Sugar Goes to the Hospital

Before April 4, 2009, I'd never spent the night in a hospital and my husband had never changed a diaper. By the end of the weekend we'd both conquered these rites in spades, and so ended the chapter of life so many others have wrapped up by our age. I guess it better serves to say how all this began.

My husband won me over exactly four years before our daughter was born. When it happened we were on our fourth date. After waiting out the first two, he'd finally kissed me on our third date, under an oak tree on the northeast corner of Sixth Street and Lavaca, after an Easter movie at the old Alamo Drafthouse Cinema downtown. It was an awkward kiss to say the least, and although I found myself strangely attracted to him I went home and told my roommate I didn't think anything special would become of it. Nearly two weeks had passed before that fourth date found us outside a coffee shop in South Austin. I was attending college and working at the time, and with only a year left I was dedicated to the last leg of a long, hard race. I'd been banging together my degree off and on for eight years at that point. A busy girl I truly was, and determined as well. As I explained to this handsome new suitor why I hadn't seen him for so many days, I left out the part about how awkward our kiss had been and filled him in on my busy week of midterms. He listened patiently to my diatribe, and then he replied, "I want you to be the best Sugar you can be." I couldn't help smiling, and suddenly I wanted the night to go on a little bit longer. I offered him a ride home, knowing he planned to catch a late-night bus back to his neighborhood all the way across town. I ended up driving him instead, and outside his house we enjoyed a second kiss that was, let's just say, less awkward.

Things progressed nicely after that, clicking in a way neither of us had ever clicked before, like clockwork really. A month later we were a definite pair. A year after that he proposed. We married in a beautiful outdoor ceremony in the spring of 2008, and I was pregnant within two months. We moved out of our apartment and into a rent house big enough for three people and two cats. And suddenly it was spring, we'd spent four years of our lives together, and we had my burgeoning belly to show for it. These were the last days of life as we knew it.

So that Friday night, two days after our due date, we indulged in dinner and a raucous comedy at the Alamo again, which would turn out to be our last trip and remains such. We'd been to more than a few final-hour dinners and movies, and we thought we were in for another long weekend of vain anticipation. My parents were coming the next day, in hopes that their long-awaited grandchild would show up while they happened to be in town. But realistically, we thought, we'd just knock a few more things around the house and the baby would be days away. We weren't paying too much mind to the "due date" after all. It wasn't even our original date. I'd first been told March 15, when I showed up at a local birthing center the summer before with a regularly scheduled exam and a missing period. Of course, that date was based on the average 28-day scheduling chart my cycle had never quite fit. I was all but turned away from the birthing center because of my slightly high blood pressure, so I found a new doctor who was natural birth friendly, an ultrasound was performed, and we discovered I was actually two weeks behind the previous estimate. Somehow my due date became April 4, probably through my own defective math skills. Then when the impending arrival got closer my clinicians began referring to April 1. But no matter what everybody said we knew it wouldn't be either date, until my water broke just hours after our movie date, lo and behold on the morning of April 4.

Day One

It was 2:45 when my husband came to bed after some late night TV time. I woke up when he opened the bedroom door, and I immediately got the feeling my water had broken. A flick of the light switch revealed that it had, and it became even more real when I headed down the hallway to the bathroom and left a light trail behind me. Behind the closed door I took a few minutes to myself to let the idea sink in as my husband rushed about, calling my mother and getting the bags ready to go, even though he knew from our childbirth class that broken water wasn't necessarily a green light for the hospital. I let him shake off the initial excitement while I thought to myself, okay, here we go.

The next phone call went to the midwife, or rather to the doctor's answering service, who had the midwife call me back. Just as I expected she told me to go back to bed and try to get some rest, and to come in around nine o'clock that night if my contractions didn't kick in earlier. When the shift changed and another midwife came in, she would call and check on me. So I happily tucked myself back in with a towel over the wet spot and tried to sleep, even though I could feel the first contractions beginning like little cramps that came and went in little rippling waves. Mom and Dad were on their way from East Texas within the hour, only leaving a few hours earlier than they'd originally planned.

My mother arrived shortly after I woke up a few hours later, ready to go for the whole show. I was walking around trying to get ready at that point, still having minor contractions and hoping to have some breakfast while I could still eat. I was also feeling a little morning crud in my throat. Then the on-call midwife rang with my chart in her hand and reminded us I was supposed to have antibiotics during my labor to prevent the baby from catching Group B strep. It took four hours to administer, so we were asked to proceed to the hospital. Dad arrived, I ate, we packed our bags into the car, and the four of us headed to the L&D for our fun-filled baby adventure! At least that's how my parents looked at it, this being their first grandchild. My husband and I were a bit more serious, this being our first labor.

