Inducing labor felt like the road of no return. As the ob-gyn resident prepared to begin the process, whatever shreds of hope for miraculous recovery I was holding on to flickered out. The steps for induction were explained; they were less than savory.
Because I was so far away from my due date, my body had not yet started to efface and dilate in preparation for labor. I would have to start from zero. This meant that in addition to medications given for labor induction, pitocin and misoprostol, the doctor would also have to (drumroll here) manually dilate my cervix. A catheter with a balloon would be inflated inside of me as I received IV medication in order to kick start my labor. I was told that there would be a minute of “cramping pain” as the balloon was inflated and was offered dilaudid for relief. Dilaudid is a opioid pain medication that crosses the placenta and can have some effects on a fetus, although it is considered OK to give in certain situations where need outweighs risk. Knowing this, I figured I could handle a minute of discomfort. I didn’t want even a slight chance of Baby Girl being in worse shape than she already was at 8 weeks early.
Once again, the my expectations were off. The process proved to be a little more than uncomfortable before the resident even got around to inflating the balloon. I was trying hard to maintain my composure and relax but failing miserably. Once the resident began to inflate the balloon, I mentally counted sixty seconds to the finish line. The pain did pass and I let out a giant sigh of relief. To my disappointment, the resident said that she was unable to correctly place the balloon and we would need to start from the beginning. I told her to go ahead and try again, hoping to get it over with. The second time around the pain was worse. Tears sprang to my eyes as I was told placement was not achieved once again. On the third round, I am pretty certain I was cutting off the circulation to Vlad’s hand. I could not hold back from screaming out in pain. The resident’s best efforts failed once again, probably in large part to how tensed up I was.
I was done trying to be a hero. No one was going to give me a medal for going through this torture medication free. I consented to dilaudid. The dose I was set to get was one milligram. Morgan, the nurse, only managed to push half of that through my IV when suddenly it hit me. I felt as though I was levitating above the bed while simultaneously being submerged into a hot tub. The air around me felt thin as my eyes widened and rolled back.
“Oh my God!” I remember exclaiming, mouth gaping. I had never had pain medicine this strong before. My body was absolutely reeling. Everyone around me snickered at my reaction. I laughed too. The comic relief in that moment was so, so needed. The resident quickly went back to work. I could feel her hands but was relaxed to the point of not caring. With my discomfort relieved, the catheter was successfully placed with balloon inflated within a minute.
I relaxed in back in bed. Perhaps the worst was behind me. I don’t remember how much time passed by, but it felt as if only minutes. The pain of the induction was replaced by the pain of contractions. I had read that a lot of women start to labor with back pain that gradually moves down and anteriorly. I was mentally prepared prepared for contractions that would slowly build up in intensity, giving me time to get used to the discomfort. Probably because my labor was induced with several methods for sake of speeding up the process, my contraction experience was unlike anything I read about. They came suddenly and from somewhere down below. The pain felt as if someone had cranked the dial from zero to ten. Unlike the beginning stages of a naturally progressing labor in which there are breaks of as many as ten minutes between contractions, I was barely getting seconds of rest. The experience was so completely disorienting that I forgot all about relaxation techniques. All I could do was sit forward and moan, holding Vlad’s hand. It took me a while to realize that I was holding my breath through each one. I forced myself to breathe rhythmically during each new wave, but the relief I got was a drop in the bucket. The epidural was out of the question until I dilated to at least 3 centimeters and was considered in active labor.
After what I felt like an eternity, the nurse got an order for another half milligram of dilaudid. I did not hesitate this time. My strength was diminishing rapidly and I knew I would need it even more after delivery. With the second dose of dilaudid on board, I was elated to find out that I was allowed to order food from the clear liquids menu. Ravenous would have been an understated description of my state. Clear liquids consisted of chicken broth, two different types of jello and popsicles. I ordered all three. I am not kidding when I say that after almost an entire day of not eating, jello and popsicles tasted like a delicacy.
With my clear liquid meal behind me, I rested in bed with my eyes closed. Although sleep was so needed, my thoughts were running a million miles an hour. I ended up pretending to snooze while listening in to my mom and Vlad talk about me.
The time wore on, although I had completely lost track of it. The resident came to check my dilation progress and was happy to report that I had made it to five centimeters. The hard work of the pain was not lost. She took out the balloon catheter and suggested that the epidural would be a great idea before I progressed any further. I consented as it was always part of my labor plan but found myself simultaneously filled with dread. So much had gone wrong and now I irrationally feared that the epidural would be added to that list. Every freak story I read on the internet ran thought my head. What if the anesthesiologist botched the job and I would end up with permanent spinal cord damage?
Thankfully, this was the one part that I did not have to worry over. The anesthesiologist turned out to be reassuring, calm and an excellent practitioner. I locked eyes with Vlad, who was masked for sterility and sitting against the wall. The nurse gave me an intentional hug to steady me as I sat on the edge of the raised bed, feet dangling, back hunched and exposed. The worst part of the whole process was a tiny prick of a needle as the area around the site was being numbed. I did not feel the actual spinal needle whatsoever. My feet began feeling like quicksand within seconds of the medication introduced into my system. The nurse helped me back into bed.
At this point the resident also broke my water – yet another step towards no return in my mind. The nurse placed a Foley catheter to measure my urine output and ultimately, my waning kidney function (I was very thankful for not having to feel this part).
The culmination happened in the wee hours of Tuesday morning. We had been there since Sunday night. The crazy seemed to be winding down. At that point we were in a waiting game for full dilation so that I could deliver. Vlad and I tried our best to rest in the dimly lit labor room. My mom was still seated in the corner and fairly traumatized by everything she had witnessed her only child go through. All three of us were past the breaking point of exhaustion.
