Oliver's Birth.

First, I'm going to tell you what a nurse named Amanda told me: "Nothing about this delivery has been normal." My experience is extremely rare, and I don't want it to scare anyone. I do, however, need to tell the story, and I want future mothers to be aware of the signs of this condition. My boss, who has been a great friend to me, told me that in order to heal, I need to cry a lot and tell the same story over and over again, so I can begin my "second life." She's a wise woman.



Oliver's birth story began on the night of Saturday, September 24. In the last few days, I'd been scrambling to catch up my grading. I guess this was a professional equivalent of nesting. I'd succeeded pretty well and intended to continue working on Saturday, but I began to feel rough. I felt sick and just not right. Contractions really got going in the late afternoon, and they went on for five hours, eventually coming three to five minutes apart. Josh called the hospital and spoke to Dr. W, who said we should come in. She is one of the few doctors whom we hadn't yet met at the group practice.



I wrapped a throw pillow in a beach towel and placed it in the passenger's seat. This helped me handle the bumps and vibrations of the drive. I had been reluctant to go until I realized I had a low-grade fever. I didn't want to take chances with that.



I told our moms but asked them to wait until I saw the doctor--no point in they're driving out for nothing. I told Josh, "I'll still be at work on Monday." Every time my contractions got crazy, I would say in frustration, "I keep feeling like this could be it, and then, I'm back at work the next day." I love my job; it's perfectly suited to me. I've felt deep dread over every other job I've ever had except my other community college teaching job. Still, work had become so surreal because I was sick and was ready to focus on motherhood for those precious three weeks of leave. I felt so unsure of my body and what was happening.



When we arrived, the receptionist nervously moved through my registration, and a woman stepped aside quickly, insisting I get help before she. I spoke calmly to another receptionist named Buffy, who complained that we were having a boy and couldn't name him after her. I got into a wheelchair, and someone took us upstairs. The contractions were weaker, but I felt more sick. I wasn't sure what kind of sick exactly.



Josh was dismayed when the person wheeling me said he had to wait in the waiting room. I was only slightly nervous. I've forgotten the name of the nurse who helped me that night, but she kind of looked like an Emma, so I'll call her that. Emma weighed me (165, 40 pounds over my pre-pregnancy weight) and took me into one of the peaceful, spacious rooms. I found the open blinds odd. She showed me a cup and a gown, and I hobbled to the bathroom. I noticed a birthing ball in the shower. Then, I got in bed. The bed was hard, but I liked the contours.



Emma said my blood pressure was high, so she had me lie on my side. She placed the two monitors (contractions and Oliver's heartbeat) on my belly. The monitor wasn't picking up my contractions. I liked listening to Oliver's heart so constantly, though. I'd been damp, but I didn't know if it were sweat. Emma said she'd have to do a dry cervix check (no lubrication), and it would be unpleasant. She was still gentle, though. The green tape didn't turn black, which meant I wasn't leaking amniotic fluid. "And you're closed," Emma said. This dismayed me not only because it meant I was going home and had done exactly what I didn't want to do--go to the hospital for no reason--but also because it meant that all those contractions I'd been having for weeks had done nothing. Emma put a new contraction monitor on me. I told her about some discomfort and symptoms I'd been having.

My blood pressure leveled out, and Dr. W came in. She said, "When your husband called, I thought we were having a baby tonight, but that's not going to happen. Your cervix is closed, and we're only picking up mild contractions. The symptoms you're experiencing are normal for late pregnancy." She was kind of soft-spoken, but I still felt ashamed. I also felt worried--if these "mild" and ineffective contractions had bothered me so much, how could I ever bear the real deal? I had no idea, though, that I would soon learn just how strong and brave I could be.



Emma sent Josh to me, and he helped me get dressed again. He didn't seem disappointed or annoyed at all. We walked out of the quiet ward, and then I had another dose of shame and frustration when we paid the massive ER copay. But I told myself that I had been able to listen to my son's heartbeat for half an hour, and that was pretty wonderful. I told Josh he would be delivering our baby at home because I would never trust myself to go to the hospital again.



I held it together until we got into the car, and then, I cried hysterically for most of the way home. I was tired of feeling sick; I hated that I'd wasted time, money, and other people's time; and I was scared that I was, in fact, a coward and weakling. I think Josh was a little scared, but he just patted me and drove in silence as if he knew I just had to get it out. Generally, I rarely cry.



Dr. W had told me to take Tylenol for my discomfort and allergy medication to help me sleep. I'd usually been reluctant to take any medicine, but I took Tylenol, Tums, and half a Cyrtec when we got home. I just wanted to sleep. I no longer cared about grading over the weekend or just bearing the heartburn or other issues.



After yet another hot shower (my main comfort), I did sleep for a while. But then, I started having contractions that were more intense. I felt them solely in my back. They were ten to twenty minutes apart, though, and I was groggy, so I had a lot of relief during the breaks and drifted in and out of sleep. They got hard enough that I started bicycling my legs in bed. I'm not sure why.



