Calling all hands--it's a staph meeting

After our long nap that Friday the 13th, I was relieved that no calamity had befallen us, but the day wasn't over yet. As I was nursing Jesse contentedly in my newly put-together, extremely comfortable rocker-glider, Dean bounded up the stairs and announced, with his usual humorous aplomb, that our baby had been recalled. We had been summoned back to the hospital for some antibiotics because one of the lab cultures had come back positive for a strain of unidentified bacteria, and because they weren't certain whether the bacteria had come from his skin (where it's--believe it or not--normally present) or from an internal infection. But his previous low-grade fever and high-ish white blood cell count meant that something was tasking his newborn system, and so he was re-admitted as a pediatric patient.

Before long, it became apparent that the bacteria was a staphylococcus, or staph, strain. What blew my mind was the number of times I was asked if I had tested positive for Group B Strep, which I hadn't. Last I checked, Strep and Staph were totally different strains of bacteria. I was also asked repeatedly if there had been anything unusual about my pregnancy. Well, aside from my tongue possibly being a map to buried treasure, no. I had to fight the urge to be smart-alecky ("At his second ultrasound, Jesse flipped us off..."), actually. I thought we'd be there for a while for them to draw new blood samples and be sent home with antibiotics, but then I found out we'd be there overnight for several courses of IV antibiotics.

I was devastated and nonplussed. We hadn't been told to pack for an overnight stay, for one--and this meant that I hadn't brought any of my postpartum supplies other than a change of pads, much less any food or drink. What was worse was that we were now in the pediatric unit, so I didn't have access to the mother-baby unit refreshment stand. I'd discover the following day that I was to be fed, being the breastfeeding mother of the patient, but in the meantime we were in for the most harrowing night I can ever remember. Dean went with the nurses while Jesse got his IV, and I meanwhile sat wringing my hands in Jesse's room, freaking out and thinking, "If I'd had him at home this never would have happened." When Dean brought Jesse back--his hand immobilized by the complicated heplock they had created--Dean said to me, "He is so brave, Helen." This struck me as a strange thing to hear Dean say, but then I realized that he was bonding with the baby too.

This being the same man who didn't speak to me for a half hour when I told him I was pregnant.

But the doctor--a very nice woman--came in and explained that we should have results of the additional tests by 3 p.m. the next day, and that they should reveal the course of treatment from that point forward. By this point, it was nearly 10 p.m. I thought I could tough it out, and Dean said he'd stay with us. Jesse cried through most of the night, and I found myself in meltdown mode shortly after 3 a.m., sobbing hysterically with my newborn, wanting nothing other than to go home. My milk was starting to come in; Dean was holding me and the night nurse was comforting me. I remember blubbering out all of my fears as I tried to nurse Jesse and he'd find no solace there because latching on was so difficult. Finally, Jesse and I fell asleep--with him in my lap in the hospital bed.

The following morning, a shift change brought us a new nurse that we didn't really see all that much of. Another doctor--different from the one we'd seen the previous night-- came in, did an exam, and explained brusquely that Jesse might be sick and might not be but we needed to err on the safe side, and left. We sat and waited, and sat and waited, and sat and waited. Jesse had two normal temperatures in a row. I got breakfast, and lunch, and was asked to place an order for dinner. That's when I started to get suspicious, and summoned the nurse to find out what was going on. It was now nearly 3. She explained that usually these infections meant a 48-hour stay in the hospital. I nearly lost it all over again. "I was told we'd have test results by this time!" I said, insistently. The nurse cocked her head. "Well, the doctor won't be back in until this evening."

ARGH! I nearly burst into tears again, but put my adamant hat on and told her what last night's doctor had said. The nurse said she'd try and find out the results of the additional testing and call today's doctor for more instructions.

An hour later she came back in and said we could go home; the tests showed he'd cleared whatever it was. Dean made the observation that I had been giving Jesse my antibodies since shortly after he was born, amniotic fluid in his tummy notwithstanding. (And I have the immune system of a tank, really. I don't get sick often, although I'm apt to get run-down often enough because I'm Type A that way.)

The nurse ran down our discharge instructions and then went on to add a bit of unsolicited advice. "And don't put your baby in the bed with you!" she said, firmly. Did we look suspiciously like co-sleepers to her? Or was she concerned about the fact that when she'd come in this morning, Jesse had been asleep in my lap? "They can suffocate," she continued, "and when you go into a deep sleep, you can roll over on top of the baby."

Yeah, like I roll over on top of my husband on a regular basis, right? I co-slept with my first son without ever having heard of attachment parenting (or co-sleeping, for that matter. It just made sense, and made him a better sleeper; he slept through the night at 6 weeks and slept in his bassinet or crib from that point onward, with the occasional exception for rough nights.

