River’s Birth Story

Please be forewarned: this is excruciatingly long (12 pages!).

The short version: River was born 2 months early via c-section. She was 2 lbs, 8.5 oz, and was 14″ long.

She spent a month and a day in the NICU before coming home a month before her due date, just in time for Christmas. :)

The LOOOOONG Version:

Background/Prenatal Care

First off, as most of you know, my pregnancy was absolutely textbook, boring, and completely uneventful. I started prenatal care at 8 weeks pregnant, with an AWESOME, extremely respected doctor at a fabulous hospital. I never missed a prenatal appointment, and every time I went in for tests, screenings, or routine visits, the results were the same: “everything is fine, exactly where it should be, and the baby seems like she’s doing great.”

Our 17 week ultrasound showed that we had a little girl who was in the 50th percentile for her assumed age.  Right in the middle of where she ought to be. Her Due Date was established as somewhere between January 3 and January 7, 2010.

I felt great and never missed even a day of work  for anything pregnancy related. I had some nausea and food aversions throughout, but nothing that caused any major problems. I gained exactly the right amount of weight (20 lbs), at just the right pace. I even felt good enough to go to BATs (the high impact aerobics class at my work’s gym) twice a week with a group of workout buddies. My energy level was lower than I liked, but everyone said: “What do you expect? You’re pregnant—you’re going to be tired!”

Baby Shower—Just in Time!

My family scheduled my baby shower for November 7th so that we could get it onto people’s calendars before the holidays got everyone too busy. I began training my temporary replacement at work so that I could go on leave the week of Thanksgiving, leaving me with a whole month to prepare for birth and for the arrival of our baby. Well, that was the plan, anyway. : ) I felt so good after my shower on Nov 7th that I even went to an Amy Sol art show that evening with my sister!

me thrilled and nervous, meeting Amy Sol, one of my favorite artists!

THE Headache of a Lifetime

On November 8th, the husband and I went to church. I also ran errands, got several small projects done at home, and around midnight decided to go to bed. I laid down and felt a headache coming on. Since I frequently get tension headaches, I knew to quickly take some Tylenol before it got bad. I took a single Tylenol and laid back down. The headache got significantly worse in 3 minutes, so I got back up and took 2 more Tylenol. I went back to bed and the headache got so incredibly bad that within another 5 minutes, I was curled up in a ball, sobbing, holding my head. I woke up the husband and asked if there was anything we could do for the pain. He made a quick decision to take me to our hospital’s ER. [Note: I had a weird sense of finality as I threw on clothes and shoes and got ready to leave. I brushed it off and thought to myself, “This must be what it feels like to go to the hospital for a delivery!” Little did I know how true this was!]

The ER

I was so sensitive to light that all I could do was clamp my hands over my eyes, throw on some clothes and stumble out to the car. We arrived at the hospital within 5 minutes (the husband’s paramedic/ambulance driving skills came in handy), and checked into the ER. The husband had to fill out and sign everything for me, as the light was so horribly painful to my eyes that I had to keep them covered as tightly as possible.

My blood pressure wasn’t actually that high, from a clinical standpoint (152/90), though it was a lot higher than mine normally is (105/70). The threshold for being concerned about someone’s BP when they’re pregnant is 145/80, so I was just barely over that. Doctor Wilson was exceptionally kind—instead of sending me directly up to the L & D section (standard protocol for someone as pregnant as I was), he came down to look at me and offered me some pain relief first, explaining that the drug he could give me wouldn’t hurt my child given that she was fairly far along. (He explained that his original plan was to send me up to L & D immediately, but after seeing me, he wanted to bring my pain level down first. He wasn’t really even able to look at my eyes with his pen light, given how insanely light sensitive I was).

NARCOTIC PAIN RELIEF!!

I VERY gladly accepted the offer of pain relief, and they started an IV and administered Dilotid. When the drug went in, my entire body started to tingle and feel warm. “I feel REALLY weird, babe!” I remember saying to the husband. “That’s just the narcotic taking effect,” he reassured me. And sure enough, approximately 3 seconds later, my 10/10 on the pain scale headache DISAPPEARED. It was like the best magic trick in the world. I breathed a massive sigh of relief and fell asleep about 30 seconds later. (I’m REALLY not used to narcotic drugs!)