We reached the new Women's Center at St. David's North Austin Medical Center before ten and took the elevator up to the Labor and Delivery unit. It really was like checking into a hotel at first. The shiny new lobby had that welcoming appearance, and even the ladies at the counter were expecting us and had our room all ready. It was quiet when we got there. Nothing exciting was happening; no one was screaming. I was one of the first new moms to check in for the weekend, and the nurses laughed lightheartedly when they spotted the new grandparents from a mile away, snapping pictures of me and my husband through the little windows by the unit entrance. Then we were taken to our large, luxurious labor room, the same one we'd seen on the Labor and Delivery Tour a few weeks earlier. The first of so many nurses came in and introduced herself, and we got right down to business. When it was all said and done, I'd have a huge new respect for hospital nurses. Before I'd had very little to do with them.

I said goodbye to my clothes and suited up in the ugly hospital gown I'd be sporting for the next few days. I had my vitals taken and climbed into bed, where I was soon fitted with an automatic blood pressure gauge. I used to get nervous getting my blood pressure checked, which is probably why my readings typically come out just a little high. There's just something about that boa constrictor squeeze I can't make myself like. But I can say I'm no longer afraid of it, having endured it every few minutes for an entire weekend. I was also hooked up to fetal monitors, given my IV port, and finally, the antibiotics and some fluids to keep me hydrated. And there I sat, strapped to the bed for all intents and purposes, with nothing to do but watch the monitors, wait for the contractions, watch TV, and talk to my support team. Yet I still managed to screw up the fetal monitors every time I moved, losing the baby's heartbeat or mine in all the shifting it took just to make a minor change in position in my hospital bed. Going to the bathroom with my IV cart trailing behind me was an even bigger undertaking. But the nurses were patient with me, and I always ended up back in bed with medicines pumping and machines chirping.

The day went on and on like that. I received my antibiotics and visitors. I checked in periodically with my favorite midwife, Leah, who fortunately for me was on call until Tuesday and would without a doubt deliver my baby, or feel very sorry for me. I ate a bit of food that was brought to me. My relatives took a few last minute photos of my huge belly. I had contractions, but I found them easily manageable, so I knew I wasn't anywhere near hard labor, yet. Leah was reluctant to examine me internally for the simple fact that my water had already broken and I was therefore prone to infection, so we went by observation of my condition and my monitors. My contractions were escalating, but things were not moving quickly; that was for sure. I was still smiling and making jokes even, between contractions anyway. So when my antibiotics were finished and pulsing through my veins, I was allowed to disconnect from my bed and walk around, with my IV cart following, of course. I went for a short evening walk around the unit with my mother, my aunt, and my husband, hoping gravity would work in my favor and pull the baby a little closer to the exit door. I guess it worked, because the contractions began to intensify after that. And naturally that's when my sun went down and things began to get dark.

I remember exactly when things turned. It was nearly ten o'clock that night, I'd been there for about twelve hours, and my water had broken about nineteen hours before. There were several people in my room--my husband, my parents, my aunt, a friend, my two younger sisters, and their significant others at least. My flamboyant friend, Jordy, was doing one of the spontaneous stand-up comedy bits for which he's famous, and my whole family was cracking up and relieving quite a bit of tension. I would've joined in right along with them, if I weren't in labor. But things were far too serious for me. I'd been sitting around having contractions with people all around me all day, without a problem. At that moment it was no longer okay; I didn't have it in me to smile. I was suddenly, seriously hurting. I pulled my husband close and assigned him the task of getting everyone out of the room, at least everyone who'd never been through a childbirth--meaning Jordy, my sisters, and their boyfriends--but I settled for everyone because it was easier. I was sure things were about to get ugly. It was really only the beginning.

Before my due date I'd told myself that I'd give labor a good eight-hour try before considering the drugs. I was born drug-free in eight hours to a first-time mother, and I figured if she could do it, so could I. Of course, my mother was ten years younger when she had me than I was when I had my daughter. But short labors had been her forte, and according to my doctor that bode well for me. I was optimistic. And I didn't want any needles in my spine. Or a doped up baby, or a doped up uterus for that matter. So when the hard stuff started, I told myself I'd probably have a baby by the next morning. And so I labored. And labored. I breathed. And breathed. I squeezed my husband's hand, and my mom's hand, and my aunt's hand, and my dad's hand. And squeezed. I did it all night long. Leah was back around six o' clock Sunday morning, and I just had to know how far we'd progressed, especially if we were going to have a baby that morning. So she checked me out. Since my water broke, a period of about twenty-seven hours including the eight painful hours I'd just spent breathing my way through contractions, I'd managed to dilate a little more than three centimeters, about a third of what I needed. It was epidural time. No explanation needed.

