Friday, May 15, 2020

Giving birth during COVID

I’m a little reluctant to share my birth story because I think there’s enough panic out there right now for pregnant women, and there are so many people who are having perfectly normal births despite the circumstances. When people ask me how it went, I tell them it was hard but we’re fine. And we are fine. I’m usually a results driven person, so I tend to focus on the outcome and not the process. So it’s natural for me to tell myself that it’s fine because in the end I am here and I have a baby and we are okay. 

But I’m also not okay. The actual birth was a perfect storm of circumstances that led to the worst few hours of my life. It’s going to take me a while to process it, but right now I’m just accepting that it was scary and I can feel angry about it. 

I was scheduled for a c-section on Wednesday, which I knew was pushing my luck because Thursday was my due date. But Adrian had been a full week late and I really wanted to schedule with my own doctor, so I decided to do that thing where you trust in the universe and just believe that it will be okay, which is very out of character for me. I told myself that this baby would wait, I visualized a smooth hospital experience. I knew Dustin wouldn’t be allowed in the actual OR with me, due to the COVID precautions, but he would be there as I was prepped and he would be there in the recovery room. We asked my mom to self-quarantine for two weeks prior so she could come up and watch Adrian for the day. Our back up plan was to drop Adrian off at her in-home daycare, which has been closed since mid-March, but had offered to watch her during the hospital stay. 

On Sunday I packed a small hospital bag, and typed up an obsessively detailed explanation of Adrian’s schedule, food options, and stuffed animal preferences. I got in bed around 9pm, feeling peaceful and truly believing that this whole trust exercise thing was working, looking forward to our last couple days as a family of three. And then my water broke. Thanks, universe. 

The contractions started right away but they were still 10 minutes apart. I talked to the L&D nurse and she said to monitor for an hour. I called my mom and told her I was pretty sure this was it. I showered and washed my hair and got dressed. By 9:45pm the contractions were 3 minutes apart and I knew we couldn’t wait to go to the hospital. My mom got in the car and we called a friend who lives close by to come sit with the baby monitor until my mom could arrive. We were at the hospital by 10:30pm. 

I was prepared for the screening at the hospital entrance, where they check your temperature and ask a few questions to assess COVID risk. But when Dustin tried to pass through they stopped him and told him that partners weren’t allowed in L&D until the patient was actually admitted. I tried to explain that I was having a c-section and was definitely going to be admitted, but they told him he’d need to wait in the car for the time being. I was so desperate to get upstairs that I accepted it more quickly than I might have otherwise, but I remember standing in the elevator alone as the doors closed and just crying. 

I went through the intake process and got settled in a triage room by 11pm. A frazzled young doctor came in to check on me, apologizing and saying that they were really busy that night. I was 5 – 6 cm dilated and having contractions every 3 minutes and he confirmed that my water was ruptured. The next hour is a blur. I was in a lot of pain, more than I remember from my labor with Adrian. The contractions were starting in my lower back and wrapping around my abdomen and I was feeling like I couldn’t manage them. A nurse came in and put in an IV, the doctor came back and swabbed me for COVID. I have never come closer to hitting a medical professional than when he reprimanded me for not holding still enough while he was reaming my brain out through my nostril and I was having a contraction. By 11:45pm I was starting to panic. The anesthesiologist was still busy, the pain was increasing quickly and I was starting to feel like I needed to push. With Adrian, I’d managed the contractions by having Dustin watch the monitor and tell me when a peak was coming and talk me through it as it eased off. I tried to do it alone but everything was hazy. I was distracted by pain and couldn’t figure out which monitor was tracking the contractions and which was tracking vital signs. All I could hear was the baby’s heartbeat, thumping and speeding up and down. I wanted to get up and move. I called out for the nurse and told her I needed to get up and go to the bathroom. The doctor came in and asked if I was saying I needed to push and I told him I didn’t know but I couldn’t sit here. He sighed and said he’d check my progress, telling the nurse as he was gloving up that he was only checking because I said I needed to push. And then he said what you probably least want to hear when someone has their hand inside your body, which is “Oh shit.” He told the nurse to get me into the OR immediately, that I was over 8cm dilated and they needed to move. The nurse reminded him that the anesthesiologist wasn’t free yet and the doctor said they’d get him to meet us, and if need be they’d just put me under general. 

At this point I freaked out. Looking back I realize it wasn’t totally rational, because I was at a good hospital about to undergo a routine surgery. But I was suddenly terrified that I was going to die. I didn’t trust the doctor, there was no way I was going to agree to general anesthesia when I was alone and had no one to advocate for me or the baby. I was in so much pain, and I thought about bailing on the whole surgery but I knew that if I did I would be having a completely unmedicated birth, possibly alone, and I was in no way prepared for it. I’m not sure I can really communicate the level of desperation I was feeling in that moment, when it just seemed like I didn’t have any good options and no one was listening to me anyways. 