Looking back: I’m SO grateful for what this ER doc did. He got yelled at for not sending me up to L & D immediately, but honestly, L & D would NOT have given me relief from my headache as quickly as the ER did—I’m eternally grateful for Dr. Wilson’s knowledge and compassionate actions toward me.

Although the ER doc still wanted to do a CAT scan to see if I had a brain aneurism, I was then transferred to the L & D section to be evaluated.

L & D

Naturally, L & D’s big worry was pre-eclampsia. Pre-eclampsia usually manifests around 32 weeks, and I was 32 weeks and 1 day. Textbook pregnancy, I tell ya! : ) Pre-eclampsia is a condition where a pregnant woman’s BP gets way too high, there’s protein in her urine, and she can experience liver failure, seizures, brain damage, and kidney damage. Obviously, those things are very bad for the baby, too, so pre-eclampsia is taken very seriously. The only known cure is delivery of the baby.

I had an AWESOME team of OB’s and nurses at LLUMC—they took such good care of me, carefully evaluating my tests, talking me through everything so that the husband and I knew exactly what was going on, and advising us on our options. Around 4 AM, Monday morning, they gave me a steroid shot to help River’s lungs mature faster in the event that she would need to be delivered early. The doctors noted that if she did not need to be delivered early, the steroids would have no harmful effects on her development. (Doc names: Dr. Pak, Dr. Chac, Dr. Sakala)

They tested my urine for protein for 24 hours—the first 12 hours showed a level of 661 (normal is below 120). I wondered if the protein was higher b/c the repeated doses of Dilotid (I needed 4 total to finally “break” the headache) had made me throw up. The 2nd 12 hour set of urine protein values was MUCH lower—only 220.

By this time, my headache had “broken” and I only needed Tylenol #3 (w/ Codeine) to keep it at bay. I also needed my room 100% dark (as all my poor visitors noted) and kept my eyes covered with a black shirt that I borrowed from my sister. After my headache broke, I had at least 4 people introduce themselves to me as “I’m the person you met when you had that that thing covering your head and couldn’t look at anybody”. : )

The headache kept trying to come back and felt like a really bad tension headache that kept tensing up the muscles at the base of my skull. I kept thinking it was a result of the fluid restrictions I was on (8oz/12 hrs only) and b/c I wasn’t allowed to eat in preparation for possible surgery.

Mag Sulfate-UGH!

The doctors also started me on a fierce little drug known as magnesium sulfate. It’s a smooth muscle relaxant, and they started me on it to stop the contractions that my body was initiating (I didn’t feel a thing, being totally distracted by the headache) and to hopefully stop me from having seizures if the pre-eclampsia decided to try to move to full blown eclampsia.

Me bloated and loopy from the mag sulfate, but very happy to see visitors! That flesh colored blob is a PILLOW, not my leg!

River was also monitored, and her heartbeat and kicks were still very good (amazingly good, given all the drugs she and I were put on!).  The sound of her heartbeat on the monitor was the best lullaby imaginable, allowing me to finally fall asleep. I drew such comfort from hearing her strong, steady heartbeat, sounding exactly the way it had sounded at all our prenatal visits.

I continued exhibiting borderline symptoms as they monitored me—everything was just a teensy bit off—my BP was higher than they would’ve liked, but still within normal ranges for a pregnant person. My protein levels dropped off but were still present. My headache pain was manageable but still there.

The Ante Natal Unit

I was moved to the “Ante Natal” observation unit. I had a roommate who had very similar symptoms, and she delivered her baby the very next day. I was glad she was there, however, b/c I decided to shower on Monday night, and when I got out of the shower and stepped into the cool air of the bathroom, my BP dropped 30 points and I had to crouch onto the floor to avoid passing out. My roommate called for the nurse, and the nurse and nursing student held my hair while I vomited all my stomach contents, then gave me mouthwash to freshen up. There’s something incredibly sweet about someone who makes it part of their job to hold the container a patient is vomiting into and who THEN goes above and beyond to help the patient feel better after! I apologized—it’s so embarrassing to have one’s body just not work properly.

