Claire's Birth Story: Part Three

WARNING: This series of posts contains content that some may consider TMI, as well as a fair amount of hippy-dippy stuff that may annoy some readers. Just a heads-up.) 

Please read Part One and Part Two before continuing!

When the pulmonologist came to see me the morning of September 15, about sixteen hours after I'd given birth, I was pretty scared. The swelling in my face made me extremely self-conscious and it was rapidly worsening. It hurt to inhale, my voice had changed into something hoarse and unfamiliar, and the vision in my left eye was getting blurry. I'd just come back from the x-ray department, where they had captured images of my chest, and now I was nervous about what this lung expert had to tell me.

Having grown up in this town and completed nursing school clinicals in this very hospital, I knew of this doctor; I knew he was one of the best, most thorough physicians in the area. So I grew even more anxious when I saw the look on his face as he examined me. He looked serious. Concerned.

He told me my lungs had undergone some trauma during the pushing stage. I'd pushed for four hours (Yes. After laboring for two freaking days, I pushed for FOUR. HOURS.).  And at some point, during all this prolonged pushing, it seemed that I had ruptured some bronchial tissue, which caused the air inside this tissue to leak into other parts of my body. That's what the "crunchy tiny rocks"- subcutaneous crepitus- in the swollen areas of my body were. Displaced air from my lungs.

He said typically, this condition, pneumomediastinum, is seen in traumatic accidents, such as car crashes, but it can happen during childbirth, though it's rare. He went on to say that while this was usually benign, it could get serious. He talked about pneumothorax, potential collapsed lungs, air moving to the cavity around the heart and causing serious issues. He mentioned moving to the ICU if things didn't improve.

I was a bit terrified.

He ordered oxygen at 4 liters (which surprised me; I've only ever administered oxygen at 2 liters except for one resident I had with advanced COPD, who received 4), a repeat chest x-ray for the next morning to check for changes, and he told the nurses to monitor my oxygen saturation frequently over the next 24 hours. Though we'd expected to go home the next day, he let me know we would not be going anywhere until this appeared to be resolving.

Shortly after his visit, I began to feel like a patient on House. Nurse after nurse, a few of whom I hadn't even met, stopped by my room to see me, because they'd never seen my condition before. Even Nurse E, my awesome labor and delivery nurse, came by to visit. Everyone who came in knew about my ridiculously long, unmedicated labor, too, and was asking questions and commenting on how calm and quiet I'd been despite pushing such a big baby for so long, without an epidural. It was sorta neat to learn I was the talk of the nurses' station (and a little uncomfortable, too).

After just a couple of hours on oxygen, the swelling began to decrease slightly. This seemed to be a good sign, so I tried not to worry about all the potential complications the pulmonologist had discussed with me. But that was kind of hard, especially when I had other things to worry about.

Like figuring out how to take care of this newborn baby. Like fretting over who might inconveniently show up to the hospital to visit me when this was all going on. Like wondering when the milk of magnesia would kick in and I'd have that inevitable first postpartum bowel movement that everyone with perineal tears dreads. Like my already sore and cracked nipples and Claire's inability to latch on and stay on.

We were really struggling with breastfeeding. Everyone talks about how "natural" it is, but isn't "naturally" easy. The pediatrician came by to examine Claire for the first time this same day and told me she had a mild tongue tie that could be causing latch problems. He said it could be corrected with a simple procedure if feeding continued to go poorly. And it did.

By Sunday, I cried every time she cried. I cried when she started sucking on her hands or rooting around in search of a breast. I hated having to feed her because it hurt so dang much, and she needed it so dang often. Plus, I couldn't tell if she was even getting milk. She didn't seem to be latching properly, and I couldn't see if anything was coming out of me. I just hated it. 

It all came to a head Sunday night when she screamed constantly and I couldn't stop crying. My breasts hurt so badly, I couldn't bear to try feeding her. One side was actually bleeding a little. And Claire...her coloring was off. She was looking more and more yellow with each hour. Even the whites of her eyes were turning dark. I also noticed she wasn't urinating often enough; it seemed like we were rarely changing diapers.

I confessed all of our problems to the night shift nurses and finally asked for help. Claire was jaundiced, likely due to not breastfeeding well, they told us. Due to her latch troubles and my milk not coming in fully, she wasn't getting enough to eat. Without enough milk, she wasn't urinating enough, which forced bilirubin to remain and build up in her body, causing jaundice.

Claire's nurse brought us donor breast milk to give her via syringe. She showed Matt how to insert the tip of his finger into Claire's mouth for her to suckle, simulating sucking a nipple, as he slid the curved syringe inside her cheek to slowly dispense the milk.

She slept for hours after this feeding. We couldn't believe the difference. She had been so fussy for so long, and now she was quiet, resting peacefully. All she needed was milk. Which I couldn't give her.

This, of course, made me feel like a terrible mother, so I cried about that for a while. But now that Claire was finally sleeping, Matt and I were able to get a decent night's sleep for the first time in days, and I woke up feeling refreshed and more optimistic Monday morning.

The pediatrician came by early to check on Claire. They'd drawn blood at 6 AM to check her bilirubin level, and he informed us that it was elevated enough to require at least 24 hours of phototherapy in the nursery (I began to wonder if we'd ever go home). Also, after all the breastfeeding difficulty, we agreed to have him correct her tongue tie that morning.

So, for the first time, Claire and I were separated. They took her to the nursery, where she would stay under the lamp until it was time to feed her, then they would bring her back with donor milk for us to give her or I could try putting her on my breast.

