My First Baby- The Birth of Luca Jacob: Hospital Natural Labor to Unplanned Cesarean

 I met up with a friend in the middle of my bartending shift.  It was a slow night so the bar back just took over the bar for the three or four regulars sitting at the bar while I had a couple of beers with my high school friend.  We talked about college, both of us were in our fourth year and thinking about graduation.  We talked about our significant others, I had been dating the same guy for two years which was unheard of for me.  I said all I wanted to do was graduate, marry this guy, and start a family.  He was the one for me.  The next day, I realized that my period was late.  Only a couple of days but I was very regular.  I bought a pregnancy test and sat in the little hall bathroom I shared with my boyfriend and our two roommates.  I stared at the little faint line not believing what I was seeing.  Positive?  I yelled into the house and my roommates confirmed what I thought I saw: the faintest of positive lines. 

I drove to school at noon to pick up my boyfriend, Adam, from class at the usual time.  He got in our car in front of the iconic tower on the University of Texas campus and I immediately blurted out that I was pregnant.  He sat there stunned for a minute.   Then he smiled.  My forever.  

We drove to the campus health clinic to get another test to confirm the pregnancy. We walked in, they were surprised at our positive reaction to the possibility of being pregnant in college.  I took a urine test.  Negative. What?  That didn't make any sense.  I told them they needed to do a blood test.  They said that wasn't necessary, it was clearly negative.  I said I wanted it anyway, I couldn't keep bartending in a smoky bar until I knew for sure I wasn't pregnant. I was so surprised how sad I was at the possibility of not being pregnant. I had only thought I was pregnant for a few hours and I already loved that little poppy seed. That night, I was driving to the bar for work- I decided to assume I wasn't pregnant until I got the official word- when I got a call from UT Health.  My blood test was positive. I started crying as I pulled into the bar- I was so relieved.  We were poor, had no support, and no sustainable jobs but I knew that baby was our future. We would graduate two months before the baby was due so the timing wasn't as terrible as it could be.   Adam was working retail which could support us for about five minutes until I could find a non-bartending job.  We would be ok.  I called my boss and quit my job. 

I applied for every job that existed.  I really wanted to be a housekeeper in a hotel, I felt I could be good at that.  No one would hire me, or even call me.  I put my resume on Monster and immediately got a call from a temp agency.  It was 2007 and the mortgage industry was beginning a crisis.  They needed outbound collections callers for a mortgage bank.  They were paying $13.75 an hour as a temp and I had the opportunity to get a permanent job with benefits after six months. I felt like I had hit the lottery. I was ELATED.  (That job changed the trajectory of our lives dramatically.  Adam later started working there and is now an executive in the banking industry.) 

We worked, we came back to our shared house and ate ice cream every night instead of partying, we watched a lot of jeopardy with our roommates, we went to school, we planned for the future, we lived paycheck to paycheck, we dreamed of who this baby would be.  I learned so much about the world of government assistance.  I grew up on welfare but I never thought I would need it as an adult, which to be fair I really wasn't at that point.  I applied for Medicaid so that I could get prenatal care.  It was not easy.  The lines, the amount of paperwork, the hoops, the judgy looks, the sheer amount of TIME spent doing that when I could be working or studying.  And I had it easy compared to so many women trying to do right by their children.  They had to take the bus, had other kids with them in the welfare building for hours at a time, had little documentation of legitimate jobs or places to live- so many issues I didn't even have to deal with. When I scanned the list of providers who accepted Medicaid for someone close to my house, there was only one provider and she was fifteen miles away.  How would those women who didn't have cars get to their providers? Finding a pediatrician was nearly impossible, no one takes Medicaid.  I felt lucky when I found anyone at all, there was no option to find a provider whose birth philosophy aligned with mine.  Not that I had one yet.

I first felt the baby kick when I was in the car line at the bank. I was only 17 weeks. My stomach was still completely flat.  I could feel him from the outside, Adam could even feel him.  I have read that this is impossible but I'm telling you- that is what happened. 

I gained 60 glorious pounds during my first pregnancy. All of that weight was during the last four months.  I used pregnancy as an excuse to eat a large bowl of ice cream whenever I felt like it.  I was eating for two and the other person liked ice cream a lot. I did not work out.  I sat at the bank all day, I sat in class on the days I wasn't at work, and I sat on my couch at night.  Through the magic of the young and resilient 22 year old body, I did not test positive for gestational diabetes. I actually liked the orange drink. Our anatomy scan was perfect.  The tech placed the probe on my belly and immediately picked it up.  "Whoa, sorry did you want to know the gender?"  Yes, of course. She put the probe back down where he was spread eagle and very very obviously a boy- even to a completely untrained eye. Luca.

I walked across the stage at 7 months pregnant and became the first person in my family to graduate from college.  One month later, fifty of our closest friends and family watched us marry in the Texas hill country. I was gigantic and never happier. One month later, we moved out of our college house and into our first rental house together in the Austin suburbs. It was a busy summer. 