It looked like we’d probably be going home or maybe staying a few more days for monitoring, just in case something changed. They also still kept me on the mag sulfate as a precaution. Next, we got an ultrasound done, just to see how the baby was doing before I went home.

That was a fun experience—I was so happy to have another ultrasound and hopefully get some 3D pictures of the baby. 2 students did my ultrasound—they were sweet and their names were Pam and Brittany. Brittany had never gotten to do an OB u/s and I told her she was welcome to practice on me. Pam guided her choices, and they took over 150 images of River.

Confusion, Followed by Tears, Followed by Prayer, Followed by More Tears

Then, on Tuesday night, my OB walked in. I was chatting with some friends, and he asked them to leave the room so that he could speak to the husband and I. He looked very serious, so I figured he would be telling me that I needed to stay for monitoring, possibly for the remaining 2 months of my pregnancy.

Instead, he told us that we would need to DELIVER River as early as the next morning! So many thoughts raced through my head:

“All my prenatal visits said I was fine—he must be reading the wrong chart”.

“It’s end of shift and he’s tired—he must have mixed me up with another patient.”

He said that the ultrasound indicated severe Intra-Uterine Growth Restriction (IUGR)—River appeared to weigh only 2 lbs, 10 oz (the weight of a 28 wk old) and should have weighed at least 4 lbs at this stage (32 weeks). Her growth was so below par that it was in the 5th percentile, a huge drop from the 50th percentile she was in at 17 weeks. This indicated that the placenta was not giving River the nutrition and blood flow that she needed. Additionally, when they looked at the blood flow in the umbilical arteries and in her cerebral arteries, the numbers were opposite what they should have been, indicating that River’s body was trying to take over controlling blood flow to her vital organs (it should have still been handled by the umbilical arteries) b/c something was wrong.

As the doctor said this, I felt an enormous, irrational sense of guilt, as if my body had betrayed me. My body, the structure that was supposed to be the best place for my little one, a place to prepare her for life, was suddenly a hostile place for her, something that was causing her harm.

Intellectually, I knew that I’d done everything I could possibly do to be healthy (and thank GOD I had….I am SO glad to have no regrets about how I handled this pregnancy. I know without a doubt that there’s nothing more I could have possibly done to ensure that I gave River everything she needed while she was in utero). But emotionally, to hear that my body was now a bad place for my child was really shocking. Also, to hear her size was horrifying too—she was so incredibly tiny…and the last thing I wanted for my little daughter was to have to be pulled out of me when she was still so incredibly small.

The doctor left and said he’d re-evaluate and come back in the morning.

I cried –I’m not sure the husband did, but he was definitely as sad and as troubled as I was. After discussing our options, we both decided that we wanted the ultrasound repeated by someone who was not a student, since we were basing so much of our decision on its findings. We also decided to ask my prenatal doctor to conference with the high risk OB team to make sure that her perspective on my health (that everything was fine last time we’d checked) was represented appropriately.

The nurses chatted with us about our situation and validated our concerns and requests. They reassured us that asking for tests to be repeated was absolutely appropriate and that we should feel completely comfortable requesting that.

Re-checking, Deciding

The next morning, we wrote down our 3 major concerns/questions for the high risk OB team, and listed our requests. I called my prenatal OB’s office, and discovered she was out of the country on vacation. I still had (and have) absolute faith in her b/c she’s absurdly attentive, careful, and is described by her colleagues as “sharp”, a “compulsive test orderer”, and someone who “doesn’t miss anything.” Her secretary said she’d get in touch with her the following day and let her know what was going on with me if she didn’t already know.

Dr. Sakala assured us that even though students had done the u/s, the images were reviewed by the head of radiology and were held to an extremely high standard. Still, he said, “I want you to be comfortable with this decision and to understand why it’s necessary, so I’ll have the u/s measurements repeated ASAP”. Within a couple of hours, the HEAD OF RADIOLOGY came down and repeated the u/s measurements. It was kind of hilarious b/c he’s the head of the dept, so he doesn’t really DO ultrasounds—he reads them. So he brought a tech with him to basically operate the machine for him while he took the images and explained them to us. : ) The tech knew more about the machine than he did, but it was a sweet gesture for which we were extremely grateful. Also, his explanation of what he was finding and the concerns he had was very enlightening. River’s blood flow looked a bit better, but it was still far under par. Also, her growth was confirmed as severely below what it should have been.

