Lets train

It is July and I promised that this month I would provide some examples of how other cultures are dealing with the work/family balance. In doing so, I promise to postulate some, what I would like to think are, workable hypotheses for how we might change our approach in this country to benefit mothers in a more efficient way.

There is a general consensus in the anthropological literature that it is intrinsically difficult for women to combine income-producing activities (ie: work) with the domestic responsibilities of child care and housework that almost universally fall primarily on the shoulders of women. The ease or difficulty in which women navigate this has a lot to do with the cultural realities in which they function. In other words, societal and material factors can either help or hinder a woman's efforts to provide an income for herself and family. This extends not just to income production, but the production of children as well. The number of children that a family HAS is often at odds with the number of children a family WANTS depending on the cultural and material context in which they live. In addition this can change historically over time.

Reading C.H. Browner's article, "The Politics of Reproduction in a Mexican Village" the women of a small municipio (township) were caught between the pressures of the Mexican government to restrict births and local pressure that was seeking to maintain and promote population in the area to avoid loss of autonomy. Browner found that the women were succumbing to village pressure to raise more children than they felt they could comfortably afford or care for because of the prevailing pro-natalist mentality that was characteristic within the specific area. Most women, because of economic and domestic pressures desired few children, but feared public censure for any attempt to curb fertility.

So, these women were having more children than they desired because of societal pressures.

Then there is the U.S. In some ways we are the opposite from that village in Mexico. I know many women in my circle of friends who have made the comment, "Oh we would have loved to have more children, but I just knew there was no way we could afford it." Our culture has it set up so that the resources required to care for, provide for and educate each child mean you have to have access to a fairly high income if you wish to have a larger family and avoid a daily struggle to eke out a living. I have even seen passing references in newspaper articles that have likened a large family in America to a status symbol, much like a big house, fancy car or expensive vacation. By that same token, I know women who want so badly to have a meaningful career that they would never risk it by having a family. The unspoken, but often acknowledged fact is that many women, through the mere act of procreation, are signing the death warrants on their employment future.

Just like the women in Browner's municipio, who should not be forced by society to have more children than they want, the U.S. should invest in families more so that women don't have to unwillingly restrict or forgo fertility.

Throughout my pregnancy I absolutely loved soaking in all things birth-related. I wanted to read stories of other women so that I could better prepare myself for all of the possibilities that lie in the birthing process. I wanted to hear both easy and difficult, positive and negative, long and quick, natural and medicated, vaginal and cesarean, and happy or scary stories. And yet, reading all of those stories could never have totally prepared me for my own experience. Giving birth to my son was one of the most intense, joyous, painful, emotional and surreal experiences of my entire life. No matter what I write here I could never put into words how amazing it was. But I will do my best to capture at least some of the dream-like world that is Truman's birth story.

And if words aren't enough, here is his birth in pictures. 

I'll start from where I left off after my 'Hospital Fun' post. If you do recall, the end of my pregnancy was rather chaotic with bedrest due to Pre-Eclampsia then the decision to induce at 38 weeks. You can look at my story in one of two ways as far as speed goes: two whole days full of induced labor with a 4 night hospital stay OR you could focus on the fact that from the time my water broke to the time he was born was a total of 3 hours. THREE FREAKING HOURS for a first-time pregnancy is insanely fast, right? I'm still reeling from it:)

So as I said in my last post, I was feeling more positive about the second day of induction because I had more cramping and the contractions were now more intense. Nate was doing homework in one chair and I was painting my nails, doing crossword puzzles, and attempting to flip through a few magazines to keep my mind at bay. Oh, and I was going to the bathroom like it was my full time job. At 11:00 I rolled my IV pole and pregnant self into the bathroom yet again and felt the infamous POP when I stood back up from the toilet. I thought to myself, 'Did I just imagine that?' and waited for the gush of water but instead I just felt the urge to pee again. It took me a few seconds but I finally realized that this was not pee because it wouldn't stop and was a little bloody. I yelled to Nate, 'Baby? I think my water just broke!' and my head started to spin with the implications. I was not going to need the nurses to break my water like we thought! This was really happening on it's own and maybe a C-section wasn't in my future after all. As I came out of the bathroom Nate had already called the nurse and was standing there with the cutest look on his face: both excited and nervous and ready to do the darn thing already.

The nurses got me in bed to check me and I felt my first intense contraction. I was 2.5 cm dilated, 70% effaced and at a -1 station which was already a lot better than my measly 1 cm and -3 station from the day before. My best friend, the blood pressure cuff, spit out a reading that had my nurses worried with a big fatty 155/102. They mentioned the possibility of Magnesium to prevent me from having a seizure but thankfully I didn't need it because apparently it makes you 'feel like crap', as per my nurse. Could it really get much worse? Um, yes. Yes it could.

