Cristian's Entry (Lisa's Inverted T Cesarean)

Cristian's delivery was, I suppose the best day of my life, but also the worst experience I've ever had, how could it be both? At my 6 week postpartum visit, the OB explained that she did a low transverse incision and then that she had to cut up the middle about one inch because his head was stuck on the way out, and inverted "T-like" incision-he had been frank breech. I asked her about VBAC and she told me something like, "oh, you'll be fine for VBAC, no problem at all." This was a lie, OB's and midwives backed by OB's don't want to "let" a woman w/ and inverted T incision VBAC. She also told me on the way out of the room, with a lot of enthusiasm, and I swear this is what she said, "If he would have been a little further down the birth canal, I would have just let you push him out." My operative report says he was at + 1 station and that I was fully effaced and dilated to 10 cm when they put me under general anesthesia. My mother pushed me out of her birth canal in 1973. I was frank breech, the OB was very experienced at delivering frank breech babies...... My mother said that it was a very difficult delivery, but she did it, guided by someone who know what he was doing and who respected the process of birth (he was slurring his words drunk during my birth, by the way). I remember one of the meetings w/ my doula before Cristian's delivery (I can't call it a birth, it was s surgical removal of my baby), she started talking about general anesthesia and emergency cesarean. My eyes glazed over and I wondered why she was even bothering talking to me about it. Something like that would never happen to me. I was so very humbled by Cristian's delivery. It changed my life, the way that I look at the world, at pregnant women and at babies, and the way I see physicians and nurses. It greatly affected my second pregnancy and the delivery of my second child. I know that I am blessed with my husband and two healthy children, but I will forever grieve their births that I so longed for.

The worry started around 32 weeks when they did the sono, I didn't even really want the sono, I almost declined it because I didn't feel it was totally necessary. I decided to go ahead with it because I rarely felt movement all over, it was usually in only two spots and I thought this was kind of weird. “Your baby is breech” is what the sono-tech said. Oh, ok. The sono was very uncomfortable for me. I was disappointed because I was excited to see the baby, then she said the baby was breech, then my back started getting hot and cramped and I couldn't lay in that position any more. It was so uncomfortable and dissatisfying. The sono was over. Looking back, this was an omen. After the sono, we saw Dr. S. I asked her if she recommended anything to help the baby turn. She recommended nothing and said something like “you have time.” So baby was breech and I knew I was pegged for c-section if the baby did not turn. But we had time… supposedly.

It happened so fast, too fast, and too soon. We were not ready, I was not ready, but I guess Cristian was ready and so he came. I had been to see Dr. L the day before Cristian was born. It was a routine appointment, he chatted confidently with me a bit about what I may start to experience over the next several weeks, and how to cope with the symptoms. We listened to the beautiful sound of Cristian's heart beat, he did a quick manual exam of my belly and told me that the head was down. He even held my hands down on my belly to show me where the head was. I told him I could tell, but really I could not tell, I had no idea where the head was. I trusted that the head was down, after-all I had been swimming and diving down to try to flip baby, playing music at the bottom of my belly.I went back to work telling everyone that the baby was no longer breech, “The head is down!” I called Jorge at work, “The baby's head is down.” I was totally relieved. I went swimming that night, I was feeling quite huge and heavy, my legs and feet were swelling at night and the only way that I felt at all like myself was to be in the water.

I went to bed as usual that night, and then woke up as usual around 4:15 to go to the bathroom. In the bathroom I noticed that my underwear felt wet, I turned on the light and when I wiped the tissue had clear/pink, shiny fluid on it. Nothing was pouring or leaking out when I stood up, I thought my mucus plug had begun to dislodge as I had just read about this! When I lay back down in bed, I felt some sharp cramping down low, it wasn't very strong, but it was noticeable. I thought that was kind of strange, but still thought nothing of it. I laid there awake for a few minutes and then for some reason I coughed. When I coughed I felt a small gush of fluid come out of me. I sat up, got out of bed and started walking around the room in the dark. I knew this was not normal, that my water had probably broken, but there was no way I could be in labor. I had 2 more very short and sharp contractions, they were not awfully painful, but I definitely felt them. After the 3rd contraction in 15-20 minutes, I turned on the light and saw that the sheet was wet, I decided I had to call the doctor. I called the answering service and a sleepy Dr. T promptly returned my call. I told her what happened and she concurred that my water probably did break and I should go to Holy Cross to get checked out. By this point it was just before 5am. I was feeling fine, I was making a list of things to bring with me, my popsicles, tooth brush. I went to wake up Jorge, he was no more ready than I was. He asked if he could shower, I said sure. I went to the kitchen to eat, had some oatmeal, juice, yogurt, made some toast. Packed a few things and by around 5:30 we were on the road.