Around six, I felt a little wet. I got up to go to the bathroom, and I thought I still heard liquid coming out after I was done. That seemed odd, but of course, water breaking is rare. I then realized I was bleeding a little from Emma's exam. Seeing blood is unsettling after so long. I put on a pad and lay down again on my side. Josh had gotten up to sweep the floors. Another contraction started, and I felt fluid coming out of me in tiny pumps. "I need a towel!" I shouted to Josh. He ran in with a beach towel, and I got on top of it. I was scared that I had really started bleeding. I looked at the pad and saw only pink streaks.

Josh said, "It happens."
"I didn't pee myself," I said. "And it's not just blood. Feel it. It's heavy." The pad was drenched with something that was mostly clear.



I called my mother, but she didn't answer. I called Susan (Josh's mom) and told her that I thought my water had broken. We discussed it and agreed that we didn't know what else it could be, but I wanted to wait a bit. She said that if that was it, it wouldn't stop. I reached my mom, and she had similar thoughts. I got on the ball for a bit. I walked around the living room, and a slow trickle continued. I went back to the bedroom, stood over the beach towel, and bowed over the bed when contractions came. Josh pressed his hands to my lower back and confirmed that fluid was still coming out when I contracted. I decided to take a shower; it would feel nice, I could see if the leaking continued, and I'd be clean if we did go back to the hospital. Of course, I was in no hurry to go back! Josh got in the shower with me and held me up during contractions. Even in the water, I could feel the leaking. I went to the bathroom again while Josh showered, and the fluid saturated the toilet paper. Red, stringy mucus came out too, which was probably part of my mucus plug. "Okay," I said. "We need to go."



Josh called labor and delivery and basically said, “We're coming.” He didn't even ask to speak to the doctor. I wondered who would be on call then. We got dressed. I put on the same odd clothes I'd had on the night before--a pair of Josh's red plaid pajama pants and a turquoise tank top (which used to have Matron of Honor in white iron-on letters on the back--from Melissa's wedding) with a big gray Gap pullover (a hand-me-up from my brother) in case I got cold. The night before, I'd asked Josh to get me some socks, and he'd brought my favorite pair: wooly with purple and silver stripes. I put those back on with my old gray and blue New Balances and put on a cloth headband. Josh wore black pants, a gray T-shirt, and a blue flannel shirt with those black boots he loves. I went to the car and kept sending Josh back for phone chargers, deodorant.... Our neighbor was in his yard and waved hesitantly, probably knowing what we were doing. He must have really wondered later when we didn't come back the next day or the next day.



I called Susan, and the leaking was fast enough that I felt confident. My mom had gone to the first service of church (she's the acting children's minister), so I didn't reach her at first. Then, I dropped my phone between the seats. Great. Right then, the phone rang—probably my mom. We pulled over and got the phone, so no one would worry. I called Mom back and told her we were on the road. I again told everyone to wait.



The drive seemed much shorter this time. The contractions were hard, but I felt sort of exhilarated and peppy. The contractions were about eight minutes apart and lasted about thirty seconds. Josh could check the car clock and tell me when another was coming. I texted Susan, “Maybe Sept 26!” This was at 8:43 a.m., and I expected a long, long labor. I ate a cinnamon PopTart, knowing I wouldn't be able to eat once I got to the hospital. I didn't feel up to eating more than one.



I made a few jokes about the doctor sending us home again, but at this point, I felt justified. What could be more obvious except a massive gush and flood? A security guard at the ER entrance said, “Is it time?” with a big grin. I said I hoped so since my water had broken.



Luckily, my information, and registration was brief. I made another grim smile for the Web cam-style bracelet photo. This time, I got a wheelchair immediately. Ruptured membranes seem to be the ticket to fast service! Josh and I waited for a minute, and we heard a lullaby playing over the intercom. Someone said, “A baby was just born.” We smiled to ourselves.

Buffy was there (I asked if she was back or was just, horribly, still there. She said she was back.), and she remembered most of my information. Josh was quick to answer how long and far apart my contractions were. Buffy called up to L&D and told them my water had broken. The nurse asked if I were sure, and I said I was pretty darn sure. A sweet, older woman wheeled me up. She asked questions and was then quiet while I had contractions. Josh went quietly to the waiting room. I wondered if everyone would say, “Oh no, we don't want to see that girl again.” A young, blonde-haired, blue-eyed nurse met me at the desk. She looked me over and asked if I were wearing a pad. I don't know if she asked because I wasn't visible leaking or because she didn't want me to leak everywhere. She started me toward the scale (which reminded me of a skiing game at Jillian's...a big platform with handles) and said, “You were just here last night, right? How much did you weigh?” I told her, and she took me to a different room. The cup and gown were there, and I felt rather wise and experienced. This room had no birthing ball that I saw but did have a jet tub. Even then, though, I didn't think I'd be using the tub. I could see strange, swirling fluid in my pee cup.