So we just smiled and nodded and took our little boy home--for good, this time.

The first few nights

When we moved to the mother-baby unit after Jesse's birth, I discovered that I had a psychotic bed. As I'd lie in it, various compartments would inflate and deflate, and I joked that it was alive and breathing. Dean immediately conked out on the couch, and I set up my computer to start sending out notifications to folks while getting the hang of breastfeeding and swaddling. It quickly became apparent that Jesse didn't like the hospital bassinet, and I didn't either -- they were clearly set up for standing up care by nurses rather than bedside care by moms, and I had to get out of the psychotic bed to lift him out of the bassinet, then clamber back into the psychotic bed, which would then heave and sigh and readjust to the change in weight. Jesse took to breastfeeding pretty easily, all things considered, but showed (and still shows) a strong preference for my left side.

I couldn't sleep, though. I had an incredible amount of adrenaline coursing through my system. So I watched the baby, transfixed, in awe. In fact, at 1:30 or so I sent my first tweets out, and one of the comments I made was "And I just cannot get over how beautiful this baby is. Seriously." Seriously.

But about 4 a.m., something weird happened. Jesse started making choking and retching noises and I freaked out. The nurse happened to walk in before I could hit the page nurse button, and she picked him up and started vigorously burping him, explaining that he was now clearing amniotic fluid from his tummy and it would need to be burped out. The stuff that he kicked out was a foul-smelling mix of colostrum and amniotic fluid. This continued for the next two hours, before he started a whining scream that carried down the hall. The nurse rushed in again, took his vitals, and discovered that he was running a mild fever. Off he was whisked to the nursery for monitoring, and there he treated everyone to a grand show of projectile vomiting amniotic fluid.

I was half panicked, but so exhausted that I collapsed into a fitful sleep for an hour or so, punctuated by my iPhone alarm to get Dean up so I could send him to get Elder Son off to school. At that time, we asked if we could see Jesse before Dean left, but apparently Jesse was getting labwork done and a checkup by the pediatrician. The nurses were more nonplussed that I was up and walking around the floor so easily. I was more nonplussed that we couldn't see our baby.

An hour later, I was summoned in to feed Jesse. He had stabilized considerably since the vomiting thing, and if he could feed without any reflux this time around they'd be satisfied that he was ok in spite of the mild fever. They offered me a chair in a room for privacy, and I realized, horrified, that I was in the circumcision room--with two immobilization stations that made me weep that I'd put my first son through this procedure. It struck me also that the chair I was in was the antithesis of a comfortable breastfeeding chair, and the boppy they gave me did nothing to improve my own comfort level. But Jesse did fine, and so he came back with me to my room.

When the lab results came back, he showed a higher than normal white blood cell count, and between that and the mild fever, the pediatrician was a little concerned. But he seemed to be "over the hump," as he put it, and when Dean got back we spent the day cuddling Jesse. But I wanted to leave. I'd passed through my postpartum checkups with flying colors, refusing Percocet for the cramps (though I did take a couple of Motrin) and peeing just fine. In fact, I was amazed at how little pain I was in, having had a second degree tear--with Elder Son, I'd had a second degree episiotomy, and had a hell of a time with basic elimination functions.

And the second 24 hours passed without much of a glitch aside from the fact that Jesse went on a crying jag about 3 a.m. And nothing I could do would appease him. I just wanted to go home, to take Jesse home, and realized, somewhat blankly, that I really could have, and should have, done all of this at home. My midwife had even suggested it to me at one point, and I was reluctant, thinking of the risk factors I had. But really, looking back on it, I was so aware of my body and my baby that I'd have known if any of those risks were coming into play.

But I don't have regrets, either. It took the experience to teach me that I could do this, and that I could help others do this.

At any rate, we were discharged late Friday morning. I couldn't wait to get my little boy home, to introduce him to his big brother, and to enjoy getting some rest in a bed that didn't sigh every five minutes. After having a light lunch, I took Jesse upstairs, and we both slept-comfortably-for the first time in his life.

Jesse's birth story, part 3

Back onto the ball I went at 8, and immediately, it seemed, I went into hard labor. I started hee-hee-hooing in time with my bounces, and got Dean into a pattern where he'd steady my back and massage the small of my back during the contraction and then move his hands up toward the center of my back during the time between contractions. This system worked really well and soon I could just say "Hands Up" as the contraction would fade and "Hands Down" as the next one would start. Faster and faster they came, and Dean would remind me: "Baby down, Mama open."

Contrast this with the epidural model where you can't leave the bed and your partner has to tell you when the next contraction is happening when the needle rises on the monitor. We'd have been there all night and probably wound up having a c-section.