I kept saying we should call Helaine, the doula. Jorge kept telling me that we should wait until we get to the hospital and know what is really happening. I reluctantly agreed, because I really wasn't feeling bad at all, the sun was starting to come up. Jorge and I were joking around on the way to the hospital. I don't remember our conversation but it was light and it still had not really hit me that I was in labor. I do remember that as we were driving, the contractions were getting closer together and sharper, they were low and very strong. I was holding onto the passenger handle on the roof of the car and was trying to breath.

When we got to the hospital, I got out of the car and immediately vomited all over the parking lot. I don't even remember feeling nauseated, it just came right up. At the same time, I pooped! I pooped in my underwear, just enough! Early in the pregnancy, I had such a fear of “pooping” while pushing in front of my husband. I had gotten over that fear at some point, I had never feared pooping my pants, and that is what happened. As soon as I vomited and pooped my pants, I demanded to Jorge that he “CALL HELAINE NOW.” Looking back, I guess at that point, I knew I was in labor, but still was not getting it that the baby was going to be born right away.

We went up to L&D and I went immediately to the public restroom to clean myself up. I sat on the toilet, took off my pants and underwear, threw my underwear away in the trash can. I was trying to clean myself off, the toilet paper roll was FULL, and it was so full that I could not get the toilet paper roll to unroll. I kept trying and was only getting very small pieces of toilet paper, not enough to clean myself off. My contractions were really hurting bad and they were getting faster, I had a flash picture of me delivering there in the bathroom, I looked at the emergency pull chord and decided that I had no time to waste-I did not want to be pulling that chord. Looking back, I should have freaking stayed in that bathroom as long as possible.......I grabbed the toilet seat/sanitary covers to my left and wiped with those. Threw the sweat pants back on and went out to L&D triage desk. Jorge was there and was giving them our information. I remember leaning on the desk and marching in place because the pain was getting worse. I told them what happened at home and that I had spoken to Dr. T. They asked me when was my last menstrual period and answered with indignation, “I don't know, sometime last September, why are you asking me that now.”

They took me back immediately and the triage nurse told me to get changed. As I was changing, Jorge was calling my parents, they were on their way. He was calling Helaine and could not get through, leaving messages. At some point, she answered or called back, I talked to her and she told me “this is probably happening now.” She said she was going to tie up some loose ends and get to the hospital as soon as she could. For the first time I felt scared. Scared, how could this happen now? It was going to happen now, but it was too soon. I did not want to get into the bed, I kept holding onto the wall and marching in place. Jorge was right there with me. The triage nurse checked me and said that I was 4 centimeters dilated and that it didn't feel like a head. The fetal monitor was on. She asked about the baby's position. I told her about the ultrasound 2 weeks prior to this which showed baby was breech, but then Dr. Lizardo palpated my belly just yesterday afternoon and said the head was down. She rolled her eyes and again said that it did not feel like a head.

At this point, they took us immediately back to L&D to do ultrasound, and I guess to get me ready to deliver. It was probably 6:30am by this point, I don't even know. From here it was crazy, it went downhill, I lost all control of myself and of the situation. It was a nightmare, insanity, total chaos, painful, the pain was mind blowing, it was the force of nature taking over my body. It was so fast and just ridiculous. I still can't believe how it happened.