He really didn’t find anything that the students hadn’t taken images of already (so good job, students!). We felt very reassured that the test was accurate and realized that my prenatal OB would probably agree with the high risk team’s assessment. We couldn’t argue with the fact that River’s arterial blood flow was trying to take over from the umbilical flow—we saw the numbers and images as the radiologist was taking them. We also couldn’t argue with the fact that River HAD been fine, as far as her growth was concerned (we had a dating u/s at 8 weeks and those are known for being extremely accurate) and was suddenly NOT ok, meaning that I’d had pre-eclampsia “brewing” for at least 3 weeks with no clinical presentation.

Dr. Sakala explained that pre-eclampsia “is a funny animal” with strange presentations, no explanation for why it occurs, and the potential for very sudden, scary consequences.

I wrestled with the idea that maybe the doctors were prioritizing my life over River’s—a horrifying thought. Then I realized that keeping her on board while my body was NOT nourishing her appropriately was simply not a good idea. There were other possible reasons for all my symptoms, but as the husband and I talked, we realized that the most elegant, simple, and logical explanation for all my symptoms was pre-eclampsia. In medicine, you go with the simplest explanation of your presenting symptoms (Ockham’s razor for healthcare).  : )

We prayed and prayed and prayed for wisdom to do the right thing.

We chatted with the chief OB resident, Dr. Pak. He reiterated to me that my diagnosis was “severe pre-eclampsia” and that I was experiencing the clinical definition of “end organ failure,” due to my placenta’s failure to function adequately. He reiterated the need to deliver River. Dr. Sakala thought that induction so early on (32 weeks) could take up to 7 days for delivery, and he didn’t want to put me through that and risk my BP spiking, and he wasn’t sure that River could tolerate it either. He recommended a C-section as soon as possible.

We agreed. I’d actually wanted a C-section before I decided to go with a doula-assisted birth, so this part wasn’t bad news. A C-section was never something that bothered me. They scheduled the C-section for 7:30 AM the following morning—the very first operation of the day.

“Are we really doing the right thing??”

In the middle of the night, I woke up in mental agony, wondering if we could really trust the high risk OB team: “They only human,” I told Anthony. “It’s Thursday….what if they just want to get done with me b/c they know they don’t want to have to come in for an emergency over the weekend?”

He reminded me that the doctor had a huge amount of knowledge….far more than we did. And that this gave him power. And that the doctor was using this power to help us, and we ultimately needed to trust his recommendations b/c he was in a much better place to know what was best in this situation.

Another factor that helped immensely…maybe even made the whole decision possible—was that Anthony and I both knew the doctor on a semi-personal level. I’d worked with him, and Anthony had taken an OB class from him while getting his PA degree. We’d both admired his discipline and absolute devotion to his field. He’s also a committed learner, with multiple Master’s and PhD’s in other fields—he absolutely loves learning. He’s been to my work and taught students there—an activity that gave me further witness to his compassion and absolute devotion to patient care and to doing the very best for his patients. He’s also written one of the pivotal textbooks on OB-GYN. So, we felt comfortable knowing we were trusting a good person to help us with this decision. If we hadn’t had that reassurance, the decision would have been far more agonizing and awful.

We continued to pray—we acknowledged that River’s life has always been dependent on God for sustenance…this situation just made that realization a bit more poignant. We also reminded ourselves that life has many unexplained turns of event—things like this happen to people all the time, and we didn’t need to torture ourselves with “why” this happened. We simply needed to deal with things a day at a time and to make the best decisions possible with the knowledge available.

We were also deluged with visitors: Meg Simmons (my temp), Diane Schoendienst (from MSC), Bob Schaefer (from MSC), Tito Ric (came TWO nights in a row), Kourtney Brewster, Lauren Ritz (LLU, BATS), Tom Thomas (our renter), Sony Stewart, my dad and brother Christopher, Ashley Nick, Melissa Farmer…we felt extremely loved and supported. My mom also stayed in the nearby Loma Linda Inn w/ my sister Rose and came to see me daily.