I got into bed, and Debbie put the monitors on me and checked my blood pressure, which was high again. She put me on my right side, facing her. The monitor still wasn't really picking up contractions, but she said it probably wouldn't since I was on my side. She stood at the computer and asked me tons of questions—everything from my last menstrual cycle to whether or not anyone was hurting me. another nurse came in. She was brunette, friendly, and confident. She took out the green tape, barely touched me with it, and said, “It's positive.”



She checked my cervix and said, “She's in labor. She's three...maybe four centimeters. I give her four.”
“How effaced?” Debbie asked.
“80%, plus two.” Plus two, I think, referred to how far down Oliver was.



I felt both excited and relieved. Four centimeters! Whoa! I would not be going home. I wondered when Josh would come in. I had lab work, and then I got my IV. Neither were bad. I was still having good breaks between contractions. Debbie opened the doors to the baby alcove, turned on the lights around the warmer, and started laying blanket after striped blanket in the bed. She went to a cabinet (whence had come my bed pan) and showed me a tiny diaper and a tiny pink and blue striped hat, which she placed in the warmer. I felt so happy seeing those.



I thought about my mom and how long it would take her to arrive. I strained to hear Josh in the hall. Finally, I did hear him, and he came around the curtain at the door. He said hesitantly, “What's going on?”
I told him what Amanda had said and showed him my IV. “We're not going home,” I said. He had been in the waiting room for over an hour.



I had a fierce need to pee, and I asked Amanda what I should do. She looked regretful and said I'd have to use a bedpan. Since my water had broken, she didn't want me to get out of bed. I thought briefly about how I wouldn't be using the birthing ball, rocking on my hands and knees, walking, leaning on Josh, leaning over the bed, or doing any of the movements I'd imagined. I had no problem with the bedpan though; I just had to go. She set me up and told me to hit the button when I was done.

I thought I'd never be done! I don't know how I peed so much. I felt sure I was flooding the whole bed, but Josh said I wasn't. Poor Debbie was the one to answer the call. I still felt like the bed was flooded. At some point, I used the bedpan again, determined not to have any extra pressure.

He called his mom, and I tried mine. I had to try again, and I told her that I was pretty sure I was sitiing in my own piss, and I was okay with it. I told her about my dilation and effacement. She said she and Shane (my step father) were about to pick up my brother, James, and come in two cars (so Mom could stay). I called my dad and told him. He seemed surprised and excited. He said he'd be on his way. He ended up bringing James a little later, so Mom could hit the road.



Dr. W was still there! She checked me, and I was still at 4. She and Amanda placed internal monitors. That wasn't fun. One tracked my contractions (much more effectively than the belly strap!), and the other tracked Oliver's heartbeat. I tried not to think about the latter piercing my son's scalp. Instead of the heartbeat sound, we started hearing beeping to signal his heartbeat.



Amanda was then doing something to my IV, and I said, “I have GBS. I need antibiotics.” GBS is Group B Strep, a bacterial infection many women have in their reproductive tracts. It doesn't affect adults, but it can be fatal for a baby. IV antibiotics ensure that the baby doesn't get the infection during delivery.
“I know,” she said. “That's what I'm doing right now!”



Amanda had asked what I wanted to do for pain management, and I had firmly said, “Epidural.” She came in and looked a little nervous. She said my labs showed that my platelets were at 62, and they had to be at least 100 for me to get an epidural. She said, “We'll redo the labs. Everyone makes mistakes.” I stayed surprisingly calm, hoping, like her, that the results were an error or that my platelets would magically rise. I didn't think about what platelets meant beyond my ability to get an epidural. I probably didn't even know that they represented my blood's ability to clot.

I called Mom, who said she wasn't speeding right then because she was driving through Wadesboro and didn't want to end up in jail there (she had just returned from a conference in Dallas and had lost—as in misplaced—her license at the airport). I told her that I might not be able to get an epidural because of my platelets, but I was getting another lab.

She said, “It might come out okay this time, especially if they were borderline.”

“I don't think they were borderline. They have to be 100.”
“And what are they?”
“62.”

She must have hit the accelerator then. I think that at this point, the Crytec was still helping me stay calm, and I wasn't thinking anything through very thoroughly.

I heard Amanda tell Dr. W, “I've changed it from stat to critical.” Someone came to redo the labs.

Another check, and I had maybe reached 5. Amanda said that we had to start Pitocin because my contractions were still too weak and far apart. I was enjoying those breaks, and the contractions certainly didn't feel weak. I asked to see Oliver, and Josh tucked the Oliver-on-a-seahorse Mary Engelbreit card between the rail and the mattress. I began staring at it during my contractions, telling myself about it. Here are five fish. This one is blue; this one is yellow. This dolphin looks happy. Oliver's toes are gripping the seahorse's sides....

Oliver's heart rate dropped. I'm not sure how I was really aware of it, but people rushed in. Amanda said, “I know you're having a contraction, but I have to do this.” She checked my cervix. “Sometimes, the baby's heart rate drops during sudden, fast dilation. That hasn't happened. Let's get you on your side.”