I was in the OR by midnight and the luckily the anesthesiologist was the kindest and most reassuring presence I’d encountered since I got to the hospital. I was sobbing and telling him I wasn’t sure I could hold still for him to place the spinal block. My contractions were coming every two minutes and they felt like they were ripping me apart but somehow he managed it and as the pain from the contractions eased up my mind started to clear a bit. The surgeons came in and there was some consternation over the fact that my COVID results hadn’t come back yet and they tried to figure out what to do because they didn’t feel like they had enough time for everyone to get the additional PPE needed if I did have COVID. Just as they were deciding to move forward as is, the results came in negative and everyone cheered. The rest of the c-section was uneventful, and pretty similar to Adrian’s, except that I was alone and the surgeon was less communicative and I cried a lot more. Ian was born at 12:39am and we were in the recovery room by 1:30am. I thought Dustin would be allowed up but they told me that he’d have to wait until we were actually taken over to our hospital room, so I held Ian and just luxuriated in the knowledge that we were both alive and safe.

I was moved into a room around 4am and Dustin was allowed up. They reminded us that he was allowed to stay as long as he wanted but once he left he wouldn’t be able to re-enter. We were already prepared for this and knew that he would be staying for the day and heading home in time to put Adrian to bed. We were worried about how she would react to both of us suddenly disappearing when we were the only two people she’d seen in two months. 

I still don’t know if that was the right decision. The first night alone was incredibly difficult. Ian was having trouble regulating his blood sugar, and they needed to test him before every feeding, and then they wanted me to triple feed him each time (breastfeed, hand express and feed with a cup, then give formula). At this point I had been awake since 7am on Sunday morning, nearly 48 hours without any sleep at all, and I was starting to feel like I was losing my mind. He cried most of the night, and instead of being able to just feed him on demand I’d have to call and wait for a nurse to come in each time for the blood sugar checks and they kept reminding me that if he didn’t get three good readings in a row they’d take him to the NICU and I wouldn’t be able to see him. I was struggling just to be able to sit up with the c-section incision, and having to get up to change diapers and walk him around the room felt like a brutal physical endurance test. 

On Tuesday morning when the doctor came to check on me I just couldn’t stop crying. Physically I was okay, and able to move around, but I was deliriously tired and missing Adrian so much and just feeling like I couldn’t take much more. The doctor told me that she’d be willing to discharge me earlier than normal, as soon as Ian was cleared to go home. And then Ian miraculously got a couple decent readings in a row and the pediatrician agreed to discharge him. We were out at 1pm on Tuesday and I have never felt so relieved. 

The first week at home was hard, of course, with a very active toddler and a newborn and the c-section recovery, but I did much better than with my first one, probably because I was more aware of how careful I needed to be. 

In our second week we’re settling into a routine and just missing the presence of family and friends. I’m so grateful for how well Adrian has handled the transition. She’s excited about her baby brother and just loves seeing him. It makes my heart ache to not be able to lift her up, but it isn’t as bad as I was expecting. We explained to her that I have a boo-boo and in a few weeks I can lift her again, and in the meantime she can always snuggle with me on the couch and I’ll read to her. 

In retrospect I would have scheduled the c-section for 39 weeks, I would have gone to the hospital immediately instead of waiting for an hour. In short, I would have trusted my own instincts and not just hoped for the best. 

Again, I don’t think that my situation is representative of giving birth in this time. My labor was moving quickly, there were way more patients than usual which spread all the staff thin, and it would have been a stressful and painful situation even if everything else in the world was normal. The only difference COVID made is that it was a stressful and painful situation that I went through alone (and that’s huge – I know that it would have been so much better if I’d had D with me to talk me through it and help advocate for me). I am grateful that everything worked out, and I’m also allowing myself to acknowledge that the process was really fucking hard and it’s okay for me to not feel okay about it.

If you’re pregnant right now and feeling anxious, I will say that the L&D department felt safe, so the precautions do seem to be helping. Every hospital has different restrictions and they change as the current situation changes, so I think the only thing you can do is keep in touch with your doctor as the birth approaches so you know what to expect. And if it’s at all possible, I would recommend having someone with you. I thought (and still think?) that I probably could have handled the scheduled c-section on my own, if I had my own doctor and I wasn’t in labor it would have been hard and sad but okay. But laboring alone was terrible, although I admit that I’m not the best candidate for it, since I had an emergency c-section pretty early on with Adrian and was not mentally prepared to labor with this baby. Right now, I am just very grateful to be home with my family, and the birth experience gets a little further away each day.