It was clear that I was in labor now, though, and the bouncing no longer seemed silly. In fact, during the interludes of "rest" where I'd have to get on the monitor for 20 minutes, I was aching to get back on the ball. It was more comfortable to bounce through the damned things--and bouncing has a rhythm that you can really flow with. My next round on the monitor was at 8:30, and I found I hated being in bed and got back on the ball as quickly as possible.

At nine, I was bouncing, and trying to breathe, and howling as I did so. It was an uncanny ululation as I allowed the baby down and felt myself opening, finally. I clumsily banged the call nurse button and told her what I'd just felt. "I need to push!" I said, I think with a scream. Keep in mind I'd just hit 5 cm. at 7:45.

She hurriedly got me into bed, hooked me up to the monitors, and checked me. "She's at 8, and look at those contractions!" she hollered, galvanizing several other nurses into action and sending one off to get the doctor. I realized I was in transition and glanced at the monitor; the contractions were literally happening on top of one another, cresting like great waves pounding into one another before washing ashore in violent cascades. I think I finally understood what it meant to be in both agony and ecstasy at the same time, and stared down in bewilderment as they removed the bottom of the bed and Lisa began to manage my breathing using a counting technique that forced me to refocus my attention away from the wild banshee I was becoming as I continued to howl.

"Helen, you still have just a little bit of cervix left," she said. It was happening that fast. "Breathe with me, now." Five hees. Hooooooo. Four hees. Hoooooo. Five. Hooooooo. Lisa was holding one leg, Dean was holding the other. Three hees. Hooooooo. Five hees. Hoooooo. Two. Hooooooo. The doctor was at the foot of the bed. The other nurses were frantically getting everything ready, I was suddenly aware that It Was About To Happen.

(It was right around this time that my midwife found out I'd been admitted. She called and was told I was about to deliver. She commented back on my Facebook update: 'Why do my best patients always give birth on days I have my pager off?")

At 9:30, I got the ok to push. "Already?!" I said. I heard Lisa tell Dean to support my head as I did--and then, I pushed. With each contraction, I'd push three times; with each push, I'd visualize where he was. The baby crowned on the third contraction, and Dean looked down as we moved into the fourth to see his skull molding to emerge. "You'll feel some burning," said one of the nurses, and -- I felt his head move through me, and screamed again.

"Don't scream," said Lisa, and I nearly laughed. "Pant like you've never panted before." The baby was being suctioned, and I felt goosebumps as I fought the urge to push him the rest of the way out before the doctor had a chance to move his shoulders safely.

"Ok, push again," and out he came. Phflump into the doctor's waiting hands, and then--that first cry. They placed him on my abdomen to dry him and suction him, and I sat there breathless and awestruck, stuttering the only thing I could think to say as I wrapped my arms around him: He's beautiful. I was blinking rapidly, trying to get a sense of what had just happened as he was carried over to the examining table. He had a lot of fluid even after the first round of suctioning, and so I sent Dean over to watch as they got him breathing better.

I had more trouble delivering his placenta than I did delivering him, and I was bleeding a lot. But at that point, I was transfixed watching him, watching Dean watch him, so I didn't really sweat the Pit they attached to the INT to control the bleeding and help deliver the placenta. I probably should have, but I couldn't breastfeed the baby right away because of the excess fluid. Turned out, he'd come down the pipe so fast that he didn't get all the amniotic fluid squeezed out of his lungs and tummy.

Because when it comes right down to it, I had him in about two hours flat, and only pushed for 15 minutes, if that.

I had a small tear that needed repairing, and once he was stable they brought him to me to breastfeed. Lisa disconnected my IV, saying, "They probably want you to have a second bag of this but I know you don't want it and you definitely don't need it." As he tentatively latched on, I murmured his name, Jesse.

The doctor not only congratulated me but also--significantly--apologized to me. "You did say that if you could just get to 5......."

Jesse Heath Mosher, 9 lbs. 11 oz., 23" long, with a 14" head. 11/11/2009, 9:47 p.m. And absolutely beautiful.

The story doesn't exactly end here, though. Jesse's first night will be another blog post in a bit. :)

Before that, though, a couple of observations. I think if my midwife had been available for my labor, I would have gone into active labor more quickly. I also think I could have avoided tearing had I been able to give birth in the squatting position instead of flat on my back. That said, in my heart I feel like my midwife DID deliver my baby. She gave me nearly all of my prenatal care, and took time to educate me so that I would be empowered if she wasn't there, and helped fill me with a passion I didn't know existed--or, should I say, still existed.