We alternated sides, and Oliver seemed to tolerate me on my right side better, so we stayed with that. Susan had come in at some point. I think she kissed my head and sat down behind Josh. I don't think she had expected so much to be going on. I'm sure she knew right away, far more than Josh and I did, that something wasn't right.

Amanda said that my labs had been correct. No epidural. She said I could get some IV medication, and that they would coach me with breathing, rub my back, and do whatever they could to help me. I thought coaching? Rubbing my back? Seriously? But I just nodded and got ready for another contraction. With the Pitocin, I wasn't getting those good breaks anymore.

Amanda told me to breathe in through my nose and out through my mouth. She modeled it. I held both Josh's hands and kneaded them. Sometimes, I clutched his shirt. He prompted me to breathe. Sometimes, I'd forget to or get confused about when to use my nose and when to use my mouth, and he'd remind me. I could follow directions but not much else. I kept looking at the Oliver card.

Josh sometimes looked at the monitor and told me when a bad contraction was coming down off its peak. I had started pedaling my legs again; and I was dipping my head, lifting it, and pulling it back like a seal in water with every breath. This seemed to help me somehow. I didn't squeeze Josh's hands but kept kneading them. Sometimes, I wanted to dig my nails in or bite, but I was just self-aware enough to not do it. The same was true of cursing.

I was at 6. My mom arrived. I don't remember what she said, but I saw her and Susan talking to Dr. W. I knew this should scare me, but it just annoyed me. Susan and Mom were talking close to the bedside. I couldn't understand them, but the sound and sight irritated me terribly, and I would have kicked them if I hadn't remembered that I needed the energy (to pedal and seal, of course). Seeing them walk away and text also drove me crazy, in part because part of me knew something was wrong. But Josh's voice continued, telling me what to do.

As I learned later, my mom had told Dr. W she didn't like my blood pressure numbers, and Dr. W had said, “That's because we have a serious problem.” I had severe pre-eclampsia with HELLP syndrome. Pre-eclampsia is serious high blood pressure related to pregnancy. HELLP stands for 
hemolysis (loss of red blood cells), elevated liver enzymes, and low platelets. The liver enzymes are elevated because the body begins to reject and fight the placenta's hormones. This leads to breakdown of the placenta, and the liver begins to destroy the mother's blood cells along with everything else. I didn't know any of this at the time. I think Amanda did say pre-eclampsia at some point, and I remembered it as a complication I'd read about on a pregnancy Web site. Little else registered, though. I was busy.

I remember Amanda saying, “Sometimes we can be very, very sick and not know it.” Later, I would start to understand why I felt so awful during the last weeks of my pregnancy. Being strong at work every day had been such a struggle, and I usually surrendered to bed and misery as soon as I got home.

Amanda asked me if I wanted ice chips or a Popsicle. I'd been wondering if I could drink or have something wet, but I hadn't used my energy to ask. I eagerly said Popsicle and was even happier when another nurse said grape was an option. We always run out of grape at home; it's my favorite. But Dr. W said no, and Amanda said, “Ice chips.” I tried not to be too bummed about this. I got a shot of IV medication. For a moment, I felt woozy and whirly. I fell asleep between a pair of contractions. The medication seemed to cut the very top off the contractions and make the dips a little lower, but that was all.

I had a question; I don't remember what it was. I said, “Amanda?”
She turned to me in disbelief and said, “You remembered my name.” I don't know if this was because most patients didn't bother remembering or because I shouldn't have been rational at that point.

Amanda stopped the Pitocin because of Oliver's heart rate. She said I might have a C-section because he might not tolerate labor. I didn't really react to this. I had told Josh that I thought Oliver would be born early and by C-section. I didn't know, though, that a C-section was nearly impossible because of my platelet count. I could bleed out.

I felt a tube. Dr. W and Amanda put fluid back into my uterus to cushion Oliver and reduce his stress.

Susan mostly stayed near the monitors. Mom and Josh started feeding me ice chips between contractions. My throat was getting dry and sore from the hard breathing. At some point, I switched to my left side. I asked my mom to rub my back and butt, where I was still feeling all the contractions. Josh also tried, and Mom was distressed that she couldn't rub very hard. But I didn't want hard rubbing during the contractions; I didn't like the movement. So I told Mom to rub during the contractions and Josh to rub between them. This became 100% essential. Once, Mom left the bed, and a contraction started.

“Mama!” I yelped.
She responded as if I were begging for comfort; I think she said something encouraging.
But I said, “You must rub it.” I had to make her understand, and she did.

Amanda started the Pitocin again. Mom and Josh had a bit of a hard time juggling this and the ice chips, but it was working. Poor Josh was leaning over the bed and me to rub my back. They were also trying to hold the Oliver card where I could see it. Kind of like a crucifix against evil, they held up that sweet little art work against my pain. Eventually, though, I couldn't focus on it anymore and told them to put it away. I was between 7 and 8.

Mom's rubbing wasn't helping anymore. I said, “I think you and Josh need to switch jobs.” My occasional sentences were very purposeful, and as far as I remember, clear though clipped. Mom got in front of me and took on my hand-kneading. I was leaning into her, pulling her. Josh got behind me and rubbed my back and hips hard, still coaching me to breathe. He didn't tire, complain, or stop. I was so grateful. Once again, just as I had scoffed at the focal point and breathing techniques, I had to accept that the back rubbing did help.