The contractions went from intense but spaced a few minutes apart to FREAKING INSANE and just a few seconds apart. I was doing my best to stay relaxed and in control, breathing through each contraction but I wasn't catching a break in between. And that, my friends, is the beauty of Pitocin running through your veins for two whole days: less space between contractions = no time to wrap my head around what was even happening. By 11:45, just 45 minutes after they last checked me, my nurse said that I sounded like a person who was much further along than 2.5 cm and they wanted to check again. I told her that if I was still only 2.5 and in this much pain they might as well just knock me out because I would absolutely die. Sure enough, I was at 5 cm, 80% effaced, and -1 station. The nurses were sort of freaking out about how quickly this was going and I said I needed something to make me more comfortable. They knew that I really wanted to avoid an epidural for as long as possible and respected that decision offering me Stadol instead to 'take the edge off'. It was supposed to feel like a cocktail and I was totally craving an ice cold margarita at this point if it meant getting a little relief.

As they left to get the meds things went from bad to worse with my pain intensity. I seriously cannot describe the amount of pain I was feeling but all I can say is if you imagine the worst pain in the world you have to multiply that by about 100 to even come close to what I felt. I was crying, screaming, hoo-ing and haa-ing, and finally succumbed to cursing like a sailor. I am not kidding when I say it was like my evil twin emerged and spouted off enough obscenities to last me a lifetime. The funny part is that I would apologize to Nate and the nurses in between contractions, saying, 'I'm sorry I'm being so loud and obnoxious and obscene but I just can't help it!' I absolutely could not remain in control of myself and began to feel very anxious, telling Nate that I had heard Pitocin sometimes causes uterine rupture and I was worried that's what I was feeling. He informed me that I HAD to stop being so negative, that I could do this, and everything was just fine. I wanted to believe him but I informed him that all I wanted was just a minute break to catch my breath and collect my thoughts. Nate, with good intentions, said, 'Well you aren't going to get a break right now, baby' and I almost cut through his heart with my death glare. All I meant was I needed the contractions to slow down enough for me to regain composure but it was a total lost cause at this point. They couldn't turn off the Pitocin because they were worried it would slow me down too much but promised not to amp it up anymore. Gee thanks! :)

My nurses returned to the room after hearing Julia-The-Evil-Twin's screams throughout the hospital. They said that they were worried this was happening way too fast, that I was wearing myself out and wouldn't have the energy to push--which they thought would be very soon according to how I looked (what, I didn't look like a supermodel at this point then?). Before they could even finish their sentence I said, 'I'll take the epidural, just as long as it doesn't stall my labor. I cannot do this much longer and will die before I have to push.' From that point until the time the anesthesiologist came is a total blur but I know they were trying to get me to sit up at the edge of the bed and I literally could not move or even open my eyes the pain was so severe. Once they did get me up to place the Epi I informed them that I felt like I could push right this second, which of course scared the heck out of them. He finally got the Epi in me somehow at noon and I know it took a few contractions to work right away because I remember yelling at the poor guy about how it was NOT working and he needed to re-do it. Just a few minutes later I felt the immense relief that everyone talks about to the point where I was falling asleep in between contractions. I could still move my legs because it was a 'walking epidural' but the pain was gone--only pressure. I am told I had one helluva epidural and I have to agree.

The nurses checked me at 12:20 and I was already at an 8. They frantically paged my OB who was not on call that date but wanted to deliver me since she started the induction process, which basically makes her my favorite person in the entire world (aside from that anesthesiologist that I verbally assaulted). I don't remember anything until she entered the room at 1:00 with a halo around her head and took one look at the monitors to say, 'What is that all about?' I was so out of it I had no idea what they were talking about so I asked Nate to translate it for me. Apparently my BP had dropped to the 130s/80s after the epidural which is still high but lower for me, and baby's heart rate dropped into the 90s. So she gave me epinephrine to raise my pressure and had me try a few different positions to get baby better aligned and his rate back up. Somehow I maneuvered my exhausted and partially numb body into all fours, then both sides but none of them worked. Finally my OB suggested I give a practice push, even though I still had a small 'lip' of my cervix left at this point and that worked. Baby's heart rate went back up and I was completely dilated all of a sudden, but not before I peed all over the doctor. FABULOUS, right? :)