We also received flowers from Nate and LiseHelene Smith, Anthony’s work (aka, Dennis Tankersley—white Lilies that made the room smell heavenly), Sony Stewart (really cute sunflower arrangement), my mom (a mini teacup setting and roses from my baby shower), Tom Thomas (Gerbera daises that we later planted in the garden), and a gorgeous mixed Iris bouquet from my work, as well as a gigantic balloon bouquet from Lauren and Kourtney. The flowers were so amazing to look at during my time in the room—they really cheered me up, which is something I’ll remember when I have other friends in the hospital!

Kourtney posted facebook updates on my wall, and we were deluged with calls from Anthony’s family (Tita Miriam offered to fly out to help us), friends, church, and my family. Aunt Sylvia called and checked on us, as did Uncle Tony.

Thankfully, my vitals continued to be stable, so the C-Section was able to be scheduled rather than rushed and emergent.

The husband helped me shower—I was determined to get a good shower in before my tummy was cut open. He washed my hair for me and shaved my legs….I was too unsteady and nauseated to do anything but stand up and wash my body. Now, it wouldn’t have been the end of the world if my legs hadn’t been shaved before my C-section, but my sweet husband knew how much showering and shaving meant to me and was incredibly sweet and accommodating. He was also terrified that he’d nick my skin in the process, but didn’t. Mad skills! J

C-Section

The C-section was scheduled for Thursday, Nov 12, 7:30 AM

We woke up early—around 4:30 AM and began chatting and preparing.

My mom and sister arrived around 5:30 AM—she stayed in a nearby Inn for most of the week to be with us, a huge sacrifice of time given her home obligations!

I felt SO out of it—the mag sulfate, my fluid retention, and everything else made me feel pretty sluggish and just plain awful. I’d been NPO (nothing by mouth) or throwing up anything that I *was* allowed to eat for most of the last 4 days, and the mag sulfate made my mouth dryer than I ever thought possible. Anthony got me some fake lollipops to suck on—they’re made of blue sponge and have peppermint flavoring. They were definitely better than nothing. Thank God Anthony was vigilant about making sure I didn’t get the ice chips I was asking for—more on that later.

We made a quick video saying that we were excited to meet River and hoped all would go well.

Then, the team came in and chatted with us about what would happen. The Neonatology fellow chatted with us about what to expect for River’s outcomes and what they’d do for her when she was delivered. She gave us some interesting LLUMC data and noted that for some unknown reason, medical professionals tend to have premature babies. She also noted that the vision outcomes for preemies at LLUMC are extremely positive, even for those receiving supplemental O2.  She was very sweet to come in at speak with us at 4:30 AM so that we could be informed before the delivery.

The OR

I was taken in for prep around 6:30 or 7 AM….I made Anthony videotape us walking in toward the OR. The OR was a little scary—it’s filled with crazy equipment and lights, and the table looks small and confining. It’s shaped like a cross, with places for your arms to lay out, away from your body. Anthony couldn’t come in with me for the prep, but the team was SO nice to talk me through every step of what they were doing. It really helped keep me calm. Also, the girl talking me through everything had been doing lectures at the simulation center for weeks in the months prior, so her voice was familiar to me. J

They had me sit on the edge of the OR table and lean forward onto a surgical tray with a pillow on it. Then they told me to “arch my back like an angry cat”—this exposed my vertebrae so that they could see where to insert the needle. The idea, of course, was to make sure that they avoided hitting my spinal cord with the needle. They scrubbed my back with some really cold soap (they warned me first), and told me that when they put the needle in, I’d feel stinging and burning and that it would be the most painful part of the procedure. I did my Hypnobabies breathing while they inserted the needle, and the pain was really not bad….just a sting. My legs started tingling, and they said that was to be expected, and then I suddenly couldn’t move from the hips down. I remember being amazing at how many different meds they were giving me—there were tons of glass ampoules all lined up, and they broke them open and gave me meds incredibly quickly.