I had another shot, and Amanda told me I couldn't have anything else after that. I felt a bit of panic, but the medication hadn't done much the first time. This time, it didn't nothing. The contractions were too close. I barely had time to crunch a couple of ice chips before another contraction came. I had no rests. I tried to get the moisture from the ice chips fast, so I wouldn't inhale the chips and choke.

Soon, I felt another insertion: the sting of a catheter. At least I wouldn't have to think about bedpans.

Amanda started magnesium sulfate (or as the hospital staff usually called it, mag) in my IV, and she and another nurse rushed to pad the rails of the bed with blankets and tape.

“What are you doing?” I asked since the action was irritating me and disrupted my motions.

“This is in case you have seizures,” Amanda said simply.

I accepted this, assuming that it was a normal part of delivery, a part I just hadn't read about. I was wrong; my extremely high blood pressure put me at risk for seizures, and the mag was supposed to prevent them. I would be on the mag for the next twenty-four hours, and it would soon make me feel mostly out of my mind.

I was at nine. Susan came back. I knew that I would want to push soon. I was glad I'd read so many birth stories and repetitive articles. I was more prepared than I'd thought.

The pressure started in earnest. I could stand it, but I didn't think I could for long. I was breathing maniacally through the contractions. I couldn't speak. I stared wide-eyed at my mom, and she tried to soothe me. But I was trying to tell her something. I glared frantically at Susan, willing her to understand, and she said, “Are you feeling pressure?” I nodded crazily.

She told Dr. W., and Dr. W. or Amanda, I'm not sure which, told me that I could push when I had to, but that most first time moms push for two hours or more, and I needed to conserve my strength as long as possible. I think I got through a two or three more contractions before I was again popping my eyes out at Susan. She got Dr. W, who I think checked me again and said I could push.

“Deep breath in! Push! One, two, three, four, five, six, seven, eight, nine, ten! Breathe out. Breathe in. Again!”



“Push like you're having a bowel movement!”



After suffering major constipation for over a year because of endometriosis, this was language I could understand. I went with it, and I knew that most women do have a bowel movement during delivery. Josh and I had discovered this during a funny moment in Scrubs, and we had read about and discussed it. I couldn't really understand why women get so upset about it. Why have anything in the way? I pushed. I heard Josh say, “Just let it out,” and I felt Amanda's quick clean up. I couldn't care less.

Josh picked up on the pattern and coached me through three pushes. Maybe I got to push through two or three contractions. Then, I heard a voice shouting numbers. Oliver's heart rate had dropped dramatically, and a nurse was counting the rise after I stopped pushing. Dr. W said I had three pushes to get him out, or I had to get a C-section. My mom asked how Dr. W could do a C-section with my platelets so low, and Dr. W said, “That's the problem.” I wasn't really aware of any of this.

Dr. W said, “You have to let this baby rest. You have to breathe through every other contraction.”

Breathe through it? Now? This sounded utterly impossible and a bit like gibberish. I was going to obey her, though. She said breathe. I pushed myself up using the handles at my hips. I imagined that I had horrible indigestion and was stuck in the car. “Don't ruin your nice Loft pants,” I told myself. I wasn't just not pushing; I was holding him in. Amanda told me to blow out the pressure when I exhaled. I blew hard. I cannot describe the utter impossibility of what I was doing. Hearing don't push was like hearing don't breathe, don't come up out of the water, don't blink, only more intense and massive and urgent. My body was going to push without me, and I had to fight it. Oliver was recovering.

Then, I had my reward and got to push. The pain of it was slightly smaller than the relief. I hoped I was pushing correctly. I tried to stay focused. I began to moan, but Amanda told me to hold my breathe and use everything for the push. Eventually, only Josh was counting. Amanda was grabbing people from the hallway. No one else was delivering. I could see girls in the baby alcove. I could hear new voices. About fifteen nurses were in the room, some for me, some for Oliver, and some for an emergency C-section.

Then, I had to breathe again. Sometimes, I had to breathe through two contractions. Everyone told me to blow hard when I exhaled to release some of the pressure. Every time a contraction mounted, I asked frantically, “What do I do?” and either Dr. W answered, or Susan asked her.

Amanda turned me on my back put my legs in stirrups—not the GYN kind, but major ones that held my calves. Most of the bed disappeared. Amanda put an oxygen mask on my face. Every time I inhaled deeply and frantically before a push, the mask collapsed around my face, and I felt that I'd suffocate.

I remember bottles squirting soapy fluid and water to clean me. I remember the vacuum and the rumbling sound and the weird pop and splash as the vacuum came off Oliver's head. It wasn't holding. I heard Dr. W's soft, calm voice and looked up. I saw her face behind a blood-spattered shield, and it was like a horror movie moment when a trustworthy person becomes frightening. I would see that image in nightmares for days. The vacuum kept popping off.