For some reason, the nurse would not leave me alone. Every time I would drift off to sleep, she would be adjusting my positioning in bed or the heartbeat monitor on my belly. I was so annoyed. Everyone had told me to try to rest and wait, yet I kept getting bothered every few minutes. I couldn’t even get comfortable because I was only allowed to lay on my left side, propped by pillows. I should have probably realized that any time I built up expectations they would be shattered but I was too tired to think. My mind was so overworked that I failed to clue in that the reason the nurse, and all her nurse friends, kept crowding me and “bothering” me, was because of Baby Girl’s heart rate. It kept falling off the monitor. After a minute of searching, it would be found again but lower than the previous reading. This kept happening over and over for several hours.
One of the lead attending physicians, along with a several wide eyed residents, interrupted our trance-like state. He said that because of the repeated drops in Baby Girl’s heart rate, it was no longer safe for me to progress in labor. The best course of action was now an urgent c-section. His words fell on me like an avalanche. All through the course of my pregnancy, I had always told Vlad that whatever happened, the absolute last thing I wanted was a c-section. Although I worked in the medical field, the idea of personally undergoing surgery always struck a fear cord. Now it was inevitable reality.
I was so caught off guard by this turn of events that I asked the doctors to step out of the room “so I could think about it”…as if I were going to come up with an alternate option. Vlad, my mom and I took a moment to pray. I tried to collect my thoughts. The prospect of c-section had an air of finality about it that was unsettling. My pregnancy was about to abruptly end two months early. The little girl being grown inside of me would be out in the world.
Within five minutes I was being wheeled out of the labor room and towards a surgical suite. My mom was shown to the waiting room while Vlad was led towards a place to change into sterile scrubs so that he could be by my side. I was acutely aware of how alone I felt with no loved ones beside me while the nurses were helping me from the bed onto the surgical table. Thankfully, Dr. H. was smiling down at me – she had left her home at 3am that Tuesday to make it in to perform my c-section even though the attending physician on duty was more than capable. Seeing her familiar face gave me a sliver of peace.
I had been in several c-sections during nursing school. I listened in to the conversations going on around me as I was prepped, trying to pretend I was once again a nurse and not the patient on the table. It was not working to relieve my anxiety. To add to my nerves, Vlad was nowhere to be found. The anesthesia team increased the dose of my epidural until I was completely paralyzed. The curtain blocking the surgical site from view went up and I heard a voice say,
“I’m prepping her belly.”
“Don’t worry, don’t worry, he’s coming!” The nurses said in response to my frantic repeated questioning of my husband’s whereabouts. This could not be happening without him.
I was told with the epidural I would not feel pain but perhaps some pressure. Perhaps it was my imagination, but I seemingly felt the scalpel glide across my abdomen. Just as the first incision was made, Vlad was allowed to join me at the head of the table. He locked his eyes with my tearful ones.
Dr. H. was excellent at peeking over the curtain and giving encouraging updates as she and her team worked. It was mind blowing to know that on the other side of the partition, the muscles of my abdomen had been cut away and my inner organs exposed. Very quickly, Vlad and I heard the words,
“Her uterus is exposed. Bring in the neonatology team.”
A whole team of specialists just for Baby Girl rushed in, bringing the total headcount in the room to about 15-20 people. The anesthesiologist, sitting by me opposite of Vlad, looked at me.
“They are about to take her out.” He said. “You will feel some pressure in your chest and it will be over.”
I held my breath as all my emotions were squeezing together. It happened exactly as the anesthesiologist had described. The pressure was there and just as suddenly it was gone. The time was 3:30 am.
There was a split second pause followed by a giant wail from our two pound thirteen ounce little human.
Hearing that cry opened a floodgate of relief unlike anything else. Vlad and I put our heads together, letting out a simultaneous sigh as we both broke into tears.
“Zoya!” I exclaimed. That was the first time we openly said her name in front of others, although we had been calling her by it for months.
The moments after that one are truly a blur. Vlad was allowed to cut the cord as the neonatal team evaluated her under the infant warmer. She was wrapped up in the classic white-blue-pink hospital baby blanket. One of the nurses put her head up to mine so I could kiss her forehead before she was taken to the NICU. Vlad followed her infant warmer out of the surgical room as Dr. H. was already working on repairing my incision. When I first got pregnant, Vlad and I somehow thought to have a conversation about what he should do if things went wrong and the baby needed to go to NICU. Together we decided that unless I was actively dying, he should leave me and go with the baby to make sure it is OK. Looking back, I am so glad we made that plan in advance and were not frantically deciding what to do in the moment. Vlad was able to see Zoya get settled in the NICU, sign consents for her treatment and meet her nurses before returning to me as I was getting stitched.
After my repair was complete, I was transferred back to a hospital bed. The team went above and beyond by wheeling that giant thing through the halls of the hospital to the NICU so that I could see where Zoya was for myself. She was laying under the warmer without a blanket and I could see her limbs, as thin as my fingers, for the first time. Her breaths, assisted by an oxygen mask, were fast and hard – she was working overtime at life. I wanted to be there for her in every way possible but also felt utterly exhausted and helpless and overwhelmed. I was brought into the recovery room on the high risk maternity floor where I would be for the next 5 days. Everything that had happened seemed like a bad dream. I knew I had a baby but she was not by me. I was a mother yet I was still supposed to have been pregnant another two months. Zoya had been an extension of me and suddenly I was empty. Nothing made sense. All of these feelings continued to be blunted by the magnesium drip that was still running into me and would continue for the next 24 hours.
I laid in the dark of the recovery room as she laid, one floor down, in the NICU. It was the end of the beginning. The light from our heart monitors cast a glow over our beds as we started out on life as mother and daughter.