“Cow-Tipping”

Then our “cow tipping moment” occurred. Once I was numb and couldn’t move, the resident said, “OK, I just want you tip over to the right and we’ll lay you down on the table.” Everyone laughed at her and said, “Tip over, huh? Are we working on a patient or are we cow tipping?” She laughed too and said, “Well, I’m Canadian. I guess we say things a little differently.” It was nice to have such a lively team, especially given that I was the first operation of the day (also AWESOME!).

I “tipped over” (with help), and lay flat on my back on the table. The anesthesiologist did a “pin-prick” test, pricking me with something sharp to see exactly where I was numb and where I wasn’t . When my left side was numb further up than my right side, they actually moved me around to sort of “slosh” the meds around to better distribute them. I was pretty scared that I would suddenly not be numb while they were cutting into me, but thankfully, this didn’t happen!

Prayer

Thankfully, Anthony was able to come and be with me at this point, as it was getting pretty scary. Someone gave me a nasal cannula with some O2—cool, b/c I’d always wondered what it felt like to receive O2! Then, Dr. Sakala and Dr. Pak came in and chatted with me. Dr. Sakala asked if it was OK for him to pray with me before the operation—umm, YES, a thousand times, YES! We prayed holding hands, then he disappeared behind the surgical draping that covered me from the ribs down. He called over, “Miriam, some patients are just patients, and some patients are special. You’re special.” I breathed a sigh of relief, and felt very cared for. (Though, yes, I’m aware that “special” has multiple connotations!)

Something feels funny...

Say Cheese!

To my shock, I FELT the pressure of everything he proceeded to do—I felt him cut into me (first incision at 7:56 AM), and felt him pull out River (at 8:02 AM). As he cut, I squeezed Anthony’s hand and struggled to stay conscious and not throw up. I’d been NPO for HOURS (my mouth was dryer than I ever imagined it could be), so I couldn’t actually throw up, but I kept getting extremely nauseas and feeling like I was going to hurl. There was no pain at all, thankfully.

“CAMERA!” Said Dr. Sakala. Anthony fumbled and grabbed the camera just in time to take some awesome pictures.

our tiny girl emerging from the womb. Note how the doc's hand goes almost all the way around her torso

The BEST Sound in the World

When the doctors pulled out River and suctioned her nose and mouth, she immediately started crying: the BEST SOUND IN THE WORLD. “She’s CRYING,” I exclaimed in relief, indescribably grateful that she was breathing on her own. They held her up for us to see and for Anthony to get a picture, then the NICU team whisked her away.

“Is it a girl????” I asked, and received confirmation that yes, our River was a girl!

thumbs up for my doctors!

I was so relieved and it was such a shock to my body to have her and the placenta out, that I started crying, then started dry heaving. I briefly considered that I might aspirate my own throw up and die from a subsequent lung infection, since I couldn’t roll to my side or tummy to get it out of my mouth. Thankfully, I didn’t produce anything, and the anesthesiologist said she’d give me something to take away the nausea. It worked well…so well that it knocked me out! :-P

At some point, someone yelled into the room “Apgar’s 9 and 9″ (out of a possible 10). Then someone yelled over River’s stats: She was 2 lbs, 8.5 oz, and 14” long.

They took about 25 minutes to sew and staple me up, then I was off to the recovery room.

Background: When I decided to go the hospital route for River’s birth, it was with great reluctance. I was also concerned about being attended to by nursing students.  I spoke w/ one student who was frequently training at my work about how to avoid them. She gave me several tips. Well, guess who was the FIRST PERSON I saw in the recovery room? Yep, that exact same student nurse! We both laughed upon seeing each other.

Our Moment

At some point, either on my way to my room or on the way to the recovery room, we were allowed to peek into the room where River was being evaluated. She stared at us with huge, open eyes…she was laying on her tummy, curled up with her knees under her and her head turned toward us. She looked very peaceful.  A nurse was gently stroking her back with one finger. And then we moved past the door. It was a surreal, magical sort of moment. It was also the last I’d see of my little girl in person for a day and a half.

Anthony saw her that night, took pictures, and brought me the hand and foot prints that Denise, River’s nurse, had taken for us. He also took some video footage of River in her isolette. She was amazingly cute and beautiful.