Everyone started responding to my groans and deep inhalations. They didn't seem to be watching the monitor anymore. Their voices changed.

“Come on, Becky! Push him out. Get Oliver out. You can do it. You're doing great. He's coming! He's almost here!”

I wanted to know what this meant. I could feel burning, and I could feel Dr. W trying to stretch me with her fingers. She seemed to be circling Oliver's head. Was his head out? Had he crowned?

Only Josh's voice didn't change, though he was apparently counting through gritted teeth. He reminded me to breathe between pushes and between contractions.

Sometimes, I heard, “Don't cry out! Hold your breath!” Apparently, my face turned red and then purple.

Then, I heard, “We can see his hair!” I pushed past ten when I could. I don't think Dr. W was making me breathe every other time anymore. I'd been pushing for an hour and a half. He had to get out. Dr. W was using oil to grab the small visible amount of Oliver's head and then to reach in to grasp his shoulders. Suddenly, I felt a great release and quake and bumpy slide. I knew he was out. “Please God, please God, please God,” I whisper-breathed. He was born at 6:28 p.m., twelve and a half hours after my water broke and nine hours after I arrived at the hospital.

No lift-up to show us; no asking Josh to cut the cord; no slick, bloody, white-coated baby on my stomach; no cry came. The baby alcove was wild. I hadn't glimpsed my son at all. My mom had disappeared to the alcove. Josh stood steadfast beside me. “You can go,” I said. I was getting ready for the relatively easy part: delivering the placenta. My friend Melissa had told me that she wasn't even aware of delivering the placenta. This would be simple.

But it wasn't. Susan had stayed, and I think I gripped her. Dr. W was smashing my belly with her palms. Then, she was reaching. Reaching, grasping, pulling, tearing. I think she told me she was sorry, but she had to do it. The placenta was falling apart and had also adhered deeply to my uterine wall. The pain I had already experienced was massive but had nature and instinct in it. Everything about this was wrong.

Oliver was out. I didn't have to supply his oxygen or protect his cord. I couldn't. My courage and strength couldn't save him. So I cried, thrashed, and begged Dr. W to stop as her arm disappeared to the elbow inside me, as she tried desperately to remove the disintegrating placenta that was so offending my body and that would cause an infection. I felt something ripple out in her hands. Is that it? No. I didn't see it, but everyone said that instead of a massive steak, as a placenta should look, it looked like a jellyfish. The cord was a weak string inside of a thick, braided rope. I don't know how my baby survived the end of my pregnancy let alone delivery. Dr. W hand went back in. “No, please!” I stared at the doorway, thinking of the hall beyond and escape.

Mom and Josh came back, both red and wet and weeping. I became hysterical. My baby was dead. All of that, all of this, for nothing. I felt myself imploding.

“He's okay!” Josh said. “I saw him moving.”
“He was very gray, but he pinked up,” my mom said.

I breathed for a moment. They wouldn't lie to me. But what was happening to me was very bad. Maybe they would lie. “What is he crying?” I choked, pointing at Josh.

“I'm happy!” Josh said. This hadn't even occurred to me as a possibility.
Amanda came to me and said she had seen Oliver pink up, and he was breathing. He had gone to the NICU. I knew she had no reason to volunteer a lie, so I relaxed back into weakness and returned to thrashing, crying, and begging. I don't know how much of the begging was out loud. I looked at my mom. She had lost it completely. Susan was sort of hiding behind her, rubbing her back. Only Josh locked eyes with me and said, “I'm right here with you. Keep your eyes on me.” I tried to. And in that moment, I think I loved him more than I ever have. A second piece of placenta rippled out. A third.

Dr. W said, “There's more, but I can't get it with my hand. We'll have to do a D&C.”

“Will I be awake?” I said. Clearly, no horror was closed to me.
“No.”
“Okay.” I couldn't help my son, and I had experienced mortification and violation I couldn't have imagined. I wanted to disappear for a while. My body relaxed with this, and I didn't feel my pain.

I felt a little cowardly again and said to Amanda, “I thought this was the easy part. My friend didn't even feel the placenta coming out.”

“Honey, nothing about this delivery has been normal.” Instead of frightening me, this comforted me.



She and Dr. W replaced my catheter, which they had taken out at some point. I didn't feel it. In fact, now that the active assault had ended, I didn't feel anything.



A pediatrician, Dr. P, came in. I don't really remember this, but he told us that Oliver was improving and was breathing “room air,” which meant he hadn't had to have breathing assistance. He was still in the NICU. The magnesium had made him floppy and lethargic, but he was recovering.

An anesthesiologist and a her nurse came in and told me that they would try to put me under twilight anesthesia. If that didn't work, they'd use general anesthesia.

“What is the difference?” I asked.

“To you, nothing.”

Amanda brought me a gift bag with a beautiful teal blanket she had knit. She gave me a hug and told me I had been so brave. I thanked her for helping me. She had been honest without frightening me, and she had helped Josh coach with her quick commands while she wasn't running around grabbing nurses and preparing emergency transfusions.

