Watching a Friend Become a Mother

Awhile back, I had the opportunity to take care of a former coworker having her first baby. She was a great L&D nurse with the sweetest disposition, very caring, and never hesitated to advocate for her patients. She started about a year after I did and after a couple years, she went to work in my OB/GYN's office. She had mentioned about 2 years ago that she and her husband were going to start trying to get pregnant, so I've been waiting to see her roll through the doors pregnant and when I'd see her in the office, I'd look to see if she had a belly. She did finally come in. An induction was scheduled for PIH and she had requested that I be the nurse. It was what we call a staged induction: a cervical ripening agent was used to "ripen" the cervix and once the cervix was soft, then pitocin would be started to get things going. They arrived at midnight and I got the induction going...and it lasted all through the day and when I came back the next night, she was still there. Only 3 centimeters. The nurse handing off to me told me that there had been some late decelerations, but she said they had resolved so she had talked with the doc and the pitocin had been restarted. I looked at the strip, still saw lates, and wondered why on earth she had restarted the pit. So I go in and do all the things to try to get the baby to be happy, but it was to no avail. I called the OB, she called for a c/s and we head back to the OR. It seems most of the time when we go back for a c/s for a non-reassuring fetal heart rate pattern, the baby, thankfully, comes out with Apgars of 9 & 9, leaving you to wonder if it was really necessary. Not the case here. This baby did not tolerate labor and was worn out and came out pale, floppy and was not breathing, but after resuscitation, she came around and made her feelings about the whole process known! The pediatrician showed the patient her baby and she looked at my friend and told the pediatrician "That's her mother, let her mother hold her". And with that, the very young birth mother made a huge sacrifice and changed the life of my friend by making her a mother. My friend, who had to leave the OR for a second because it was too much to watch as they worked to get her child to come around and take that first breath, cried tears of joy and relief. Watching someone become a mother is always amazing, but when it's someone you know, it's even sweeter.

The birth mother makes what is probably the most difficult choice she'll ever make when she decides to give the baby up for adoption, its a choice that she will think of for the rest of her life. I can't imagine the grief that birth mothers feel as they hand their baby over to a couple who will provide the life she wants for her child, a life that she can't provide herself. This birth mother said that it was a difficult choice, but she was comforted by the fact that the adoptive parents would provide a life she couldn't at this time, and that this little girl would be surrounded by love. Thank you to all the birth mothers out there for giving couples who are unable to have a biological child, the opportunity to be parents. Thank you for being brave enough to decide not to terminate the pregnancy, but to nourish and carry the child, to labor and deliver, to bear the physical scars of childbirth as well as the emotional scars, in order to give that child the life you want for her. May God bless you.

6 Years

Wow, 6 years. It's been 6 years since my niece Mirabel was stillborn at 39+ weeks. It's amazing how quickly time has passed. She'd have been in kindergarten. I talked with my SIL tonight and she said she is comforted a bit because this Christmas, her daughter has a little cousin to take care of and play with. It is a nice thought if heaven is really like that. Two souls of innocent children, who left this world before they were even born, one left at full term, the other while it was still an embryo. Tonight, the family is remembering little Mirabel Ozara.

Here's a link to Mirabel's story.

Are you tired?

Dear well meaning coworkers,

It is not helpful nor is it ever nice to comment to me "Nurse Lochia, you look tired. Did you not sleep?" or "Are you not feeling well?". Trust me, hearing this every single weekend from the dayshift is old, but when evening shift starts saying it, it gets downright irritating. Yes, I am tired, I work 12 hour night shifts, I have 3 children, the youngest still will wake up in the middle of the night, and he thinks that 5:30am is an appropriate time to wake up for the day. I have a house, kids activities, so yes, I guess I am a bit tired. People, this is how I look. Thanks for the boost to the ole' self esteem. Grrrrr.

Thanks so much,
Nurse Lochia

Football?

