercise in my 36th week of pregnancy and it has been the best thing I have ever done in my pregnancy. Now, I know what to do in my next pregnancy - it's amazing! Throughout my pregnancy, I have been continuing my yoga practice, attending only prenatal classes and continuing my pre-pregnancy ballet bar workout (although with increasing modifications) and in the past few weeks (despite my modifications) my joints started aching after both. It's fairly common for your ligaments to loosen up due to the release of relaxin and for your joints to ache in pregnancy and I was not surprised when it started to affect my old knee and wrist injuries. Water takes the pressure off your joints so you can have a great workout without any pain. What's more amazing is simply just being in the water when you're pregnant - or like me, very heavily pregnant (38 weeks and already 2 cm dilated!). I am so buoyant in the water now, due to to all the water in my body and it's a fantastic feeling. I also feel more connected with my son, with both of us immersed in water. When the class ends, I don't want to leave the pool! The other benefit of indoor pool classes, is that the temperature is always just right and you're out of the sun - I for one, found a day in the sun insufferable throughout my pregnancy, even though pre-pregnancy I craved the sun and beach.

I had to fight to get into the workout however. In fact I have never had more difficulty trying to throw money at someone before. I suppose it's a faint glimmer of what lies in store, since if we continue to live in the city, we're not only going to be forking out our income for good preschools (what's going on with your plan there, De Blasio??) but enduring a series of waiting lists and tests. Enrollment in New York starts as soon as you dip that stick in and see red. I've heard stories of preschools accepting DNA tests from foetuses for early enrollment. Apart from the waiting, there is of course the dire scrutiny of both you and your child. Many parents leave in a deluge of tears after being told that their John or Jenny just didn't make the cut - either their temperament didn't fit the school ("I'm sorry, he just appeared to act like an infant") or they didn't pass the test ("she just couldn't get the pattern right - it's obviously the purple trapezium in the black checkered background that slants to the right that comes next!). I decided to try one of these tests for kicks. It may be pregnancy brain, but even so, I even found some questions required strict concentration and I'm nearly 32. It was more than a little embarrassing to discover that while I have my undergraduate and graduate degrees from two of the top ten universities in the world, I most likely would not be able to enter an elite New York preschool. I'm going to keep that little fact to myself. The harsher afterthought was that if I couldn't make the cut, how could my two year old?

I could of course always beg and connive my way through - just as I did with my water workout.

I spent over forty five minutes on the phone trying to convince the owner/instructor to let me enter. She wanted to know about my health, about my exercise routine, about my career, my personality and how I found out about the program. This is one business that does not covet clients (we come grovelling!). They do not advertise and keep their classes small (max 10 to a class). I started perspiring when I was asked how I found out about the classes- friends can let friends in but how wide was their definition? Is a girl I've spoken to only a few times in my prenatal classes sufficient to encompass the "friend" that holds the key to the most amazing workout ever? I floundered when I was asked her name, wondering whether I had it right. I knew I was being assessed when I was asked to describe her. Luckily, my description fit and I was allowed a coveted pass into this pool paradise. Each time my class approaches, I go through a blitzkrieg of nail biting wondering whether the instructor has spoken with E and asked about the "friend" whom she recommend the classes to, resulting in a confused expression and my quick expulsion from the group. So far, this hasn't happened and the main threat to my weekly joys seems to be giving birth itself (I am nearly there!). But then again, I would not crave the classes so much then.

Go out there and immerse yourself in water! You will feel amazing. And if you're in New York and pregnant - book those preschool prep classes.