Jorge was to my right, there was a night stand and a couch, the phone was on the night stand. I wanted to be on my right side. The monitor was on, I guess I could hear his heartbeat, but don't remember it now. All I remember was the pain was so bad, there was no room to breath, I was crying, cursing, praying, asking them to help me, God please help me. I was scared. One nurse was telling me to breathe because my baby needed all of the oxygen I could give him. This helped me calm down a little bit. But she only said that a few times and I needed someone right there in my face to talk to me the whole time because the pain was so bad. The contractions were so fast, I had no time to recover between them. I was vomiting all over the table and fluid was coming out of me, I guess it was the rest of my water, I didn't know or care. Jorge kept handing me clean bed-pans. He looked so calm, supportive, he looked worried, I guess a little scared. He didn't even flinch with the vomit and immodesty. He was there when I was most vulnerable. For this I love him that much more. They kept trying to turn me on my back, I don't know how many there were, 5, 6, 7, 8 nurses? The sonogram machine was there between Jorge and me. They put the ultrasound on my stomach for not even 5 seconds and confirmed the baby was breech. I could not deliver vaginally. They had to do a c-section. (lots of tears) I was going to be cut open, that was not what I wanted.

I, for the most part, speak my mind. I know what I want and I say it. I'm not a total control freak, but I do like to be in charge of things when I can. I'm a leader, not a follower, I get things done. I'm competent. I read up on child birth, I met w/ my doula several times. I talked to all of the docs in the practice about natural child birth and my wishes. I researched birth plans and tried to write one. I don't think I ever wrote one. But even if I had, it would not have been honored. One of the worst things, looking back was, I didn't even question what they were doing, I didn't ask one question! I wasn't able to discuss the process. I am a process person! I wasn't able to do any processing or discussing or thinking. I was totally not a part of the process and this was my delivery, Jorge's and my baby, my body. Once I went into transition, I couldn't even stop to think, let alone ask a question or challenge the nurses or the doctor. I couldn't “discuss my options.” And if I could have discussed my options, well what options did I even have? None. What was there to discuss? Nothing. All I could do was beg for mercy and try not to let them turn me on my back. I was holding onto the bed railing for life.

The doctor was there for a second, I think when they did the sono. Between contractions, I kept telling Jorge to call people. I made him call my office (I work at that hospital), I told him to press # and to tell them that I was not coming to work today because I was having the baby. They gave Jorge scrubs to change into, they were paging anesthesia, Dr. T was in and out, they were trying to turn me onto my back to check me, they were asking me questions. I kept not wanting to turn on my back, I was holding onto the right side rail of the bed with both hands, I did not want to be on my back and they kept turning me on my back. Couldn't they wait until the contraction stopped to turn me on my back? They were trying to draw blood from one arm and put an IV into another arm. There were so many people there. Jorge and I were telling them that I am very sensitive to anesthesia, that I vomit easily (really?). At one point, I started to push, I wasn't trying to push, it was just happening. I was grunting and pushing. I couldn't believe I was pushing like that, laying on my side pushing. It was so weird. It was like the waves breaking on the beach, they roll in, break hard, and the water rolls back out. The baby was coming down the birth canal, frank breech.... My body was totally out of my control, I was contracting hard, and I was fully dilated within 3 hours of waking up to wet underwear. I ate oatmeal, Jorge took a shower, we made some jokes, I crapped my pants, started vomiting, and here you have it: The baby was breech, I was not able to deliver my baby naturally as Jorge and I had so desired (at least to try). Just because of the position, they basically attacked me and stopped nature. Even though my body was doing what it was supposed to do, they had to cut me open because they didn't know what else to do. Well, really because this is how most people deliver breech babies these days-in hospitals that is.

Now, there was no time for the epidural, they kept telling me not to push. They said that they would have to put me under general anesthesia to deliver the baby and so Jorge could not go in the OR with us. Our baby would be born with neither one of us present, this is so sad for me. They moved the bed to the hallway and into the OR, they had me climb onto the table. This surprised me, that they had me climb out of the bed and onto the table. They were in charge so why did I have to climb onto the table by myself? They wanted me on my back and I did not want to be on my back because the pain was so bad. They kept trying to push my knees flat and I kept resisting. I was so annoyed that they kept pushing my knees down, didn't they know I was in pain? Don't they know that flat on your back with legs flat is the worst position during a contraction? I wanted them to put me to sleep, then put my legs flat. They put a mask over my mouth, there were two people looking at me, a man with glasses and a woman. They had surgical hats and masks on their faces. The woman kept calling me sweetheart and telling me that everything was going to be ok, over and over again. She kept yelling/asking “is someone going to prep her” – in between telling me that everything was going to be ok and calling me sweetheart. I guess they could not put me under anesthesia until I was prepped? At this point, I could not WAIT to be prepped so I could be put under and out of the misery. I looked to the right and saw the blood backing up into my IV line, I didn't know if this really meant anything, but I didn't think it was a good thing. I just lay there and looked at the man's face, the man holding the mask onto my mouth and nose, he looked peaceful, I could see his eyes looking at me through his glasses, he was quiet. I prayed that I would not die, I thought I might die, I had a fleeting wish for death, it was so awful... I wanted to see my baby being born. I wanted to wake up to see my baby, my husband, and all of the other people I care about. I wanted to tell them the IV was backing up, but I couldn't, I just hoped I would wake up, and that was it, I was out.