So there we were, ready to push at 1:00 after my water had broken at 11:00. My OB told her assistant to cancel her patients back at the clinic for the next hour because she was guessing it might take me that long. In my overly-fatigued and dreamy state I thought she was joking and it would take about three pushes then be over. I have no idea why I thought that but let's remember I was pretty much having an out of body experience at this time and wasn't thinking clearly. The OB and nurses kept telling me how amazing I was doing for a first time mom and thanked me for being athletic, but my epidural was so strong that it really did make it hard for me to time the pushes. Eventually I asked them to turn it down a bit so I could really focus because all I wanted to do was sleep. Then all of a sudden my OB says, 'How do you feel about looking in a mirror for this?' I never in a million years thought I would be okay with that but heard myself say, 'Oh, why not?' so they wheeled in a giant full length mirror for me to get the view of a freaking lifetime. The image of my lady parts in that position will forever be burned into my retinas but I can honestly say it was freaking incredible to look down and see my son's head ready to emerge. I heard Nate say, 'Look, he has more hair than I do!' and he was holding my right leg and head coaching me through each push. And yes, Nate was even watching in the mirror which I would have never predicted but it totally made sense at that moment.

I had to push with every ounce of strength in my body to get his head under my pubic bone but once that happened I could see he was almost out. At this point I asked if I could just keep pushing without waiting for a contraction because I really wanted it all to be finished, and my OB sort of raised her eyebrow in astonishment and said, 'Go for it!' I had been pushing for just a little over an hour just like she predicted.

With Nate on my right, my nurse on my left, and what seemed to be another 10 people in the room waiting for baby to arrive, I pushed my son out of my body at 2:11 pm and saw the most beautiful human being in the entire world for the first time. Both Nate and I were crying and in such shock the doctor had to ask, 'Well? What is the name?' I muttered, 'Truman Anthony' and could not believe he was finally here. The took him over to the warming table to clean him off and I told Nate to go with him as I could not move my eyes from that side of the room watching my baby boy. I have no recollection of what my OB was even saying to me at this point, other than I had a small second degree tear, because all I could do was try to wrap my head around this whole experience. His cry was loud and he was pinking up right away. When I asked how much he weighed and Nate told me '7 pounds 10 ounces' I was floored. I totally prepared myself for a 6 pound baby because he was a whole 2 weeks early but at 7.10 he was bigger than I was at birth (I was 7.8) and longer than me at 21.5 inches. His lungs were completely normal, his Apgar scores were 8-9, and my baby boy---who I spent inconceivable amounts of time worrying about his early arrival---was totally fine. I asked how much longer I'd have to wait to hold him and they said they were done with their assessments and brought him to me. Again, the tears started to flow as I stared as his preciously greasy and perfect face. I looked up and Nate and back to our son with the purest sense of joy I've ever had in my life.

My parents were in the waiting room and came in shortly after, which was exactly how it was supposed to be. Nate got to hold Truman next and the grin on his face immediately made him a candidate for 'Best Daddy of the Year', in my opinion. The rest of the evening was spent staring at Truman, visiting with my parents and also Nate's parents, and stretching out my sore biceps. Seriously, they were the most sore part of my entire body from pulling my legs up to my chest and even 5 days later they are still not back to normal. I could barely even nurse Truman for the first day because it was so painful to hold him in my arms but of course he was a total trooper and showed me exactly what needed to be done for him to get his food.

Speaking of him being a trooper, poor little buddy had to have a full vile of blood taken from his arm right after delivery. A little heel prick wouldn't do because they needed to do a full blood culture. I was Strep B positive which is no big deal except you have to get 4 rounds of antibiotics in before you deliver so that the baby doesn't risk getting a serious pneumonia. Well because my labor went SO fast the nurses didn't have time to get all 4 rounds in so they had to test and watch Truman very closely. The mean lab tech could NOT get his tiny vein and even called him 'a little fart' as she was trying. Even though I was out of it and tired I kind of wanted to rip her head off for hurting my mister man which means I'm definitely a mom. My own mother went over there to supervise to make sure she didn't hurt him too much and although his little hand is still bruised he acted like it wasn't that big of a deal at all.

I think throughout this birth experience one thing resonates with me and that is Truman is one tough little bugger. Two weeks early? No biggie. Tons of Pitocin? Eh, whatever. A quick and intense labor? Barely affected him. It's as if he's telling me, 'Mom--chill out. I'm okay. Just relax' and I think I needed to hear that from him:) I love him more than words can describe and the black-out pain I went through to get him here was well worth it.

So there you have it: a birth story that is both long but short, and very intense. I'm not disappointed in myself for getting the epidural because in all honesty, there is no way I could have survived Pitocin-laden contractions for much longer without going certifiably insane. Of course, next time I'm hoping to avoid an induction (Pre-E can kiss it and stay the heck away from me forever!) and maybe that will be different for me, giving me more time to catch my breath and focus between 'natural' contractions. But the ultimate goal for me was to have a healthy baby and possibly even avoid a c-section. You can bet I'm pretty satisfied with my experience when I get the privilege of holding baby Truman every day.