Monday, June 18, 2012

Ashlyn Esther: A birth story. . . and coming to terms with the unexpected. . .

I've been stewing about writing this for a while.   I've never experienced such a profound mixture of utter joy and deep sadness all at once in my entire life.  It's really bizarre, actually.  At one moment I am looking into the eyes of this gorgeous gift I have been given, this great responsibility that God has trusted me with while at the next, I am begging Him for a "do-over" and asking why He allowed this to happen and what the future holds for us now.
At my cousin Michelle's a week or so before Ashlyn's arrival
I spent the last two weeks of my pregnancy at my grandparents' house in Whittier.  We had not planned on this but at my 38 week appointment the doctor checked my cervix and I was at 3 cm and rather effaced.  While I understood that this did not mean I would go into labor soon, there was concern that since I already started dilating, that my previous labor was relatively short and early (38 weeks 2 days) that I needed to be closer to the hospital than the "45-min-with-no-traffic-but-more-like-hour-and-fifteen- during-rush-hour" distance we were looking at from our house.  The OB offered to induce me-I think to reduce the risk of a 60 freeway baby.  I declined regardless of his promise that it wouldn't increase my risk of c-section since it was my second baby and I was practically ready to go anyway.  I just didn't want to go the Pitocin route. When I promised I would move closer to the hospital, the OB seemed to relax a bit about the situation.  He wasn't pushy, just gave me the option.  So to grandma's we went.  While we are so grateful to my grandparents for letting us move there for a while, dragging all of our stuff there for an undetermined period of time with a nearly 2 year old was not a picnic.  We enjoyed time with my grandparents and Claire loved being with them as well but we just wanted to be at home where Claire could be in her own bed, with her usual routine and I could get things done before baby got here.  With each passing day, I would hope and pray that night would be "the night" but as my "due date" neared, I lost hope that I'd be early like my first and tried to settle into the unknown.  "She will come when she is ready" a phrase this Bradley momma was well versed in, one that is easier to accept when you are sleeping in your own bed, in your own house, and your first baby came early anyway and you didn't have to worry about it.
 CSUF's graduation MSIDT :-)
May 19th was Christian's graduation ceremony.  Before I had assumed I'd be nursing a newborn through the ceremony. Turns out I was still pregnant.  I'm grateful I was able to go, however, since if she had come the day before, I could not have gone and seen Christian walk and get his diploma he'd worked so hard for.  Had she come the night before or that morning, he wouldn't have been able to participate in the ceremony.  Throughout the graduation, I felt a little crampy but had learned not to get too excited about anything, that if I started thinking labor was eminent, it wouldn't be and I'd only be disappointed.  Besides, how "perfect" would that be?!  Attend graduation, have a baby that night.  Riiiiight. . .
That evening, in a last ditch effort to try and "evict the baby", Christian went to Burrito Track and picked up dinner.  Greasy Mexican food always works, right?  Whatever.  It's one place I miss about living in LA County.  Nice excuse to make him go get dinner there :-)  After dinner, we watched the Dodger game and after the game, I went to bed.  No major cramps, no indication that this might really be the night.  At one point, I did get in the bath because of a few contractions but I wasn't too concerned and went to bed pretty early.
Around 2 am I woke up.  Cramps had definitely gotten worse.  I had a moment of panic when I realized the contractions were starting in my back and radiating to my abdomen.  Back. labor.  I feared she might be "sunny side up" and I was really in it for the long haul.  I headed to the bathroom and when I got back, I woke up Christian.  "Something isn't right.  I think you might want to time these. . ." Every. 5. min.  We got up and started throwing things into the hospital bag.  Living away from home meant that we were also living out of the hospital bag.  By the time we were done and decided to get in the car, they were 3 mins apart.  Like last time, I hated being in the car.  Every second.  Luckily, we didn't have far to drive.  When we made it to the hospital, we headed straight for Labor and Delivery.  I signed a few papers and had a couple contractions at the sign in desk.  Two. minutes. apart.  I was directed to the room where they check your cervix and decide if you are ready for a room.  They gave me a cup to pee into in the bathroom.  I tried.  Nothing would really come out and the contractions were coming closer together and more intense each time.  We sat in that room for, what seemed like, a long time.  At least, it seemed like we were in there longer than I had been in there with Claire.  Finally, someone came in to check me.  8 cm. 8.  I looked at Christian and said, "Oh good. With contractions like these, I was going to be really mad if they said 6 or something."  I was told to follow a nurse down the hall to a labor room.
Now the next set of events may not have happened in the order I'm reporting them.  This labor was so much more intense, it seems, than Claire's.  Claire's birth was much longer.  Ashlyn waited longer to come out (39 weeks 5 days compared to Claire's 38 weeks 2 days) but when she was ready, it was fast, so fast, so intense, that much of my memory of it was the intense pain and flashes of images, emotions and events.  I feel like there were so many people in that room. Nurses everywhere.  A very young, very sweet resident at the hospital talked to me a bit and asked if I minded if she was there for the birth.  "No, I didn't mind" I told her.  What was one more person, and she seemed nice.  A couple of nurses began to try and prick my left arm for the IV.  Between contractions, I looked over at my arm.  Apparently, they caught a vein that was pretty full and blood seemed like it was everywhere.  Christian, who had done so well at Claire's birth, who saw dozens of birth videos in both Bradley classes and in our hospital class two years before, had seen the blood on my arm.  The next thing I knew several nurses had him in a rocking chair.  He had passed out.  Later, one nurse said she thought he might have been seizing (his hands were flapping slowing while he had passed out).  I felt helpless.  I felt terrible.  When he came to, he kept telling them not to worry about him, that I was close to having the baby, that he does this, sometimes.  He'd be ok.  Finally, they brought him over to a couch that was to the left of the bed.  He sat there for the remainder of the birth, coaching the best he could after his ordeal, my mom on the other side of the bed.
When I had Claire, I'd been told that I would feel an overwhelming urge to push at one point at the end of my labor.  I, honestly, never felt it.  I pushed for about 30 min with her but never felt the need.  This was different.  I told the nurses in the room, "I have to push, this is crazy.  I have to now."  One of them said, "Breathe, breathe through it."  In my mind, I thought, "Oh, heck, no. One of you is catching this baby."  I pushed.  They didn't seem to get upset by this.  Looking back on it, I'm thinking that since the resident was in the room, they were not going to worry too much about it but who knows.  Maybe I was just too far gone.   I felt the baby crowning.  The very calm OB, Dr. Yu, finally came into the room.  I had seen him before, once, when I was pregnant with Claire.  I liked him then. He quietly put on his coat.  He came over to the resident who seemed ready to catch the baby.  My water had never broken.  Christian said it looked like a water balloon, ready to explode.  He broke my water.  After a few short pushes, the baby came soon afterward.
Maybe it was because my labor was so short, I didn't have time to tell them what I wanted.  Last time, even with the poopy OB I got, they gave me the baby right away and I was able to nurse.  This time, Ashlyn was taken straight to the little scale on the far wall of the room.  7 lbs. 1 oz.  20 inches.  I wanted my baby.  But she was here and healthy.

