…I Have Prayed
Suggested Reading: Psalm 30
Speak ye to Jerusalem
Of the peace that waits for them;
Tell her that her sins I cover
And her warfare now is over.
~Johann Olearius, trans. Catherine Winkworth
It was all great until it wasn’t. Then it was a nightmare.
I had been laboring for more than twelve hours with my second child, my daughter. My firstborn, my son Sam, had been born by a C-section, and I wanted a “true” birth experience, so I, with my doctor’s approval, was attempting a vaginal birth after Cesarean.
Having gratefully received an epidural hours ago, I was having fun. The baby wasn’t in position, and I wasn’t dilating quickly, so my doctor had instructed the nurse to have me squat with the help of a bar. I would watch the monitor to know when I was having a contraction and hoist myself up with the help of the bar. When I wasn’t squatting, I was lying on my side, flipping myself periodically. It was during one of these breaks that I noticed a contraction start and not seem to end. I could even feel it through the epidural, pinching strangely on the right side of my pelvis. The nurse glanced at the screen then began making adjustments to the band across my belly tracking the baby’s heartbeat.
“Flip over to the other side,” she said, and I flopped awkwardly, thinking nothing of it. Maybe the pinching would stop when I moved. Jeremy continued to watch a home improvement show on TV, undisturbed.
She frowned. “I’m not getting Baby’s heartbeat,” she said.
Again, I thought nothing of it. The fetal monitor often shifted with contractions.
And, then, there was a doctor in the room. And, then, a couple more. They began moving me, checking me. Talking with each other, not to me. I heard the word “rupture.”
Ruptures are a rare but serious risk of VBAC. A rupture occurs when part of the uterus tears or becomes dangerously thin. During VBACs, it’s usually along the previous C-section scar. Many of the ruptures that occur aren’t even noticed unless the woman winds up needing another C-section, and the doctor sees it as she’s being stitched up. Very, very rarely, a rupture so severe occurs that it seriously endangers the life of the baby.
Mine was one of those. My previous internal C-section scar completely opened up, and my daughter’s foot was poking out of the opening. During the rupture, the placenta detached. My body, thinking that there was no longer a little life inside to support, stopped providing blood and oxygen.
This is why the heart monitor was not registering a heartbeat. It hadn’t slipped. My daughter had no heartbeat.
Although I wouldn’t know all the details until later, I understood that we were in serious danger. The light on the ceiling of my room seemed very far away as the cluster of doctors loomed over me.
“We need to get her to the OR now.”
They began wheeling me away. Struggling against the weight of the shock and the drugs they had just put in my IV, I turned my head, panicked, toward my husband.
“Everything’s going to be OK,” he said as they pushed me out the door.
He’s always telling me stuff like that. Stop worrying. It’ll be fine. Everything’s going to be OK. And he’s almost always right. But he couldn’t know this time.
The OR was just around the corner from my room. I think people were talking to me, nurses or doctors wearing surgical masks trying to comfort me, but all I can remember is the distant light and the disorienting feeling of moving while lying prone on the bed. When they began cutting me, I could feel it, and I screamed. They gave me more meds, which meant I was even more disoriented. Jeremy came in, dressed in scrubs, while I was still yelling.
There’s a lot of pulling and tugging during a C-section. When they were done, I turned to Jeremy. “Baby?” was all that I could say.
If everything was OK, he would tell me. If everything would probably be OK, he would tell me.
He didn’t tell me it was OK. He said that she had been born not breathing and blue. Along with the rupture, she had aspirated meconium. Her initial APGAR was a 1.
When they finished stabilizing her, they pushed her over to me in her little plexiglass cart. I couldn’t sit up, so I could barely see her. The doctors asked Jeremy if he wanted to stay with me or go with her to the NICU. After a moment’s hesitation, he said he would stay with me. They rolled her out the door.
Nobody told me what she weighed or how long she was. Nobody asked me her name.
The doctors were still working on me. My own obstetrician had arrived for the end of the surgery, and she finished stitching me up. A nurse told me to close my eyes and rest. It was hard to breathe. I thought if I closed my eyes, I might die. Just in case I couldn’t keep my eyes open, I told Jeremy I loved him and that I was sorry.
My doctor finished and said she had saved my uterus — oftentimes severe ruptures end in hysterectomies. I told her it was my fault that it happened. I shouldn’t have chosen the VBAC. She had told me about the minuscule risk of rupture. I hadn’t given it much thought, assured by a thousand blog posts and internet forum comments that a vaginal delivery was far superior to a C-section, a badge of womanhood that I was envious to possess.
She said nobody knows why it happened. She said it wasn’t my fault.
I didn’t believe her.
I listened to the medical team decide I didn’t need a transfusion, and then they took me to a recovery room.
