Story #92 - Caroline, Chicago IL (USA) - IVF Treatments, Induction, Cesarean Section, Near Miss, Postpartum Plan & Mental Health Care for All
We went through IVF to conceive. Our first transfer was not successful, but luckily, it worked the second time. Going into it, I wasn't fully aware that the process would take up all the space, even more so maybe than the pregnancy. When you get pregnant naturally, you think, "Hey! It happened!" but with IVF, you are reminded multiple times a day that you are trying to conceive. There's this constant reminder of your choice, and although we knew we wanted a child, it was a lot. I didn't realize how much work it was or how emotional IVF would be. I remember thinking, "Shoot! I missed a shot. Will my body lose this child now?"
But I was lucky. My pregnancy was easy, and I felt good. I didn't get sick, and in a way, it felt like a gift from the universe; I'd had a hard time getting pregnant, so I was rewarded by an easy pregnancy.
The baby rolled so much—and now that he's out, he's still moving a ton!
I found out at 20 weeks that we had a single umbilical artery*. It can be a big deal, but our case was benign. Other indicators pointed out that he was growing ok, and that his heart and kidneys were fine. It really didn't come into play until the end of my pregnancy. My doctor wouldn't let me go past 40 weeks because the placenta could stop working, and as an anxious person, that wasn't something I wanted to deal with.
I was scheduled for an induction at 39 + 6 weeks. I did everything my sister [who's a perinatal counselor and works for PSVa] told me to do: I had a doula and was flexible regarding my birth plan. I went in early in the morning, and they started me on Pitocin and put a balloon in. I was progressing well, and everything was going exactly as it should. The nurses were cheering me up, "You're gonna have a baby today!"
By 3 or 4 pm, they removed the balloon, and I got my epidural. I was already at 6 or 7 cm when the doctor came in to break my water. I don't know why she did that. I didn't ask many questions because everything was going so great, but maybe I should have.
As soon as she broke my water, it became apparent that something wasn't right. There was a lot of fluid.
Then she looked at me and said, "You have an umbilical cord prolapse**." The mood in the room changed.
I asked, "What does that mean?"
She said, "We have to take you in for an immediate c-section."
I asked, "Can my husband come?"
She responded, "No. And you can't be awake."
My delivery room was the farthest down the hall. They wheeled me out at 7:40, and by 7:46, he was out.
The protocol in these cases is that the doctor can't remove their hands. As soon as she broke the water, she felt the cord and kept her hand inside of me and on the baby's head. They rolled the bed with her kneeling above me, her hand inside my vagina.
I asked if I could kiss my husband before going and if the baby was going to be ok. She looked at me in the eyes and said, "Yes."
Everything moved very quickly. I remember the lights as they rolled the bed, and I entered the OR. I felt wetness, which I later learned was the iodine on my belly. The anesthesiologist was the same who had done my epidural. He said, "You're going to sleep now." And then they knocked me out.
From what I understand, my husband tried to get into the OR but they wouldn't let him. He waited for us for what I'm sure felt like an eternity.
My doctor didn't do the surgery because she had to hold the head. Two other doctors performed the c-section. I had a vertical incision, which left a pretty gnarly scar. My mom also has a vertical incision from me because I turned in utero and got my shoulder stuck under her ribcage. In a way, I find this scar weirdly poetic.
My husband said that they basically took my son out and handed him, like, "Here you go! Good luck! Go sit in the recovery room."
I feel a lot of sadness about not being there in those early moments with him. I woke up one or two hours after he was born, and I was so out of it, throwing punches and trashing the bed. I was mostly confused because I went under knowing what was happening. At the time, I was leveled and calm, but I think I went into shock when I woke up.
I thought I had been prepared for everything. I knew my sister's story and the realm of possibilities. I knew friends who had been put out, but I still thought it was rare, far out of what could happen to me. My worst fear had occurred.
Eventually, they moved me into recovery and handed my son to me. I couldn't move my arms because of the anesthesia.
The first moments are foggy, but he nursed right away. He was the best. I remember him being on me, but I don't remember feeding him. It's all bits and pieces. I also have very few memories of the first night. I remember the doula had set up our room and stayed with me when my husband went to the car to get our stuff.
There was a lot of "Did I cause that?" thoughts in the weeks that followed his birth. I kept going back and forth between "Maybe it was just being at the right place and the right time," and "We should not be alive." I kept thinking about what if we hadn't gone to the hospital for an induction. What would have happened then?