Everyone found it comical (as much as they could) that I was reminding Josh to move the car and bring in the bags while I was in surgery.

Two male surgical nurses appeared, and they looked terribly nervous. Since Labor and Delivery had its own operating room for C-sections, they had never come to get a woman from the ward and take her down to the main OR. I just couldn't stop being horribly unique. They kept telling me that they had plenty of women working downstairs as if this would comfort me.

I glided through the hallway I had entered twice in a wheelchair. I couldn't see Josh, Mom, or Susan as they were behind me. I heard Mom saying that she would go to the OR waiting room to wait for me. This surprised me a little; I thought she would wait to see Oliver. I'd be unconscious anyway. I didn't realize (nor did Josh) how very dangerous this surgery would be with my platelet levels.

The automatic doors opened, and like something in a movie, the men in my family had stepped out of the waiting room and were lining the hall: my dad; my stepdad, Shane; my brother, James; and my father-in-law, Greg. They grinned and touched my hands as I passed. I could see from their faces that they had no idea what had happened. At the elevator, I gestured to Josh and kissed him. Mom and Shane got into the elevator with us.

I don't remember anything until the two nurses and I were next to the surgical nurses' station. They were pointing out various women to me and said, “See? You don't need to be scared.”

I paused for a moment and said, “I think you are the ones who are scared.”

They laughed uncomfortably.

The OR seemed small, bright, and reflective. Several people were there. They told me to get off the bed and onto the table. Amazingly, I did it. They then moved me to a better position. Someone put an oxygen tube across my nose. It was much less claustrophobia-inducing than the mask.

Slings came down from the ceiling, and two nurses placed my ankles in them. My legs were far apart and almost straight up. I started to get nervous. I'd had two surgeries, a laparoscopy for endometriosis and a D and C for the miscarriage of my twins, and I'd never been awake this long. Maybe they'd lied. Maybe I would be awake. Maybe I'd be awake and just wouldn't remember it later. Everyone was busy; I had no one to ask. I began looking around for my IV bags as if I would see the anesthesia.

Then, I was looking at a clock. I always look for a clock when I awaken from surgery, trying to understand the lost time. The hour was 11, which meant I had been gone for about three hours. The nurse gave me morphine.

My mother had been going crazy. One would have to know how stoic and pragmatic my mother normally is to realize how serious this was. She became hysterical when someone called a code over the intercom. She calmed down when she heard ER.

The twilight anesthesia hadn't worked. My uterus was too clenched to relinquish the placenta. So I had general anesthesia for the first time. I had a transfusion of platelets. After the D and C, Dr. W waited for an ultrasound machine to make certain that she'd removed everything. Then, she placed a rubber, fluid-filled balloon inside my uterus to put pressure on the blood vessels and slow the bleeding. The balloon had an attached catheter to manage the blood flow.

Dr. W came out to the waiting room to explain all this to my mom, and she said, “I feel compelled to tell you that I haven't seen that kind of heart and courage in a long time.” When my mom told me this, I asked Josh to write it down in his journal.

I was horribly thirsty. My throat felt raw. I thought this was from hard breathing and crying out, but most of it was probably from having an oxygen tube down my throat during surgery. I don't remember much besides the thirst. I don't think I was aware or brave enough to wonder about my baby.

But I must have asked the nurse if I could see him. She said that he was in the NICU, and I was going to Critical Care. Neither of us could leave to see the other. We were separated until one of us stepped down and could move through the hospital.

The Critical Care room looked like the delivery room. It was large and had hardwood floors and chairs and couches. Greg and Susan had gone home. I don't know if Josh, my dad, my mom, James and Shane were already there or if they came in later. They told me again that Oliver was breathing “room air.” Josh had been in the NICU the whole time. Oliver was the only baby in the NICU, and he had a nurse to himself. Two people were allowed to visit at a time. I was pleased with Josh's assertiveness: he said he would stay, and one person at a time could join him.

Dad had taken photos of Oliver. He showed me a long but skinny baby with light brown hair and sad eyes. I reminded myself that the antibiotic eye drops were making him look sad. He was covered with monitors, tubes, and gauze. I had expected a small baby, perhaps 7 pounds. Oliver was 19 inches long and weighed 5 pounds and 8.5 ounces.

Dad showed me a video of Oliver crying while the nurse took his footprints. His cries sounded like the bleating of a lamb. But Josh was there, touching his arm, in the video. My baby. Everyone had seen him and touched him before I had. Everyone on Facebook had seen him before I'd even seen a photo. I'd tried so hard to bring him out safely, and was he even mine?

The thirst was still a pressing matter, and I asked for Sprite. I sucked down two tiny cans of Diet Sierra Mist, ate some of the ice, and then began drinking water from a huge travel mug. My thirst would be sudden, powerful, and nearly constant for the rest of my hospital stay. The nurse told me I could have a regular diet and gave me a menu from which to order, but I wasn't interested in food. I was, however, interested in that grape Popsicle. Josh fed one to me, and it was excellent.

