When did i get like this.., p.5
When Did I Get Like This?, page 5
Once at the hospital, David filled out my paperwork while I pushed, huffing, against the admitting desk. Perhaps I was managing my labor a little too successfully, because no one on the overnight skeleton crew in Labor and Delivery seemed in much of a hurry to examine me. I was finally shown to a converted closet bisected by a curtain. The examining resident, David, and I could fit in there, but our bags could not. “Let’s see what we have!” the resident said cheerily, and I was grateful someone was showing some enthusiasm as I struggled onto the table. I watched her face as she examined me, her eyes darting, settling on the right number. “Great job!” she said. “You’re about one and a half centimeters dilated!”
I could tell she was rounding up, throwing that “and a half” in for my benefit. “What?” I shrieked. “I have been having contractions for seven hours!”
“Wow! Good for you!” she said, beaming like Miss Tennessee.
“But the Lamaze teacher promised me a centimeter an hour,” I said, hoping for a recount.
“Every birth is different,” she said, winking at David. I saw precious little to wink about. “Now. You can stay here, if you want…”
I knew what she would offer next: a Demerol drip to take the edge off and let me sleep until I was dilated enough to get an epidural. This was exactly what the birth books had told me to avoid at all costs. Once I accepted any pain medication, I would be on a greased-pig slide to Intervention Town. How lovely that suddenly sounded.
“No,” David said quite assertively on my behalf. “She’s less than four centimeters, and we’re going home. That’s what’s in our birth plan.” Back down the elevators we went, David, me, and our three bags. I held on to the pole at the hospital entrance, finishing out another contraction while David hailed another cab. I couldn’t believe that I was one of those first-time mothers, the ones who rush to the hospital only to find out their perceived labor pains are “false.” I had thought being more prepared than other women meant I would be better able to handle the pain. Now here I was, the idiot being patted on the head and sent home because I was, more likely than not, not really in labor at all. If these were “false” contractions, I was terrified of how much worse they could, apparently, get.
The cabdriver regarded me in the rearview mirror with considerable trepidation. Dr. Merman had been right: more than anything, I wanted to lie down and be done going anywhere until this was all over with. Instead, I was in a cab speeding across Central Park at 1:00 A.M., holding on to the leather straps that hung from above the door. (I always wondered what those were for.) Every few minutes, back into the electric chair of contractions I would go. I would sit up as tall as I could, hiking up my shoulders and ribs, trying to climb out of my body, taking deep breaths until it passed. The books had said that the peaking aspect of contractions would be comforting. I found it terrifying. Ow ow ow OW! Oh my God it’s getting WORSE OW OW—is it almost—no! Ow! OW! Jesus Christ, OW! I couldn’t even enjoy the time off in between, since I knew each second of rest only brought me closer to the next ruthless onset. “I’m okay,” I told David, trying to smile, and he smiled back, clearly freaking out. I was being this much of a baby and we weren’t even admitted yet? He rubbed my back. “Don’t touch me!” I yelled. (The partner massage techniques Willow had taught us at prenatal yoga would prove less than useful.)
Once home, I climbed into our bathtub. According to my birth plan, at least, this is what I wanted to happen next. David said, “Try to get some rest, hon,” and immediately passed out in our bed, abandoning me as surely as Peter did our Lord and Savior in the Garden of Gethsemane. (Some doula he was.) I lay in the tub for a few hours, slumped over the side as the water grew cold, alternating 180 seconds of sleep with 60 seconds of gripping the faucet and moaning gutturally. Around 4:00 A.M., I heard a distinct popping sound, a champagne cork flying loose. It was my water breaking, though I could not be sure of that until I got out of the bathtub, toweled off, then was abruptly wet again. I went over to the bed and shook David awake. “You’re doing so great, honey. Try to rest,” he said sleepily, patting the pillow beside him. “Get up,” I said, hitting him, knowing that the clock was ticking. Now that my amniotic sac was broken, the baby was going to have to come out, one way or another, in the next twenty-four hours. The hospital would have to admit me now, and I desperately desired the finish line of the birthing bed and its scratchy sheets.