I wish the story ended there. Everyday, since her birth, I wonder at what the next part of this story was all about.  Why? Is the question that runs in my mind over and over.

The resident who had attended the birth (and may have actually caught the baby from some of the pictures my mom took) started to massage my stomach to try and get the placenta out.  She worked for some time and then the OB came over to see what was going on.  He began to work on it.  Nothing was coming.  He looked up at me and said, "the placenta isn't coming out, I'm going to have to try and go in after it."  He then did one of the more painful things I've experienced.  He tried to manually get it out.  He tried twice and on the third time told me he was going to give me a shot of morphine to try and keep me from being in so much pain.  All the morphine did was make me feel loopy.  I still could feel everything.  They decided to take me into an OR and perform a D&C.  I held Ashlyn for a few minutes.  Tried to nurse her a bit but they had to take me away.  I passed her off to Christian and my mom. "She's beautiful.  You'll see her when you get out."  I was told.  I signed a few forms about surgery and blood transfusions and I was taken into the OR.
That night was busy for babies, apparently.  Two nurses waited with me as the doctor, apparently, went to deliver two more babies.  The anesthesiologist finally came into the room.  He began ordering the nurses around.  Then he looked at me.  He told me he was going to put a mask over my face, that I shouldn't remember anything.  He was right.  I woke up in the hallway of LDRP.  The same anesthesiologist was looking at me and in a softer tone, but still very direct, told me they had to perform a hysterectomy.  I was stunned. I didn't know what to say.  I prayed I was dreaming.  Or he was kidding or he didn't really mean to say hysterectomy.  I don't even know if I said anything to him.  It might have just been a very feeble, "what?"
What I missed while I was under anesthesia was that Dr. Yu began the D&C but still couldn't get the placenta out.  Apparently, my uterus was not the typical shape.  I never knew this.  My mom remembers that a gynecologist I saw when I was a teenager pointed it out but I don't remember this at all.  It was shaped like a heart, with one half much larger than the other.  During my pregnancy, I thought I never experienced Braxton Hicks contractions.  I DID notice one half of my abdomen tightening up and my belly being lopsided from time to time but assumed it was the baby pushing against one side of my stomach.  Now I know that was my  uterus tightening with contractions and that odd shape was the shape of my uterus.   The placenta seemed to be attached to the highest point in my odd shaped uterus.  His longest instrument couldn't reach it. Meanwhile, I was losing a lot of blood.  Turns out I lost 2.5 liters and required a blood transfusion.  Finally, his back against a wall, Dr. Yu rushed out of surgery and found Christian in the nursery with Ashlyn.  Both his and my parents sat on the other side of the nursery glass in the waiting room.  The doctor took him aside and told him, "I'm going to have to perform a hysterectomy to save her life."  Christian, bewildered, replied, "There's nothing else you can do?!"  Dr. Yu repeated, with more intensity, "I'm going to have to perform a hysterectomy to save her life."  "Ok," said Christian. The doctor briefly put his hand on Christian's shoulder and hurried back to the OR.  Christian saw our parents through the glass of the nursery, all looking at him with questions.  He sent a text message to his dad who then told the rest.  He picked up Ashlyn and sat in the rocking chair.  He knew everything had changed and the shock I would feel when I woke up. 
I was taken to CCU (Critical Care).   Over the next several hours, I sat in CCU with my mom and then Christian.  A Ghanian CCU nurse sat at my doorway on a computer and brought me ice, soup at lunchtime and told me that I'd have to wait to go back to LDRP to see my baby.  I was told, first, that they would bring her to me.  Then was told I would have to wait for a room.  During my stay in CCU I was seen by two hospital Chaplains (one Protestant, one Catholic) and the sweet resident who attended the birth.  One nurse wheeled in a hospital breast pump.  I tried to pump for a while and got some colostrum that the nurses took and placed in a bucket of ice. "When can I see my baby?"  I asked.  "As soon as we can get you a room."  So I waited.  Between shock and tears over what had happened and a whole lot of pain. . .I would ask to see the baby.