River and Daddy Meet

Holding Her for the First Time

The day after my surgery, late in the evening, we went to see River and to take her a quilt to decorate her isolette. Anthony showed me how to scrub in (wash hands and arms for 3 minutes), and gown up (put a hospital gown on over what I was wearing).

She was still breathing room air (she never needed supplemental oxygen—yeay for the steroid shots they gave me to mature her lungs faster!), and had a tiny IV in one of her hands. It was terrifying to maneuver around and to make sure we didn’t pull it. Nurse Vivienne put her into my arms, snuggled under my chin, and I held her. I was initially rather horrified at how excruciatingly tiny she was. I couldn’t even feel the weight of her body on me. I was struck very hard with the idea that she shouldn’t have to be out in the world yet, and it brought tears to my eyes. Then I realized that I was amazingly privileged to meet my beautiful baby girl face to face and I focused on that. I also didn’t want to give her “bad vibes” by crying over her!

It was scary to touch someone so tiny and fragile looking, and I was so grateful to the nurse for showing me how to put my hands on her, contain her flailing limbs in a soothing manner, and how to pick her up and hold her. It was very empowering and helped me bond with River.

meeting and holding River for the first time

Vivienne explained that River would get her first feeding that night—they’d put in a tiny NG tube (down her nose to her tummy) and give her a few drops of colostrum (that I’d pumped) and donor breast milk (until mine came in). They’d see how she tolerated it and make sure she didn’t get necrotized intestines and that her body was able to move the food through effectively. She was receiving all she needed currently via the IV (Total Perenteral Nutrition, aka TPN). Vivienne also asked if we wanted to do “kangaroo care”, aka, skin to skin contact with River. I was too sore to even think about sitting in a chair that leaned back (I was still in a wheelchair), so the husband volunteered to hold her. Kangaroo Care must be carried out for a minimum of an hour at a time, so we just sat and chatted while he held her. He also got to change her diaper! :)

The next few days are a bit of a blur. I stayed as long as possible in the hospital…the food was great, I had everything I needed, and I was close to River. I didn’t want to leave!

Staples Removed. Ugh

Enoch, the med student, was awesome—he was a med/surg nurse before coming to med school, so he was great at talking with us and caring for me. He took my staples out (something I was TERRIFIED of having done) with virtually no pain to me—he worked carefully and slowly, and made sure that I’d had Tylenol with Codeine before he proceeded! :) I thanked him and told him it was a much better experience than I’d expected, and he laughed and jokingly asked, “What did you expect? Unsteady hands tearing at you and you crying while I raced out of the room?”

“Yep, pretty much!” was my response. : ) He’d framed my worst fears in one hilarious sentence.

Gorgeous Post-Partum Room!

My last night/day at the hospital, I was moved to the post-partum unit (instead of the ante-partum unit), and had an AMAZING, practically 4 Star quality room—gorgeous view of a garden 3 stories below, beautiful, natural light, wood floors, beautiful, soothing colors…and a fabulously comfortable bed. It was heavenly.

I had tons of hospital staff coming in to see me—a lactation specialist, social worker, myriad nurses, doctors, residents, the nutrition department, River’s PT, students, the birth-certificate person, the cafeteria person with the order form for the next day’s meals. I have to say: I’m extremely impressed with the amazing continuum of care that occurs at LLUMC—there are so many pieces that come together with surprising smoothness. It was a huge relief to have so many people giving me the info I needed—there was no possible way I could have remembered or even known to ask for it all! The down side of this was that someone literally came in about every 15 minutes, all day and well into the evening. I was exhausted, trying with extremely limited success to pump milk, and in a great deal of discomfort from my incision. Standing up on my own was utter agony, but I was usually able to. Clutching a pillow to my abdomen helped a great deal. I kept meaning to go see River, but slept through the afternoon (as much as I could) instead….

My parents and Kourtney and Lauren also visited, which was very nice. My balloons and flowers made the room look beautiful and cheery. NOTE TO SELF: Send balloons and plants to people in the hospital for more than a day! They are SO NICE to look at when you’re a patient.

My gorgeous, morale-boosting flowers in the hospital room!

All told, I was in the hospital for a week!! Shocking, for someone who has never been hospitalized since birth!