After I was reexamined and told that eleven hours of overnight labor had brought me to four centimeters’ dilation, I made the executive decision that I had labored drug-free for long enough. “Amy would like a ‘walking epidural,’” David reminded the anesthesiologist, who was searching for the correct injection spot on my spine. “There is no such thing,” the anesthesiologist responded, clearly for the eighteenth time that morning. “I can give her a lower dose, but from now on, she’s going to be in bed.” These were the kindest words anyone had said yet.
The epidural probably slowed my labor somewhat. It’s hard to say, since it could not really have gotten much slower. But now I was at least able to sleep through a few hours of contractions, awakened finally by the tremors of my body “in transition” but not by the pain itself. Dr. Merman arrived and pronounced me ready to push, a mere nineteen hours after my first contraction. “In accordance with our birth plan, Amy would like the epidural turned off now, so she can feel to push,” David announced. I grabbed his arm and told him, in no uncertain terms, where he could shove the birth plan. The epidural drip stayed where it was.
Two strenuous hours of pushing later, the baby’s head was crowning. There was an almost eerie calm in the room as Dr. Merman, the nurse, David, and I all waited there on the edge of bringing a child into the world. There was nothing for us to do but wait for my body to begin its next contraction and finish its task. It was a strange little moment, an anticlimax before my life changed forever. Dr. Merman decided to make a little speech while we were waiting. “I know you didn’t want an episiotomy,” he said, holding up the scissors. “But this baby’s head will come out much more easily if I make a little cut.”
“Go ahead,” I said, waving him off, feeling nothing as he snipped, no longer focused on anything but being done. And after that next push, my son Connor was born. As our birth plan requested, he was placed immediately on my chest, sans eyedrops or sponge bath, umbilical cord still pulsing. The books had considered this point nonnegotiable, and I now saw why. My baby was with me at last, and I didn’t care if he was cleaned off and bundled up or not. There was nothing my baby needed in those first moments of life but his mother’s sweaty and exhausted arms. It was a perfect moment.
Well, almost. Our three enormous bags of supplies had sat in the corner, unused. I never got around to utilizing the tennis balls in the small of my back, or the guided visualizations, or the anthemic U2 music David had chosen for me to labor by. I was happy I had packed my favorite pillow, but the rest of my careful planning had gone by the wayside, including the birth plan itself.
I thought that all I had to do to have a perfect birth was state that that was what I wanted. Anything left to chance, and I would become another victim of a needlessly meddling medical establishment. But in the end, that’s what happened anyway. I had an episiotomy, which the books warned me would happen to any mother who didn’t stand up for herself, who wasn’t informed enough to know episiotomies were performed purely for the doctor’s convenience. I had known this and still not stood my ground. I had also had an epidural, which the books warned were foisted on all laboring mothers, making them woozy, disconnected, and not present in their own bodies for the moment of birth. In actuality, it had made me calm, and unfrightened, and perfectly present, except for the corner of my brain that was clanging: You have failed. I was holding Connor in my arms, and there was a tiny part of me thinking not of how I had made it through a twenty-hour labor to deliver a perfect baby boy, but of how I had fallen short. I was a quitter. I had not made it all the way to Aqua.
But lying there holding my son, I could also see that it was screwed up to regard my caregivers’ attempts to alleviate the pain and inertia of a primigravida, a first labor, as the machinations of the enemy. They had only been trying to make me feel more comfortable, trying to deliver my baby to me as soon as possible, as safely as possible. And they had. That could not have been wrong.