Hours passed in the recovery room. I shook violently for a long time, a combination of drugs, blood loss, and shock. Jeremy left to go to the NICU. My parents and in laws came. My four-year-old son came to see me and cried when he saw all of the tubes and monitors I was attached to. My mom made me call my sister because she, away in Colorado, was worried about me and the baby. I pretended to be positive and reassuring, pretended there wasn’t a black pit gaping inside me.
When Jeremy came back from the NICU, he told me that the baby might have suffered a brain injury because of the loss of oxygen. It was impossible to know the extent of the damage, and it was impossible to fix it. All that could be done was to try to prevent further damage. She had been placed in a cooling vest that would lower her temperature, protecting her swollen brain. While she was being cooled, for the next seventy-two hours, she wasn’t allowed to be fed or picked up. She was receiving morphine through a central line in her belly button to keep her docile. This, Jeremy said, might be a problem.
“She extubated herself on the way to the NICU.”
“Will she be OK?” If Jeremy said she would be OK, I could let go of some of the worry.
“They don’t know.”
The pit yawned open a little wider. The shaking, which had almost stopped, started again. Would she ever walk? Ever speak? Would she live independently? Love to read, like me? Have an eye for detail and design, like her father? Dance, like her brother? My whole life was centered upon a trust for people in authority, that if you ask the right people the right questions in the right way that you would get what you wanted. We were in one of the best hospitals in the country, and the doctors just didn’t know why it had happened or what the outcome might be. I had never felt so powerless before.
A prayer began running on a repeating loop in my mind. Please let her be OK. Please let her be OK. Please let her be OK.
Please let her be OK.
I was desperate to see her. The nurses said that once I got placed in a room, ate something, and showed them I could stand, I would be allowed to go to the NICU. But we got caught in the transition of a shift change, and it was at least five hours after the delivery before I was placed in my room.
When you give birth and there’s something wrong with your baby, you don’t get to go to the mothers and babies wing of the hospital — that was a place for women who had successfully brought their children into the world. I, a failure, stayed in the same hallway where I had labored, like nothing had happened. Like I didn’t have a baby living outside my body whom I had never even touched yet. A half a mile of hospital hallways away, she was lying in her cold vest, not yet knowing the warmth of her parents’ skin or the comfort of her mother’s milk. All she had known of life so far was pain, anger, and loneliness.
I hadn’t stopped crying for a long time.
My new nurse came in. She barely had a chance to introduce herself before I said, “They told me if I eat something and stand up, I can go to the NICU,” I said. “Can I have something to eat? Please?”
After a lifetime she came back with crackers and cranberry juice. “Take it easy or you’ll be sick,” she said.
While she was talking to Jeremy, I shoved the crackers down my throat as quickly as I could. I gulped down the juice.
“I’m ready. Can I stand up now?”
She eyed me doubtfully.
Standing up for the first time after my first C-section had been one of the most unpleasant parts of my recovery. My nurse at the time had warned, “It’s going to feel like all of your insides are falling out.” And that had been a day after the surgery. I was working on hours this time. But if they had told me I needed to walk to the NICU myself, I would have found the strength to do it.
With the nurse’s help, I stood and then sat in a wheelchair so Jeremy could push me to the NICU, which was in the neighboring children’s hospital, joined by a walkway. My heart was always at least two steps ahead of my body, straining toward the daughter I hadn’t met yet, the daughter who didn’t know anything about mothers.
The NICU had a front desk where everyone had to sign in. My daughter had originally just been listed as “Baby Boy” in her early entrance. Now we filled out paperwork with her name for the first time: Elizabeth Carys. The middle name, meaning beloved in Welsh, had come from Sam’s idea to name his sister “Heart, because we love her.”
At last I was in her tiny room. It was dim. She was still in her little plexiglass bassinet. Machines were whooshing and beeping all around her. With Jeremy’s help, I stood and got to really see her for the first time.
She was big — 9 lbs and 15 oz, plus red and swollen with IV fluids. She was wearing her cooling vest and a diaper. They didn’t hide the central line coming out of her naval. Her head was wrapped like a mummy’s with a dozen wires poking out. They were monitoring her brain activity for seizures.
She was angry, naturally. The morphine was not enough to appease her cold and hunger. As Jeremy and I peered at her in her bassinet, she started to complain with little newborn squeaks.
I let her fingers grasp mine. I couldn’t pick her up, but I could touch her. With my other hand, I stroked a small patch of her face that wasn’t obstructed with gauze, tape, or wires.
“Elizabeth. My Lizzy. I’m your mommy. I’m here. I love you.”
She stopped squirming either at the sound of my voice or at my flutter of a touch. After hours alone in this scary, bright, loud outside world, she was meeting me for the first time.
But she knew me. Our hands were clasped in a silent, shared prayer. And I knew in that moment, if only in that fleeting moment, that we would be OK while we waited for it to be answered.