Leaving the Hospital

Everyone asked me if going home without my baby was extremely difficult. To be honest, it wasn’t. She was so tiny and fragile that it was very obvious that she needed to be in the NICU.  It was only after about 2 weeks that it became agonizing to leave her there every single day. We visited and “kangaroo-ed” her daily for at least 4-12 hours a day, switching off who was with her so that we could maximize her contact with us. Visiting her became my full time job. Still, the more we bonded, the more I missed her when I was home without her. Looking back, I’m extremely grateful for the month I had to heal from the C-Section without her home. As the NICU nurses reminded me, they were the most competent and expensive babysitters I could have and will ever have for her. :)

Upon being discharged from the hospital, I sat on a wheel chair holding my massive balloon bouquet while Anthony wheeled me to the car. On the way out, we pressed a special button in the post-partum unit that played a snippet of “Brahm’s Lullaby” throughout the entire hospital. It is only pressed by parents whose baby has just been born in the hospital.

River’s Homecoming

River continued to progress, and we finally got her home after a small hitch. She grew and stayed so healthy and stable that instead of keeping her in the NICU for 2 months (until her due date), her doctor discharged her after “only” a month and a day.

We’d been told on a Friday morning that she’d be going home on Saturday (the next day). I raced around all Friday getting the car seat installed, the house extra-clean, and making sure everything was ready for River. I didn’t  visit River that day so that I’d have time to get everything done. Then, at 8:30 in the morning, on Saturday, we received a call saying that River would not be allowed home because she hadn’t gained weight for the last 3 days. She’d be discharged on Monday or Tuesday at the earliest. I hung up the phone, told Anthony the news, and then to my surprise, I completely dissolved into tears. I’d been so ridiculously excited about her coming home that it was like a physical blow to hear that she wasn’t coming home. We went to a friend’s Christmas party that evening (Anthony’s idea to cheer me up).

The next morning (Sunday), I felt an urge to check my phone (I’d left it in the car after coming home from the party). I ignored the urge. Then, a few hours later, my sister called Anthony’s cell phone to tell us that the NICU had called my parents in an attempt to reach me! I immediately called them back, thinking something was wrong with River. They told us that a different doctor was on call and wanted to send River home. Immediately!

He had already left for the day but agreed to turn around, return to the hospital, and sign the discharge papers so that we could bring River home that day! Amazingly kind.

We brought her home at 4 PM on December 13, 2009. About 15 minutes later, my family showed up to meet her, followed by Anthony’s family. : )

Home at last! :)

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9 Comments

Filed under 2009, processing, Uncategorized

9 responses to “River’s Birth Story

  1. What an amazing story. I’m so glad that you got such good care.

  2. Tina

    Wonderful birth story Miriam! How amazing it all happened too.

  3. Rachel M.

    Thank you so much for sharing the whole story – I’ve been dying to hear!

    It just about brought me to tears more than once. So happy and relieved that you are all back together again and doing well. You have such a lovely little girl!

  4. Katie P

    wow miriam, wow. tears came to my eyes several times as i read this, and i’m so impressed with the courage, grace and faith you demonstrated through such a scary experience. i’m so happy you are all doing so well!

  5. Sarah

    Such a special story, Miriam. I kept choking up all the way through. I can’t help but think that River has special parents and is such a special little girl. I hope to meet her sometime!

  6. Thanks for sharing this story, Miriam!! I have been so curious to hear and am so thankful that you were given such excellent care.

    The part that stuck out to me the most was about how your body had become a hostile, unsafe place for her to me. I can only imagine the sense of betrayal that I would feel — and like you said, especially having done everything right.

    Blessings to you, little family. Blessings & peace.

  7. Oh wow, what a story. So much of it registered not just in my heart, but in my stomach, as I remember the belly-churning feelings of fear and hope that the premature birth/NICU journey brings. So glad that you and River made it through. She’s beautiful.

  8. scott

    hey there miriam, that is an amazing story. I so happy for you and your family. River is such a blessing. 2lbs wow, I was less then a pound when i was born. I know God has amazing plans for her. I lvoe to see you . take care

  9. She’s so beautiful. I really enjoyed getting to read the whole story about her arrival. What a gift that the doctors were able to take such good care of her – and you!

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