When there are young children in your house, you just never know what they will do or what will come out of their mouths. This afternoon, Isaiah was sitting on my lap. Well, it's more like he's bouncing, jumping and climbing. I just happen to be sitting in the chair he's climbing on. I'm fairly certain he's long forgotten all the hours we sat in the recliner, while he happily nursed and fell asleep. He seems much too old for that now. He turns to face me, reaches out and grabs one of "The Ladies". I tell him "No, Isaiah, that's not nice". And his reply? "Football?" No, Isaiah, they are not footballs.

Viability

This is the week that, should my last pregnancy have continued, I would have hit 24 weeks, or viability. I'm not 100% sure this is the week, and I decided not to torture myself and look it up to see if I am correct. But I remember when I first found out I was pregnant, I looked at the wheel to see when I would hit 24 weeks, and I remember thinking it would be appropriate that the baby would be viable around Thanksgiving. A friend who had a miscarriage told me that over the course of what would have been her 40 weeks of pregnancy, there were dates that she'd been a little sad: 20 weeks when she would have had the sono that could determine sex, 28 weeks when she'd be entering the third trimester, 36 weeks when her OB said they wouldn't stop her labor, and the due date. I guess the 20 week mark didn't really stand out for me, but 24 weeks does. Maybe it's because I'm a L&D nurse, or maybe that doesn't really matter, but for me 24 weeks was always a milestone where I could relax a bit, breathe a sigh of relief. At twenty-four weeks, the fetus has a chance of surviving if born at this gestation, although the mortality rate is high, and the likelihood of long-term problems is even higher. Of course I always hoped to hit term, but somehow knowing I had gotten to this point was a relief. Today I've been thinking about what could have been. I looked at my belly pics when I was pregnant with Isaiah, so I know my approximate size. I'd be in maternity clothes, feeling fairly regular movement and overall feeling pretty good. I would have used the excuse "I'm eating for two" to indulge in just one more piece of pumpkin pie tomorrow. (Well, I'll probably go ahead and have that second piece anyway!) I'd be protecting my belly from ornery Isaiah, answering Jacob and Clara's questions about my expanding waist and the impending arrival of their new sibling in 16 weeks. I didn't shed any tears. I was just thinking, and remembering. This Thanksgiving, I will again give thanks for the 3 healthy, happy children I have here. I'll also give thanks for the opportunity to have carried my 4th baby for 11 weeks. Even through the tears, the heartache, I can see that in that small amount of time, that life that was there, a life that only I was physically aware of, changed our lives in more ways than I can count, many for the better. But for today, I am a little sad as we reach what would have been a huge milestone in my eyes.

Second Class Birth

Last night I had an interesting discussion on face.book with an old sorority sister and a couple other people about birth. This friend had her first baby by c-section for breech, and had her second baby as a natural VBAC. I think this is wonderful, but after talking with her, I realized she is one of those people who look down on women who choose to have pain relief or have a c-section. And that I found very offensive. I think she forgot I chose to get an epidural with my vaginal delivery and had 2 c-sections. I do agree, very strongly, that the national c-section rate is much higher than it should be and that women should be given more support when they decide they don't want interventions. There are too many elective inductions. Fetal monitoring should be intermittant with a healthy pregnancy so mom can move around in labor. VBAC's should be the norm instead of repeat c-section for numerous reasons. In most cases, they are safer for mom and baby, it isn't major abdominal surgery, etc. But just because a mom doesn't deliver au naturale, doesnt' mean she has had a second class birth. I bonded just fine with all 3 of my children, and have no different feelings for the child I pushed out into the world than I have for the two that my body continued to support while they were delivered through an abdominal incision. All three of my children were awesome breastfeeders. I am a firm believer that as a labor nurse, it is my duty to help the woman achieve the birth she wants. If she wants to labor without an epidural, I am there to support her. If she wants an epidural, I will support her. If she has chosen to have a repeat c-section, I will support her. In every way, shape and form that birth can be achieved, I will do what I can to make it the best experience it can be. It is awesome when a mom delivers without pain meds and she feels this sense of empowerment. It is a beautiful thing. But it doesn't always happen. One mom I took care of not too long ago, delivered her first baby without an epidural...and regretted it, said she'd never do it that way again. She did fabulous, and I hadn't a clue she felt this way, but she later admitted to me she would have asked for the epidural but her support people were anti-epidural and were very discouraging when she started thinking about it. She did not enjoy her birth, and it made me very sad to learn this. On the flip side, I've had moms who wanted an epidural as soon as they hit the door, wish they hadn't gotten one because they hated not being able to feel what was going on. I've seen a support person make a woman who has had a c-section feel like she took the easy way out. A c-section, my friends, is not the easy route. I guess I hadn't realized how very strongly I feel about this: there is no such thing as a second class birth. The mother has provided nutrition and the perfect environment for the baby to grow since conception, and that continues throughout labor and delivery. The baby is supported in the presence of pain medication, an epidural and throughout the c-section. If the mom knows her options, has been able to make an educated decision, is happy with her experience and the outcome is a healthy mom and baby, then that is what is important. The birth experience is important, and every birth, every baby is a miracle. Let's not make women feel their birth was anything less than spectacular, regardless of her method of delivery.