A nurse put an ice pad against me and drained my two catheter bags. Mom was disturbed to see the nurse empty the blood into the bucket for measuring urine. This continued through part of the night.

The mag was keeping me groggy and confused. Shane took James home. My mom went to her hotel nearby. Before she left, I asked, “When are you coming tomorrow?”

She said she didn't know and asked when I wanted her to come. I said it didn't matter as long as I knew when she was coming. I could see the clock from my bed, and I needed to know what to expect. She said she would come around 8.

Dad had gone to move the car and get the bags. I thought about Oliver in the NICU, not hearing or feeling or smelling me, wondering where all those familiar sounds and sensations had gone. I had an idea. I asked Dad if his iPhone could do good sound recording. He said it could, and I had him help me record a message for Oliver. I don't know what I said. I tried to be sweet, cheerful, and comforting.

“Are you allowed to go back to him?” I asked Josh.

He said he was, and I told him to take the iPhone and play the message for Oliver. I told my Dad to stay and help me drink my water. Even after everything I'd endured and even on magnesium and residual anesthesia and morphine, I was managing the situation.

Josh came back quickly and said that Oliver had gazed at the iPhone in clear recognition. This made me feel calm enough to bear everything, and I was quite proud of myself for my idea. I wouldn't understand why my brilliant plan made everyone weepy the next day. I guess it was pitiful, but I still think it was a good idea. It comforted us both a little.

Josh had brought back another photo. In this one, Oliver had had a bath, his hair was fluffy, he was wearing a little hospital T-shirt, and he was smiling. The transformation was amazing.

My dad left to go back to Charlotte but said he'd be back the next day. I became more aware of a nurse named Claudia. Another young nurse who had been in the delivery room appeared a few times and told me how amazing the birth had been. Claudia came every hour to check my vitals, change my ice pad, and empty my catheter bags. Once, she said to Josh, “Have you seen her swelling?” He said he hadn't, and she said, “Come here and look.” After that, he was able to tell me if it was getting better. I had no interest in looking.

Josh pulled the recliner close to my bed, and we tried to sleep. Every time I closed my eyes, I saw terrible images and felt horrible sensations. This is just PTSD, I told myself. But when I did fall asleep briefly, I would wake up certain that it wasn't over or that I had to do it again.

In the last weeks of my pregnancy, I'd regularly felt pain and bulging under my right rib. I rubbed the bulge, thinking it was Oliver's foot. But this continued in Critical Care, and for the first time as an adult, I was too scared to tell anyone about a medical issue for fear of what it meant. This contributed to my fear of having to do it all again and my odd sense that perhaps another baby was waiting. I told myself that I'd had a D and C, and if anything else was there, Dr. W would have found it. I later found out that the rib pain and bulging were from my enlarged liver, which had begun to destroy my blood cells.

I asked Josh to remind me, whenever I woke, that I had done it and all was well. He didn't always remember. I had brought Mandy, a sweet book about an orphan who finds a secret cottage, in my bag. I asked Josh to read some of it to me to help me calm down. I think I slept a little.

Near 2:30, neither of us could sleep, and we were talking. I heard the door open and thought it was Claudia, coming to check my vitals. But a clear plastic cart appeared in the doorway.

“Here's Oliver,” Josh said.

He says I moaned and lifted my arms weakly toward the door. I had a pulsing IV in my right arm and a tightening blood pressure cuff around my left elbow.

A cheerful nurse from the NICU pushed my son into the room. She lifted his tightly swaddled body out of the plastic bassinet and placed him in my arms. I recognized the little hat. I spoke to him, and he searched my face with his liquid blue eyes. His irises were so dark that I could barely see his pupils. He blinked slowly and wonderingly. But he had a little smirk on his face as if he had always known everything would be all right and couldn't quite see why I'd been so worried. Thin as he was, he had a little sweet chub in his cheeks. I didn't cry; I just stared and talked to him. I wasn't strong or free enough to hold him close or kiss him, but I stroked his body through the swaddle. That reminded me of having him in my belly because I didn't know what the various lumps and squirming parts were. He was so very gorgeous. Josh took photos with my cell phone, and I later sent them to my parents even though it was the middle of the night. I thought they might feel better knowing I'd finally seen him, eight hours after his birth.

The NICU nurse returned, and I asked, “Does this mean he's not in the NICU anymore? I didn't think he could come to me.”

“It sort of does,” she said. “But I'm keeping him with me.” 

She was clearly in love with him. I'm still not sure if he was actually out of the NICU technically or if she was breaking the rules. My recorded message had affected her, and she'd told Josh that she would try to bring Oliver to us around 2:30 a.m. She'd told Josh not to tell me, though, in case she couldn't do it. 

She told us she had work to do at the nurse's station, and we'd just have to wait. I reveled in a few more minutes with my wonder. Claudia came in and said I needed pain medicine, but she would wait until Oliver left, so I wouldn't be drowsy.

I don't remember the nurse taking him back to the NICU, but I was at peace. My son was clearly fine and happy. Maybe he was stronger than I.