I had a pretty hard time dealing with the separation, especially since the nursery was just across the hall and I could hear her every time she cried. But I had plenty of visitors to distract me. Dr. J was back to check on me that morning for the first time since the birth, the pulmonologist came around to examine me again (and this time, he said things had greatly improved; he told me I could take off the oxygen and be discharged if my O2 sat was stable after walking a few laps around the unit), the hospital chaplain came by to pray with us, and the lactation consultant spent a long time working with me, showing me how to use an electric breast pump to build my milk supply.

The visit with the lactation consultant was especially helpful. Using the pump, I could see my own milk for the first time, and I was reassured that my body was working properly after all. The next time Claire returned from the nursery to eat, we didn't have to use donor milk. I had my own bright yellow colostrum to syringe-feed her, and that was a wonderful feeling.

That afternoon, Matt went to my parents' house to do laundry (we'd only packed enough clothing for a 3-4 day hospital stay, so he was out of clean clothes). This left me at the hospital alone. I walked laps around the postpartum unit, as the pulmonologist had instructed me, and called the nurse to check my O2 sat. It was 98%, so things were looking good for me to be discharged. I felt more like myself now, too. The swelling and crepitus only remained in my right jaw, my chest no longer hurt, and my voice was nearly back to normal. Now we just had to wait for Claire to be well enough to go home.

I took advantage of my alone time and lay down to take a nap.

When my sweet husband returned from my parents' house, he'd brought a few surprises with him to cheer me up.

With our baby still away in the nursery, we had a little date in my hospital room, sharing cake from Publix. It's one of my favorite memories from the whole experience.

Claire spent the night receiving phototherapy in the nursery, and by 6 AM the next morning, September 18, they rechecked her bilirubin. Her pediatrician stopped by to tell us it had dropped significantly, so she was good to go home at last! We dressed her up in a cute little outfit from her Aunt Jessie and put her in the car seat for the first time.

It was a pretty scary feeling walking out of the hospital with a tiny new person to take care of, but we'd also been cooped up in there for so long, it felt wonderful to leave. We couldn't wait to introduce Claire to Annie, to give her a tour of our house, to put her in the little nursery nook we'd created for her, and, well, to sleep in our own bed again.

I have to say thanks to all the people who helped me get through this, because childbirth is no joke, and I could not have done it without them.

Dr. J and his office staff were absolutely amazing throughout the entire pregnancy. I highly doubt most doctors would have hung around and coached me as patiently, as kindly, and for as long as Dr. J did at the birth. In fact, I'm pretty sure any other doctor would have induced me well before the afternoon of September 14 for "failure to progress" (maybe even as early as 36 weeks, when Claire's ultrasound weight estimate was 7 lb 6 oz; many doctors would have either induced then or done a C-section later with the excuse of the baby being "too big for the birth canal"). But Dr. J recognized and respected my wishes, and he refrained from medical intervention for as long as it was safe. As a flabby, out-of-shape, obese woman pushing thirty years old, I feared many times that I wasn't physically capable of having a natural birth, but Dr. J encouraged me and allowed me to believe of course I was capable (and I was!).

Nurse E made all the difference in the most intense part of my labor, and I can't express how thankful I am for her presence. I'd wanted a doula, but after looking into it, we found we couldn't afford to hire one. I'm so glad we were practical and decided against splurging, because Nurse E was just as helpful, supportive, positive, and encouraging as a doula would have been. I could not have asked for a more perfect caregiver. She was at my side through it all, going above and beyond to follow my birth plan, never trying to make me do anything I didn't want to do. I felt like she worked almost as hard as I did, and I don't recall her taking more than a 15-minute break.

I had a lot of great nurses and doctors who took care of me during our stay, actually. Almost everyone was exceptionally kind and helpful. I'm extra grateful for the pulmonologist who wouldn't let me go home; that was a scary situation that resolved in the hospital. Also, if we'd gone home, our breastfeeding woes and Claire's resulting jaundice would've sent us back to the hospital, and we'd have been 2.5 hours away then. The pediatrician who treated Claire did a great job as well; he even scheduled a follow-up appointment for her at his office when he learned we still hadn't been "accepted" by the snobby pediatricians in Huntsville. He made the appointment himself, setting it for the day I was already set to follow-up with Dr. J so we'd only have to drive back once.

But most of all, I have to shout-out my husband. I didn't know how either of us would deal with my labor, so I wasn't sure how him being my birth partner would go (especially since we'd been unable to shuck out $250 for the natural childbirth class and were basing everything off of a book). But he was wonderful. He reads me easily and knows me well enough that he responded to all my cues perfectly. He held me when I needed it; he let me hold him when I needed it. He gave me words of comfort and encouragement when I needed it, and other times, when he could tell I wanted everyone to shut up, he was quiet. He rubbed my back. He offered me icy cold water and held the straw to my lips for me. At the very end, when I was too tired to hold my own leg up in my side-lying pushing position, he held it up for me. He was the only constant during my sixty-something-hours-long labor, and I couldn't have gotten through all of it without him.

Now I'll leave you with a few cute highlights of our hospital stay and our first night at home.


Jessica said...

Wow! I just read all three parts and I have no other reaction haha. God bless you all!!

Lacey said...

Jennifer!!!!!!! I just read all three parts and thoroughly enjoyed! I'm not kidding when I say I teared up during part 2! What a beautiful and amazing journey this pregnancy/delivery was for you (I'm sure you can think of other words to describe it too, lol!). What an amazing step for you and your husband! Little baby Claire is one blessed little girl!
Also, I am SO proud of you for sticking to your guns and for the amazing choice you made to have a natural child birth. I am definitely hoping for that one day as well and am so inspired by your story! WONDER WOMAN!!

ADA coin said...

This is an awesome post you have! I learned a lot! Thank you so much for sharing it!