At 40 weeks pregnant, my OBGYN checked me and told me that I was not dilated or effaced and the baby had not dropped at all.  Then she scheduled my induction for 41 weeks.  I had no idea what I was doing and agreed.  My mother had been induced with all four of us so I assumed that was totally fine and normal.  We went out for dinner, which was a huge splurge for us, on the way to the hospital for our induction. I checked in to my room and gave the nurse my three page birth plan.  She gave me a timid smile and filed it in my chart.  I had previously shared my birth plan with my mother-in-law (a labor and delivery nurse) and she blurted out that I would end up with a cesarean.  In her experience, she later explained, when women are set on a "crunchy" birth for their baby, they end up getting cut.  Cesarean was not on my radar.  I had skipped over that in the pregnancy education books.  I wasn't even getting an epidural, I would not need any cesarean education, thanks.

The nurse placed the cytotec near my cervix and I sat up all night excited to start feeling contractions.  The next morning, the nurse checked me and found that I was still closed. High and tight. No progress. They placed another softening agent and I was given until noon for something to happen. They checked me again and I was one centimeter dilated.  I was feeling light contractions but nothing serious. I didn't really understand contractions. I had never had period cramps (I know, I know) so I didn't know what to expect.  They just felt like little squeezes.  At this point, they decided to start Pitocin.  Ahhh, yes...THEN I started to understand contractions.  Wow, that stuff is no joke.  I walked the halls with my rolling IV pole while my best friend tried to record the magical moment and I huffed through these terrible pains.  There is a four second video clip of my labor.  It is just me saying "Turn it off!" and leaning over to puke? cry? get on the floor? It cuts off before we learn the ending. 

They checked me after 12 hours of this.  I was two centimeters.  They decided to introduce foley bulb into my cervix and slowly inflate it to put pressure on my cervix to help it dilate.  They said the baby was up too high and wasn't putting any pressure on my cervix so it couldn't dilate. After this point, I was confined to the bed and couldn't walk anymore.  I went all night on this foley/pitocin combination. In the morning, they pulled the bulb and I was five centimeters.  I was so so grateful!  I had dilated! It was really happening! Adam was so exhausted and kept trying to sleep but the adrenaline of potentially being in labor kept me up the entire time. Also, the horrific pain.  After a couple of days of induction, I was starting to lose my mind a little bit. I was so tired.  The doctor told me that I should consider an epidural so that I could sleep, they could break my water, and then crank the pitocin to get this baby out.  Adam crawled into bed with me and we decided that I needed sleep to push this baby out and the epidural wasn't the end of the world.  

Adam still loves to tell the story of the epidural. He says the anesthesia provider marched in the room with a giant package, unsheathed a sword from it, and stabbed me in the back. He said the needle was at least two feet long. It was very painful for him. I was quite happy with the experience. I slept for about 12 hours after the epidural while they cranked the pitocin up to the max.  They checked me the following morning. I was four centimeters. The baby's station had not changed at all. I was heartbroken. 

Our OBGYN was kind of a weird person.  She made odd comments about random things during appointments and came off as a bit of a narcissist.  I liked her and trusted her because she was my assigned doctor and the healthcare industry is there to protect patients above all else.  She came in my room with a very serious look on her face and said that she had done everything in her power to get my baby out vaginally.  The truth was, my baby was just too big to ever get through my pelvis and the only option to birth him was via cesarean.  I was in shock.  She told me that he was in danger now and we needed to get him out quickly.  The physician note states that the indication for cesarean was "failure to progress".  No other problems noted.  No decelerations.  No fever.  No time to wait.

I remember very little about the operating room.  It was freezing.  Adam could not go in with me but came in once the big blue drape was in my face and I was completely numb.  I was shaking so bad. I kept apologizing for shaking.  They were talking about their weekends.  I wasn't even there.  I was so out of it. The anesthesia provider was kind.  I heard my baby cry.  Adam got to go see him.  Everyone told me how cute he was.  Everyone else was seeing my baby before I was seeing him. I was helpless.  On a table. Cut open. 

I did not get to hold my baby until later that day back in my room when I was awake enough to hold him.  He was beautiful. 8 pounds, 12 ounces. I was so grateful to have a healthy baby, the method of arrival didn't matter to me. My post operative time in the hospital was very hard.  Three different nurses tried to get a catheter in my urethra after I hadn't peed for 24 hours. It was humiliating, cold, and painful. I hadn't anticipated the pain from the cesarean.  It is abdominal surgery, everyone acts like it is no big deal. My milk came in a few days after the baby was born. Breastfeeding was easy, thank God. I was excited to go home and start our lives as a family of three. 

I suffered from pretty severe post partum anxiety.  I was the first person in our friend group to have a baby and no one really understood how to support a new mom.  I felt so isolated.  It was a very hard time but also a beautiful time with our new amazing baby. He was so watchful, so patient, and the easiest baby we could have been gifted with.