Cristian was born at 7:12am via C-section, frank breech. His little legs had been folded up against his beautiful face for who knows how long. The top of his right foot had dented in his soft little skull. He was intubated for 3 or 4 minutes just after birth because he did not respond or breathe as he should right away-this is what they told us a day or two later, as neither Jorge or I were present to see it. However, in my operative report it does say, "the infant cried spontaneously." I don't know why he was intubated if he cried spontaneously. I'll never know exactly what happened because I wasn't there. Maybe is a blessing that Jorge and I were not there to see all of this, who wants to see their newborn intubated because he is not “responding” as he should? From there, his breathing was outstanding and he had no lung problems, thank God for this.

Jorge said they brought him out of the OR in the little isolette, Jorge was with him for a few minutes, in awe of his incredible littleness, he was all of 5 lbs, 5 oz, 17.5 inches long. Jorge says he felt something he had never felt before. Jorge couldn't hold him at that time, they told Jorge that baby and I were both ok and where to go to see me when I woke up. Then they took baby right to the NICU. Jorge said our boy's legs were sticking straight up in the air because of his frank breech position, and he saw baby's dark hair. Baby was crying, he was raising hell.

They took me to PACU where Jorge was waiting for me, he says I was semi-conscious. This is all a blur and Jorge has filled in this part. I remember that when I woke up I felt so thirsty. (At least I woke up!) I just wanted to drink water, but they wouldn't let me, I could only have ice chips. There were nurses, Jorge, my sisters, my parents, and two of my co-workers came to visit. Two visitors at a time. They told me we had a boy and that he was in the NICU but he was fine.

At some point, the nurses got me all cleaned up and then we went to the NICU: Jorge, mom, dad, and they wheeled me in the bed. Baby was all wrapped up, his dark hair and olive/reddish skin showing. I don't remember holding him but I know I did hold him because there is a picture. I don't remember how long we were in there, maybe 15 minutes or so? I wish I could remember holding him there. I do remember being taken to my room without him, I felt torn apart to not have him with me. Torn down the middle. When could I breast-feed him? When could I hold his little naked body to my chest and say to him “my baby, my baby” like I saw in all of the films I watched? I was knocked out the rest of the day, I wanted to go see him later that night but couldn't get out of bed. Jorge was coming and going between NICU and my room. He was telling me that everything was ok and what the doctors were saying about baby. We didn't have a name picked out yet. The next morning I woke up early, the nurses got me up out of bed, it was so hard to get up, the pain was really bad, I was bleeding a lot, I felt totally helpless and anxious to see my baby. Someone came and wheeled me to NICU to see him, I was able to hold him. He was all hooked up to monitors and was wrapped in his little blanket. I don't remember this either, but I know it happened because there are pictures.

He was in the NICU for less than two weeks so he could grow, learn to maintain his temperature and learn to eat. When he was in the NICU I felt scared holding him, like I would hurt him, afraid that I might disconnect his monitors. Even though the nurses and doctors were so great and made us feel welcome and at ease it was still so nerve wracking. I couldn't just hold him naked against my skin. I couldn't really breast feed him. I had to pump 8-10 times a day, it was exhausting and totally dissatisfying. My incision was painful. The whole thing was miserable...... I developed bad postpartum and also PTSD that surfaced during my second pregnancy. I'm a lot better now but am still grieving as I continue to weave this experience into my soul. I'm now able to see some positives in what happened, it has added a whole dimension to my life and has brought me wisdom and gratitude for my health and that of my family.....