She asked me, at about 6 months along, if I would consider a homebirth, saying that I would make a good candidate for one. I think, at this point, if we had another freak oops and a sibling for Jesse, I would. But the chances of that are very slim. Jesse was against the odds. A gift, if you will--and how apt is it that "Jesse" means gift?

I'm glad I didn't have an epidural

I gave birth to my first son in 1992. A lot has changed in those years, but a lot hasn't, too. Now, 17 years is a long time to hold on to a birth story, and I didn't keep a journal of experiences in those days so much as I kept a journal of emotions, so I know that during my pregnancy I was incredibly depressed. I was 21, for most of it, and had married that February and gotten pregnant on the honeymoon--the same honeymoon that we had to cut short because we found out my then-husband was losing his job. I spent the entire pregnancy on WIC, food stamps, and Medicaid. Thank you, taxpayers of Virginia.

I remember more about the birth itself the closer I get to my due date, now. I had been flirting with toxemia; my blood pressure and weight gain were the biggest concerns but I was starting to show protein in the urine. But I was already showing signs of effacement and dilation, so the doctor made a decision to go ahead and induce me the following Tuesday with an amniotomy.

I remember coming in on what felt to be the coldest day of the year. It was blustery as my then-husband dropped me off at the door; he parked, we went up together. I don't recall checking in, but I do remember getting set up in the bed to be induced. The nurses started an IV. Ten minutes later, the doctor walked in, and asked why they had started an IV. They were visibly startled; I was just impressed. "I want to see how she does after we break her water. I have a feeling she won't need Pit."

I honestly can't recall how insistent I was at that time for a low-intervention birth, but I must have made myself clear at some point. The amniotomy itself didn't bother me; it struck me as a physical intervention rather than a chemical one. But what surprised me was what the doctor said upon examining me. "She's already 3 centimeters. She's having this baby today anyway." I had been in labor all morning and not felt a thing--something that is common to my mother and my grandmother. He performed the amniotomy; I didn't feel that either. By 10 a.m., labor was well established. "No need for Pit," the doctor said again.

I called my mom. "You'll have this baby by 1:30," she said. We all had a laugh, but it turned out she'd be right--I was ready to start pushing around the time that everyone else was finishing up lunch. Suddenly, the entire world turned round: my eyes, my mouth, my soul was all formed into a perfect "O" shape--and everything I could see *felt* round. (I'm prone to synesthesia, so in hindsight that makes better sense than it did at the time.) The head was out, and the nurses were pleading with me to pant, because one of my son's shoulders was hung up on my pelvic bone, a condition known clinically as shoulder dystocia. The doctor deftly worked him up, then down, then up, then down, rocking him past the barrier--and then my son came into the world, all 9 1/2 pounds of him.

One of the nurses who was helping me breastfeed made an offhand comment to me that has stayed with me ever since. "It's a good thing you didn't have an epidural," she said. "Oh?" I replied, asking her to explain. I was 6 weeks past my 22nd birthday at the time, and didn't have any more of an understanding of labor other than what I'd gotten from "What to Expect," my childbirth education class, and my mother's tales of carrying me and my brother. But I suppose I was influenced by my mother's explanation of the difference between her birth with me, done under twilight, and with my brother, done completely natural. I showed up in five hours; my brother in 3. (We're wondering, actually, whether I will have time to even get to the hospital at all, if I don't know I'm in labor until I get to 5 cm and I roll through dilation half as quickly as I did with Elder Son.)

The nurse explained that she'd seen cases where an epidural actually caused a labor to drag on and on. "Your baby was so big, that it was a good thing you and all your muscles were fully present to work with your baby and your body to get him out. I think, if you'd had an epidural, you'd have wound up having a section."

This made me curious, even then, about whether we should always trust in medication. Sometimes I think we're taught to be afraid of the pain, so afraid that the epidural looks like an attractive option. So many women in my childbirthing ed class this time around have the attitude of "pass me an epidural as quick as you can!" And while I'm a huge advocate for allowing women to make their own choices about pain management in labor, there are times when I wish this aspect was made more clear to women. Interventions have a funny way of cascading. I feel like I'm lucky that my doctor was Pitocin-averse, at least in my case--because I've heard so many stories about how Pitocin creates unnaturally strong contractions that leaves a woman begging for epidural relief. Then, sometimes the epidural creates a difficult environment for pushing; other times, the pitocin makes it such that the oxytocin rush that I think I felt in that O-moment of birth never happens. Either way, it can lead to that nebulous diagnosis that scares me so much: failure to progress.

As if women didn't have enough "fail" pressure in their lives, right?

So anyways, the point is: in 1992, I was told--after the fact--that having an epidural would have made my life more difficult. I'm glad I turned it down. And will do so again with this pregnancy, even though I'm 17 years older.