In a Funk

The last couple days I've been in a funk. I've wanted to be lazy but I am unable to indulge my fantasy of lying on the coach and napping. I am slowly coming out of it. I was on call last night from 7p - 11p, and I desperately wanted to be able to stay home. I had worked evening shift charge the night before to help out the usual charge nurse. So I worked Friday, on-call Saturday, worked Sunday night, Monday night and Tuesday evening. I just wanted to tuck the kids in and go to bed at a normal, decent time. Usually, they know by 2 hours before a shift if they need you or not, and they hadn't called me by 5:30, so I figured I was in the clear for awhile anyway. When you are on call, they could call at anytime during that call slot and you have to be there in 30 minutes. I knew I still might have to go in. At 5:40, they called "We need you to come in at 7". Rats. I moaned and groaned about having to work, wondering what type of assignment they'd give me. Evening shift is notorious for giving people coming in to help a less than pleasant load. But, I was assigned to care for a coworker, having her first baby. Early in her pregnancy, the sono had indicated there was some type of mass that was shifting her heart and lungs to the wrong side. Plans at that point were to deliver her at 34 weeks at a Hospital with a Level 3 NICU. But, at a follow-up sono at 33 weeks had shown that it had resolved and that the mass had completely disappeared. So last night she delivered a healthy little girl. It's funny watching an OB nurse on the other side of the monitor for the first time. This nurse rarely shows much emotion, but as her baby's head emerged, she reached down to touch the mass of hair and the tears started falling. Of course, that gets me crying. By the end, there wasn't a dry eye in the room. Not unusual when one of our own delivers. It was a beautiful delivery. So I had dreaded working but it turned out to be a nice shift, plus it's another 4 hours of call-in pay. It will make for a nice check for Christmas shopping. This a.m., I found myself not wanting to get up out of bed, drag the kids out in the cold rain to take Jacob to school. It was so nice and toasty warm under the blankets, and since I had worked until 11pm last night, I hadn't gotten to bed until after midnight. Obviously there wasn't any option other than to get my butt out of bed, but I grumbled all morning. I stopped at a pop machine (I have a diet cola addiction and try to limit myself by not buying a 12 pack and just getting one at the machine in the morning) and it gave me 2 for the price of one! Hey, sometimes it's the small things. I took the mail out of the box and found a Save the Date card for my old H.S friend's wedding. We reconnected this summer when we ran races together. I also received her bridal shower invitation and noticed it was on a Sunday afternoon. I thought "Well, I guess I can't go to that" until I realized I was scheduled to work Friday/Sunday that weekend, so I will be able to go. I also found a coupon booklet from the grocery store I shop at for $20 off a $200 purchase, on top of great coupons for items I routinely buy. Things are starting to look up and my motivation is coming back. I might just be able to get the 5 loads of laundry tackled today.