Day Two

After a short wait I met my first anesthesiologist, a nice man with a big needle. That was all I needed or cared to know. I listened wanly to the steps as they talked me through the process, which I'd heard before but never thought I'd need. I got my needle in the back plus a urinary catheter. That part I'd forgotten about since childbirth class, and it was definitely my least favorite, although I forgot about it again as soon as the medicine took effect, about ten minutes later. Then, attached to fetal and blood pressure monitors, IVs, a pee bag, and a pair of legs I could no longer feel, I lay back and enjoyed the sensation of my contractions melting away to Nowhere Land. I now join millions of mothers in admitting this was the best part of my labor. And then I slept. And slept. And slept . . .

After the needle I don't remember much in detail. I slept through much of Sunday while my husband, my parents, and my aunt watched over me and my guests chilled in the waiting room. I don't remember anyone asking me if I wanted Pitocin, but some time after the epidural they started giving it to me, to make sure the epidural didn't kill my contractions. I think I woke up around four in the afternoon, hazy and numb but still somewhat conscious, albeit a little loopy. I remember the weird sensation of touching my leg with my hand and feeling it only in my hand, as if I were touching someone else when I clearly wasn't. I remember the nurses having to save one of my legs from falling out of my bed, because I sure as hell couldn't stop it. I remember asking my husband to make sure my urine bag was filling up, because I felt no urge to go and didn't quite know how to deal with it. I'd also lost my voice by this point, having spent all of Saturday and Saturday night breathing through the mucus in my throat. So any talking I did came out as a faint whisper. On the other side of my wall, however, someone was screaming. I remember constantly having to switch from one side to my other, to prevent blood clots, which wasn't easy in my doped state. I also remember the button I was given to send the medicinal reinforcements into my spine, although at the time I wasn't registering that I had a port in my spine. Others were allowed to hand me the button, but only I was allowed to hit the button. Apparently I wasn't hitting it often enough, because nurses kept having to remind me I could hit it whenever I wanted, that it would only allow so many doses in a certain period of time. I couldn't overdose, in other words.

They stopped having to remind me as the afternoon trudged on and my contractions started coming back. I didn't realize it, but I was being blasted with Pitocin to "help" my contractions. My husband told me later I was receiving almost twice as much as it normally took. Eventually I started to feel it. My epidural wore off soon after I woke up. Actually the numbness in my legs stayed, and the pain relief went. No matter how many times I hit that button I could still feel my contractions hard and fast right through my sheer drug curtain. At some point Sunday evening another anesthesiologist came and gave my epidural a booster. It may have helped a little, but I still felt the pain, and little by little I began to lose my resolve. I was probably hitting that button every couple of minutes, but if I was getting any relief I wasn't noticing. The contractions were coming one after another, stronger and stronger, and I was losing the strength to breathe through them. I was crying by the time they were over, and it seemed like no time was passing before they were back. That's how I remember it. My family told me later that I was breathing through the contractions, falling asleep to the depth of snoring as soon as they were over, and then waking up and breathing again.

By nightfall I was also feeling a strong urge to push. Everything down there wanted to push. So I called upon Leah to come and look at me again. This time, about forty-two hours after my water had broken, I was about five and a half centimeters dilated, little more than half of what I needed for my daughter's head (what I'd been told was a rather large one) to pass through my body. I think that's when Leah brought up what I'd already thought up myself: the possibility of a Cesarean section, what I'd previously deemed my worst-case scenario. In that light I wanted nothing more in the world, because a "natural" birth had become a staggering impossibility. We talked it over, and Leah agreed to call the surgeon.

We waited for the on-call surgeon to get to the hospital, as my doctor was unavailable. Another exam by the surgeon confirmed that not only was I less than six centimeters along, my daughter's large, hairy head also seemed to be in the face-up position, which makes for a more difficult birth for everyone involved. Once I heard that news, I was signed up. The doctor offered me a Cesarean, and I happily accepted. For some reason I can not recall I was told I'd be waiting approximately an hour before we could get started. It had apparently been a hectic weekend outside my delivery room as well as inside, and there wasn't an operating room available for us. But shortly after I got probably the biggest break of my life and the nurse came to tell me one was available after all.