Four years and ten months later, I was back in the same hospital to give birth to Maggie. Since she will likely be my last child, her birth seemed as momentous as my first: the final chance to do things right. After waiting eleven days past her due date, I showed up at the hospital early one morning with irregular contractions, again not really in labor. This time, though, Dr. Merman told the nurses to kick-start my contractions with an IV drip of Pitocin, the unholy crack cocaine of birthing interventions. I welcomed it readily. The nurses’ shift change occurred at 8:00 A.M., and at 8:10 A.M., my new nurse, the one who would be my guide for this one last trip, walked in. “Hi, I’m Alice,” my old Lamaze teacher said, and then did a double take, recognizing my last name on my chart. To have Alice as my labor and delivery nurse seemed like incredible luck, and a sign. Maybe I could tough this last birth out without the epidural. Maybe I could do it right this time, although the Pitocin would make the contractions even more painful. Maybe I could do it, because this time, I would have Alice to help. “You’re laboring very well,” Alice said, patting my back, bringing me a birthing ball to squat on while David went looking for a turkey burger. I was actually feeling pretty good. When Alice did the next internal exam, an hour later, I was already at five centimeters. She looked at me. “If you’re going to have an epidural, Amy,” Alice said, “it’s time.”
I looked at her, unsure. “I feel okay,” I said. “And a third baby is going to go pretty fast, right? Maybe I can make it without.”
She shrugged.
“What do you think?” I asked. I wanted so desperately to please her.
“I think,” Alice said, “that you don’t have to impress me.” I gratefully accepted the anesthesia and another pain-free birth, relieved that Alice was not going to think less of me for it, even if I did.
I am not sorry that, entering into the terrifying and mysterious experience that is childbirth, the books I read armed me with information and awareness. I am sorry I created a hierarchy of outcomes that didn’t matter a whit but took even a moment of happiness away from the birth of my children. The only thing wrong with Connor’s birth was that I thought there was something wrong with it. In the hands of a perfectionist like me, the birth plan was the snake in the garden, dangling the apple of an idea that there could be a “better” or a “best” birth, one that could in any way exceed the happy ending of a healthy baby, safe in its mother’s arms, both of them whole.
CHAPTER FIVE
Nipple Confusion
Despite my overplanning for the birth of my first child, the pains of labor were not the chief focus of my third-trimester anxiety. I was at least fairly certain that one way or another, in the manner I had envisioned or otherwise, my baby would be born. The primary obsession that stayed with me throughout my nesting-instinct-fueled days, that accompanied me through all my nights of parturient insomnia, was the unnerving thought that once my child was born, I was supposed to put my boob in its mouth and milk would come out.
I could easily imagine my imminent life as a mother. I just couldn’t imagine that. I was apprehensive on two counts. Would my lactating breasts mean sudden and perhaps permanent desexualization, in my own eyes and those of my husband? At the same time, wouldn’t there be something inappropriately hypersexual about my baby (particularly if it were a boy) with my boob in his mouth all the time? To me, nursing a baby was way out there, going off the grid, packing the covered wagon and venturing into undiscovered territory. Like the majority of my peers, I had not been breastfed; I may have been a ’70s baby, but that hippie stuff did not fly in Scranton, Pennsylvania. Out of my huge extended family, only my Aunt Nessie nursed her children—not that she ever did it where the rest of the family could see her. One of my earliest memories is of walking into a bedroom at Nana’s house and discovering Aunt Nessie sitting in a rocking chair with my new cousin, Erin. It looked to me like both of them were asleep, but Aunt Nessie had her shirt off, and the baby’s little chin was moving, and they seemed connected somehow. Aunt Nessie looked up and must have seen the confusion in my five-year-old eyes. “It’s okay, honey,” she said, but I was already backing out and closing the door. I didn’t know what the heck she and my cousin were doing, only that I was not supposed to have seen it.
A quarter of a century later I did not have much more of a clue. I had no close friends who had already had children, no older sisters to light the path. I might as well have asked my mother for tips on ice fishing. Is there anything into which a modern woman is thrown with less support or guidance? Before getting married, my church required a weekend-long retreat of lectures and reflection. Before labor, my obstetrician prescribed fourteen hours of Lamaze classes so I could acquire breathing exercises I would immediately jettison when the time arrived. I have even attended a mandatory two-hour seminar at my children’s school on how to be a parent of a child in pre-K, for the last three Septembers in a row. But there were no breastfeeding symposiums for pregnant mothers. I didn’t know where to look for reassurance or advice. I watched A Baby Story on TLC twice daily, so I knew what would happen if the umbilical cord was around my baby’s neck during delivery, if meconium was detected in the amniotic fluid. What I didn’t know was how to do what was supposed to happen next.