Still now, a year in, I have to learn to be comfortable with "Things happen the way they should have." My doctor was straightforward with me when she realized I had a prolapsed umbilical cord. She didn't sugarcoat it, and I'm grateful for that. The staff also explained what had happened, and although it was quick and I could have asked more questions, I feel like I've been explained well. Although she wasn't on call, my OB even came in two days later to make sure I was ok and reexplain everything.
I was a mess. I still am when I think about it. You don't realize what you really want from your birth until after it didn't happen. And I wanted to be the first one to hold my son. I wanted to be the one to welcome him into this world.
The first couple of weeks after he was born, I was delirious. One night, he was crying, and my husband asked me, "What does he want?" and I said, "I don't know! You've known him longer!"
Going back home on our first night was awful. At the hospital, I had wonderful nurses who told me I could send him to the nursery for a couple of hours so I could rest. It was pre-covid, and I remember fighting that idea so much. I had anxiety about leaving him, but my meds were wearing off, and I was in so much pain.
I have this image of being on the toilet crying hysterically, and a nurse kneeling in front of me saying, "You have been through a lot. You're exhausted and you need to rest. We will bring him back to you whenever you want, I'll make sure of that. But you have to sleep."
I surrendered... and then he went two nights in a row!
She'd given me the greatest gift every new mom needs: three hours of uninterrupted sleep. When I left, I said to her, "Thank you. Thank you for making me do it." She said, "Thank you for listening to me."
(Family photo)
You don't realize how frantic you are until you have that first chunk of hours of sleep after giving birth. The first night I was up every 30 minutes or so feeding. Newborns do that. It's normal. But it's still incredibly hard.
We had quite an uphill battle breastfeeding. I thought I would be super zen about formula and whatnot, but I wasn't. Because the birth hadn't gone as planned, everything else needed to work, or else I felt like I was failing even more.
He didn't gain his birth weight back within the two-week window they give you. Our pediatrician told me that if I wanted to breastfeed exclusively, I needed to do "triple feeding": you nurse, give the baby to someone else who gives him another bottle of your previously pumped milk, and then pump while he drinks the bottle. It's an hour-long process every three hours.
Meanwhile, we discovered that he had both lip and tongue tie, which for the next kid, I'll get checked right away. Waiting eight weeks was excruciating for both of us. I also had vasospasm. Everyone was like, "Drop the pump and give him formula!" But I couldn't. I self-diagnosed my vasospasms and got medication, and I got him seen by a pediatric dentist. It took another eight weeks before we got things under control, saw a lactation consultant, and things started to go really well.
But I became obsessed. I wondered if he was getting enough and how much I should pump. To a certain extent, I'm still anxious about it now, a year off. Feeding him became the thing I could control, so I went all in. Now that it's almost the end, I'm not sure it was the healthiest approach, but it felt like it was all I could give him after what had happened. Nothing else I was able to prevent, so I would succeed at feeding him.
And we did figure it out. It's been a fulfilling journey. I have mixed feelings about stopping: I'm relieved that I won't have to do it anymore, but I'm also sad about it, wondering if it'll lessen our bond. That phase is over, and he's a toddler now. That went by so fast.
I'm lucky in that we've never had issues bonding. I've processed most of the birth for the past year with a therapist and felt ok about it, but something about the pandemic drudged it all up. I began to think about it again and visualizing what had happened. I'm coming up with an alternate ending, and it's scary. As if my son and I cheated death, and I fear that it might come back to bite us.
I'm trying to change the narrative into "everyone's meant to be here," but it creeps back from time to time.
Some people feel like they become a mother when they get pregnant, and for others, it's after their baby is born. To me, it was that split second when my doctor told me something was wrong, and I needed a c-section to save him. She could have told me, "We're going to amputate your leg," and that would have been fine. It wasn't about me anymore.
There is so much duality in motherhood and this particular experience. The possible tragedy and immensity of love going hand in hand.
(Family photo)
He's beautiful and perfect, but although it's not at the forefront anymore, I'm still mourning the birth.