From there things moved quickly. I was given an icky solution to drink for stomach control, which I was advised to shoot instead of sip. Good advice. My husband was given his instructions for assisting me. Everyone else was directed to the waiting room. The second anesthesiologist, I think, returned and asked me if I'd had a rough day. I responded by holding up two fingers, because I couldn't talk. He assured me the wait would be over soon and stood by my side as a team of nurses prepped me and moved me onto a portable bed. I was told to keep all hands and feet inside the bed, and away I went to my operating room, just meters away and yet a world apart from the warm, comfy, muted Labor and Delivery room to which I'd gotten so acquainted. The lights were bright white. Actually the light fixtures themselves were a lovely shade of blue over the operating table. This was the only comfort I found in the room until nearly one o'clock. But the light in that room was the brightest white light I've ever seen from such a close source. It was also, I'm sure, the coldest room in the entire hospital. I was moved onto the table and almost immediately my arms were placed on armrests and a tent went up to block my face from my chest. While my belly was prepped with cold antiseptic my friend the anesthesiologist, standing above me and looking down, re-upped my epidural yet again, after telling me exactly what was going to happen in clear, calm, understanding terms. This time I was given a different medication that numbed me from the chest down with a cold wave that traveled the length of my body. I then began to shiver uncontrollably as the medicine took effect, but of course, I still tried to control it, to no avail. I shivered my most violent shivers until they subsided on their own and all I could feel was the pressure from the proceedings going on below my chest. The anesthesiologist joked with me, "This isn't much fun when you can't talk, is it? Just make eye contact with me if you feel any pain." And I actually found it kind of funny, in a ridiculous sort of way.

Somewhere in all this my husband was escorted in, dressed head to toe in green scrubs. He had my glasses, and he wore my wedding ring on his pinky. He was seated on the stool beside my head, and as the surgical team began their work, he put his lips next to my ear and told me how much he loved me, in his own lengthy, wordy, matter-of-fact way. One would think that during all this I'd have no problem staying awake. But after nearly forty-six hours of IVs, blood pressure checks, fetal monitors, contractions, position changes, spinal sedatives, catheters, and Pitocin blitzkreig, I was having a bit of trouble. It was all I could do to keep my eyes open. I even tried to tell my husband to stop talking to me, because his lullabye tones were making my eyes heavy. I knew if I missed my daughter's first cry after all this I'd never forgive myself.

I listened and stared up at the blue-white lights as the surgical team worked, talking about how busy their weekend had been, with Leah standing by to lend a hand as needed, not about to miss this one. My body rocked and shook a little bit as my various baby-hiding parts were moved here and there. I was forewarned when sudden jolts and squeezes would take my breath away. Other than that not much was required of me. At one point Leah got to push down on my belly to help squeeze the baby out. All this seemed to be done fairly quickly, but a vacuum extractor was actually used to get my daughter's large head through the relatively small incision. I didn't find this out until two days later. I certainly didn't realize it at the time. What little juice remained in me was holding my eyelids open. Finally, fifty-one minutes into the morning hours of Monday, April 6, 2009, I heard the song of new life that only a new parent gets to hear. My daughter cried.

There were two baby warmers in the room. My daughter was taken to the one I couldn't see. My husband joined her, and when he'd had a good eyeful and made sure her passages were cleared and her digits were intact, he returned to me with her first photographs on our digital camera. My first impression of her was one of strength. She appeared unfazed by her adventure. She looked huge in the frame of the picture my husband showed me. Her chest stuck out like Superman's, and her cheeks were like balloons. And her head was covered in a mass of curly, black hair. I got my husband to put my glasses on my face so I could get a good look at her when she came my way. And then he brought her to me, wrapped up burrito-style in a dinosaur blanket with the little striped toboggan every baby in America is issued these days. I got to give her a quick kiss on the cheek, the anesthesiologist (I think) snapped a couple of first family portraits, and before I knew it my husband and my daughter were off to the nursery. As for me? My friend the anesthesiologist leaned over me and said, "Now you can close your eyes and have yourself a nap." And I did.

After that, the time passed effortlessly. I woke up wrapped like a warm burrito myself as I was transferred back into my mobile bed and wheeled into recovery. I don't think I've ever been so comfortable. Even the pressurized knee socks I was wearing to keep my legs from clotting weren't uncomfortable. When I got to recovery I was the only patient there. I was one of the first mothers to come in that weekend, and probably the last to deliver. A couple of nurses looked after me and got me started on my post-op meds. I ate some ice chips with assistance. And then my family members were allowed to come in and see me, one by one, first my mother, then my father, then each of my sisters. They'd already met my daughter, along with my aunt, my sister-in-law, her husband, our niece, my sister's boyfriend, and Jordy, the last ones standing after a long weekend for all. They'd slept on couches in the waiting room to be there when she arrived. A couple people had even slept in their cars. Apparently Leah had sneaked them into a secret spot so they could see her as soon as she came out of the operating room with her father. There'd been a midnight rendezvous in the hallway outside the nursery that wouldn't have been possible had it not been one in the morning. They gushed over my daughter's beauty and told me my husband and daughter would be the next to see me. I thought they were coming to me, but then I was taken to my next stop, my beloved Labor and Delivery room where my family waited, including my daughter. All nine pounds and five ounces of her.

To be continued . . .