In spite of my extreme apprehension, I never considered just not doing it. I had to breastfeed my baby, because I was going to be the best mother I could be, and on this particular point the world is rather unbudging. These days, one would have to be part of the last undiscovered tribe in the Amazon rain forest to not have heard that “Breast is Best.” The rest of us have all had pounded into our frontal lobes by the Internet, by Dr. Sears, by Baby Whatever magazine, and by strangers on elevators, that breast is best! for a baby’s immune system, his bonding with his mother, his IQ, and his emotional development. Formula is totally fine too, all these sources tell us, for mothers who don’t really love their children. The message was fairly clear. If I was afraid of what it would be like to nurse my child, I could not stomach who I would apparently be if I did not.
My friend Heather, who had graduated from the “Trying to Conceive” Internet message boards shortly before me, had just given birth to her son, Owen. I waited about a week before I went over to visit; my mother had always told me it took at least that long before new mothers were ready for visitors. I knew Heather had planned to nurse Owen, and I hoped to get the lowdown on it while I was there. Since Heather had already been a mother for a whole week, she was sure to have everything figured out.
Owen was adorable. Heather looked horrible. “Basically, I haven’t slept more than half an hour since we brought him home,” she said. “It’s not going very well.” She spoke of fevers and infections (hers), of searing pain and cracked nipples caused by Owen’s faulty “latch” onto her breast. “And now it’s time to feed him already,” she said, sighing. “I’m sorry you have to see this.”
Heather’s loving husband handed her Owen, then arranged eighteen couch cushions around the two of them just so. Then he got out an elaborate system of plastic tubing, which Heather placed around her neck and down alongside her newly enormous breasts (“porn-sized,” Heather called them, without the gusto one might expect). Heather explained that the tubing was a Supplemental Nursing System, ordered by the lactation consultant, who had already made several $120 home visits (not covered by their health insurance) to help Heather’s nursing go more smoothly. While Heather nursed her son, breast milk that she had pumped earlier would go through these little tubes and into his mouth, augmenting what Heather’s breasts were providing. Heather would feed Owen this way for up to forty minutes, then pump more milk out of her breasts for another thirty minutes, then have perhaps an hour off before the entire rigmarole began again.
Owen fussed and sputtered. Heather looked like she was about to cry. “Open your mouth, little guy,” she pleaded. I left soon after, since poor Heather was too distracted for visitors. All my breastfeeding questions were still unanswered, including a new one, more burning than all the others: if it were really that impossible, why didn’t she just stop? Witnessing Heather’s experience only served to further freak me out. Not only was breastfeeding altogether ooky, but it also seemed that it sucked, literally and otherwise.
A month or so later, David and I went to see our new baby niece, Alexandra, in the hospital. We had to wait in the hallway for at least half an hour when we got there because the nurse was trying to teach David’s sister Nikki how to nurse the baby. I could tell by the look on Nikki’s face when we finally saw them that it had not gone particularly well. By the next time we saw our niece a few weeks later, though, Nikki was off the hook, having been given a hall pass by Alexandra’s pediatrician stating that Nikki was not producing enough milk. No Supplemental Nursing System for Nikki. She seemed pretty happy to have been sprung, as did Alexandra, who was lying there sucking contentedly on her bottle. That night, I made a pact with David: I would give nursing a try, but I was no martyr. When the first bad thing happened, I was out.
As my labor progressed, and the moment when I would meet my child neared, my anxiety increased. From my exhaustive research, I knew that babies have a strange window of heightened alertness as soon as they are born; they regard their new surroundings with serious eyes for an hour or so, then fall into the deepest of slumbers for about a week. I was certain that breastfeeding for me would be ultimately unsuccessful, but if it were even to begin, I had to nurse Connor during this narrow window of opportunity, in the first minutes of his life.