I know I'm not as traumatized as I could be because things were explained to me while they were happening and afterward. I was able to ask my doctor questions during our post-appointment and 6-week postpartum appointment. We still don't know why it happened, and I could go down the black hole of researching, from the risk of having my water broken to being induced. But on the flip side, had I not gone to the hospital for my induction, there's nothing that assures me that it wouldn't have happened at home and with a very different outcome.
It's the mind frame I have to live in. I like to think that everything happens for a reason. I just don't know what the reasons are in this case. I'm learning to sit in the discomfort created by my story. There wasn't, nor will there ever be, a beautiful baby put on my chest with this perfect bonding moment happening.
Even with my future children, they will all be c-sections with possible triggers due to this birth. The discomfort sucks. Still, I'm happy to have a live baby and to be there for him.
I can't remember the first 4 to eight weeks of his life, but I remember watching The Great British Baking Show. It was constantly on. The other day I tried to watch the new season, and I had to stop. It brought me back to this anxious period. In the moments after he was born, I know I would have only told you that I was just tired, but the truth is, my nerves were fried. He was in our room until he was five months old. We'd creep around and didn't have our space. You don't realize at the time how it affects your psyche.
I've been in therapy on and off since I was 7. I think everybody should go to therapy. I listened to an interview by Bryan Cranston the other day in which he talks about therapy and marriage counseling. If your car breaks, he said, or even just for maintenance, you go to a mechanic. Yet we don't do that for our minds!
I've known my therapist longer than my husband! She's fantastic. I can call her out when she misses the mark, and she's just excellent. I'd stopped for a couple of years after I got married, but I reached out to her after our first unsuccessful IVF cycle. I knew I'd need the support, and I've kept my sessions with her ever since. After I went through labor and delivery, I called her, still at the hospital, to let her know that I would need her help.
(Family photo)
Before I had my son, I also did a postpartum plan. I picked a local postpartum support group. I had my therapist number on hand for myself and my husband, so he could reach out to her if needed. Putting that down took away the barrier that is so difficult to overcome when you're postpartum. The information is there; you don't have to make an effort to research and reach out. It's hard to plan a birth, but planning your postpartum works wonder. You have no buffer after giving birth, and preparing everything, down to the food to order, feels amazing!
I'm lucky that I had my sister. I said to her the other day, "Thanks for going first!" She, in so many ways, helped me go through it eyes wide open. You can never fully know until you experience it yourself, but her being so open about her experience helped me prepare. I went to the local group even before I gave birth because I knew I'd be anxious about meeting new people, and I wanted to introduce myself before the storm hit me. People who have babies get it. They brought me meals! Told me about things I didn't know existed.
So many people don't acknowledge how hard it is. And with COVID, expectations are even lower. This is not the first year postpartum I expected. I'm lucky to have my husband, who's good at being optimistic. Lots about this year suck, but at least I got to spend time with him home. I'm sad about not being able to take my son places, though, and it required a lot of reorganization, but I'm proud of what we have achieved. Looking that this second year ahead, I'm excited to let him become his own little person.
He's got a personality! I find myself always thinking, "I'm here to catch you if you need me, but you can explore and figure things out on your own."
There's a wonderful quote by Glennon Doyle that says,
A broken family is a family in which any member must break herself into pieces to fit in. A whole family is any family—regardless of structure—in which each member can bring her full self to the table knowing that she will always be both held and free.
I love that idea.
I'm trying to raise him from a social justice perspective. He'll grow up to be a man one day, and I want to impart him with fundamental values like being good and treating people with respect and dignity.
With everything that's going on in the world right now, I try to explain to him as much as possible, even if he's so young. I can stumble on things now. It's good practice. I'm getting him used to hear about the world and his role in it. I personally think he's a pretty special kid, but I'm biased! He's the definition of a sucker baby: amazing in every way. I'm not going to put him in a box.
I'll just let him be free… and catch him whenever he needs me.
*Single umbilical artery (SUA) refers to a variation of umbilical cord anatomy in which there is only one umbilical artery. It may be an isolated finding or associated with aneuploidy or other congenital anomalies.
**UCP occurs when the umbilical cord drops (prolapses) between the fetal presenting part and the cervix into the vagina. Umbilical cord prolapse occurs before or during the delivery of the baby. It is an uncommon but potentially fatal obstetric emergency. When this occurs during labor or delivery, the prolapsed cord is compressed between the fetal presenting part and the cervix. This can result in a loss of oxygen to the fetus and may even result in a stillbirth.