Finally, at about 3 in the afternoon, they agreed to let me go back to LDRP.  I told the nurse who was taking me back, "I just want to see my baby"  She replied, "Honey, I want to see your baby"  They wheeled my bed through the hospital until I was in a room in Labor and Delivery.  Ashlyn was waiting with two nurses at my door on one of those plastic hospital bassinets.  They gingerly transferred me to the bed and placed her in my arms.  Christian, my mom and Cindy and Christy Samson were all there.  I finally got my girl.  We nursed for a little while.  I tried to keep from crying.
Over the next several days, there were a lot of tears.  I'm pretty sure every doctor who was on call came to see me.  They were all ones I'd loved and seen in my prenatal appointments.  They were all so supportive and sweet.  Bedside manner was pretty important these days.  The anesthesiologist even came in.  The doctor who performed the surgery came in twice and checked on us.  We felt loved by the staff, concern for my well being and deep sorrow for what had to happen.  No one came in with a "we did what we had to do to save your life, now get over it" attitude.  We were grateful for that. They came in with grace and love.  For that I will be forever grateful. 
It's been about 3 and a half weeks.  It's taken me about that time to get this all down.  I would start part of it and then be overwhelmed and stop.  I am living in a really odd place, emotionally.  So grateful for our little family.  So blessed by my new baby girl.  So in love with the two daughters God has entrusted me with and so, so thankful to be alive.  But at the same time, there are days when the fullness of this and how much our lives has changed and how quickly it has changed hits me like a ton of bricks.  We always thought we'd have a large family. We love kids and at the start of our marriage put that arena of our lives into the hands of God.  My pregnancies have been easy and both of my births were completely natural.  Yet, according to the pathology report, I had developed "placenta accreta" a condition where the placenta attaches to the uterus. While it is usually caused by previous uterine surgery, prior c-sections etc., I really had no risk factors for this (although, my history of fibroids  may have had something to do with it). This complication was so shocking, so totally out of left field.  When we handed the control of our family size over to Him, never did we dream He would cut us off at 2.
So now I am trying to live in the moment and try not to worry about what comes next but it's not always easy.   We chose "Ashlyn" for her name because we liked the meaning.  (Esther was Christian's grandma's name). The Irish name "Aisling/Aislinn" pronounced "Ashlyn" means "Dream/Vision".  We love Proverbs 29:18 "Where there is no vision, the people perish: but he that keepeth the law, happy is he."  It was a reference to a verse we had chosen for our family.  We want God's vision to be the center point of our family and knowing and teaching and living the reality of God's law and His grace is so important to us.  We want to pass that vision and that faith on to the next generation.  "As arrows are in the hand of a mighty man; so are children of the youth" (Ps. 127:4) reaching out to generations forward. This week, however, God showed me an aspect of Ashlyn's name that, until this happened, I had never thought about before.  I was rocking Ashlyn to sleep in the morning. She was cranky and crying and I knew she was merely tired and needed a nap.  Claire came into my room and stood next to the rocking chair.  "Do you want to sing to her?"  "K," said Claire.  I immediately drew a blank.  I used to sing "Solla Sollew" to Claire when she was tiny since I directed Seussical the Musical when I was pregnant with her.  But there wasn't really anything like a lullaby in Thoroughly Modern Millie so I couldn't think of anything.  Soon, a hymn we sang at our wedding filled my mind.

Be Thou my Vision, O Lord of my heart;
Naught be all else to me, save that Thou art
Thou my best Thought, by day or by night,
Waking or sleeping, Thy presence my light.


High King of Heaven, my victory won,
May I reach Heaven’s joys, O bright Heaven’s Sun!
Heart of my own heart, whatever befall,
Still be my Vision, O Ruler of all.

God knew this story before I was pregnant.  Knew it before we got married.  Knew it before I was born. I will still grieve my permanent loss of fertility.  There are still days where I just cry for what will never happen. I still cry when people bring it up and have a hard time talking about it.  But "whatever befall," His vision is best.  Whether that includes adoption of more children or just training up our two girls, our family is still in His hands and Ashlyn is a "good and perfect gift" (James 1:17).