Scenes from a birth
Writing this while behind on sleep, so there may be a typo or four. Please send all corrections to Kevin Liu. — Alex
Ada has arrived.
She broached the world around 3:30 pm last Friday, making it home Monday afternoon. The intervening time was a crash course in baby care. Liza, recovering from major surgery — C-Sections are no freaking joke — and myself trying to learn how to care for two was a whirlwind.
We’ve had normal new parent issues. Ada likes to cluster feed at night, which means that before we got home we were forced to sleep during the day in a tiny hospital room, interrupted what seemed like every half-hour by very kind medical staff busy on making sure that everyone’s vitals were where they should be. Temperature checks. Blood pressure checks. Incision checks. Visits from the lactation department. Meds. Syncing our record of feeds and diaper changes with what the nursing staff had on record. The midwife from triage wanting to see how Ada had come out after she helped us get into surgery.
A blur of sleep-debt and wonder. At one point on the second night of caring for our daughter, Liza simply had to crash late into the early morning and I needed to get Ada to sleep. So, I held her, pacing back and forth in the tiny front of our recovery room, while trying desperately to not pass out standing up holding our child. Back, forth, back, forth, shushing and trying to figure out what Ada needed in those wee hours when all any of us needed was sleep. Mostly Ada just wanted more of her mom, but as she was fed and her mother was recovering from giving even more of her body, we just had to make do. You grin and bear it, but not in the sarcastic sense; you literally grin, and bear it.
That’s all the easy stuff. The real scare, the real danger, the real terror, was birth itself. We don’t talk about it enough as a society, but giving birth is dangerous for both the birthing person and their child. Very much so, in fact. Forget all the risks of pregnancy, birth is an order of magnitude more replete with danger.
Liza’s body is not my story to tell — I have her express permission to share the following slice of the story — but I want to share pieces of emotional landscape of Ada’s arrival.
The night before we went to hospital, and a few hours after we thought that Liza’s water had broken, I wrote a note to myself on the little Freewrite that she had purchased for me as an early Christmas present. Future Alex, I wrote, don’t forget how scared you were. I was.
The next morning we bundled up and headed to Women and Infants here in Providence, fully expecting to spend time waiting for induction or a glide into normal labor. We didn’t think that Ada would show up for a day or three. Sadly, our time in triage — where the hospital puts you until deemed ready for the labor and delivery floor — did not go as planned.
If you have had a child you are likely aware of the adventure called the ‘non-stress test.’ Mostly it’s a few sensors placed on the stomach of the person giving birth, tracking the babe’s heart rate, and how frequently contractions are rolling through. We’d undergone a NST at our OB’s office days before we went to hospital, so when our triage team (Taylor, Elizabeth, and the rest of the crew on that floor were amazing) hooked Liza up to the same set of tech we felt like we were on comfortable terrain.
Then the process of actually birthing our child went sideways. Five days past our due date, Ada was ready to come out. Liza was ready to get her out. But as the data started rolling in, the situation became fraught. Tracking Ada’s heart rate on a running sheet of paper printed like a seismometer, we noticed that her heart rate took an extended dip. This, I learned, is what the medical community calls a decel. It’s short for heart rate deceleration it turns out, and it’s not good.
Not all decels are a big worry. Sometimes your tot might squash their umbilical cord, causing their heart rate to dip for a few moments. You can rectify the situation by scooting the person carrying them around in various quasi-yoga poses until baby’s heart rate goes back up. No harm, no foul.
But Ada didn’t have just one decel. There were two or three. I can’t recall the exact number; I remember two but one of our triage team that we chatted with before going home days — years, in emotional time — later recalled three. Regardless, seeing several in quick succession changed the tenor of our triage room. Anticipation became anxiety, and the path ahead for the two people who matter most in my life began to steepen, and accelerate.
My notes from the moment remind me that Liza and I found Ada’s decels terrifying. Thankfully my job is to pretend that I am strong during those minutes of worry, I wrote, which means I don’t get to focus on my own emotions; small blessings.
Liza also bled. Some bleeding during birth is simply par for the course. Again, we should talk about this more. I was shocked at how much blood loss was considered normal before the quantity became worrisome. The bleeding picked up as we waited for our dilation score to rise. Due to Ada’s decels, we were bumped up the priority ranking, heading more rapidly for the labor and delivery floor at the time, so we needed to get Liza’s body ready.
The bleeding got worse. We started to talk about possible diagnoses, including what we thought might be a partial placental abruption. Those aren’t good. The decels meant that Ada was likely in some form of distress; Liza was as well, given her continued blood loss. We had a choice to make: keep with normal labor and hope that things worked out for babe and mother alike, or pull the rip-cord and pursue a c-section. Liza conferred with her mother, the OB, other medical staff, and made the call to get Ada into the world now.
She made the right choice. Ada wound up born with ample meconium, another sign of distress. In the end Liza chose the path that she felt was safest for Ada, even if undergoing major surgery was a risk for herself.
It went well. She’s recovering, and as I write to you is in the next room, just out of my sightline, with Ada perched sleeping on her chest. During the birthing process we didn’t know that things were going to be ok.
What follows are the messy notes I took during our time in triage (I cleaned up some spelling errors, and edited out a few things that seemed a bit too personal, but have kept the following as raw as possible.) We pick up when it seemed that our labor journey was taking a turn for the dangerous:
The bleeding, though, is surprising. It's almost amazing how far we have come from our mammalian beginnings. With technology and fiber and commerce and agriculture we have transcended discomfort and want. For at least some of the human population. But watching my spouse, my love, the entire gravitic well that I orbit around — nurse is back, will resume later — Liza and nurse off to the bathroom — possible partial abruption — Liza now up for a c-section if she wants — no beds yet on L&D — Liza now choosing what to do with her body — poor thing she is torn between trying to [pursue vaginal delivery] and wanting to get the baby out and safe — we want Ada to come out! come here!
Liza is now talking to her mom. Doctor moms are good. Liza very worried about c-section -- Liz [her mother, also a pediatrician] thinking that c-section would be better [option].
This machine is low on batteries. Alex do not forget that this was so hard. Be kind to yourself and everyone else forever. I can’t imagine how hard [birth] is and [that] we [just] accept it. Blood. So much blood.
The thing I was trying to say above is that it is shocking how animal [birth] is. How little we know. We are checking [vital] signs but don’t know that much. Amazing. We are really just animals in suits. No more, no less. In a sense I knew that, but it is humbling to watch how we reproduce.
Final thought for now — am typing in small bursts as Liza needs me or I have a moment — nurse back and going to boost [her] IV speed as Ada's HR is now too fast (180s) instead of too low [decels] compared to her [normal] ~140 bpm.
Final thought for real this time is that Liza is amazing. Strong, powerful, wise, and so much calmer than I would be. I love her more than words can express. Hugs. Ok off to care for her.
— lights down, Liza resting, slow labor playlist on the iPhone — for some reason the Sonos we bought for this is being a dick — maybe thats why their share price is in the toilet — Mazzy Star pls calm our minds so that we can make the right choices.
Again, Liza is just so impressive.
Once Liza made the call to pursue a c-section, the hospital flung itself into action. As she got wheeled into the operating room, our doula took me into a separate room so that we could put on surgical garb. We went to Liza, and I held her while she was cut open to get our child out. Thankfully our regular OB was in the hospital for other work, which meant that she got to join the surgery. Liza was operated on by two OBs and a resident, a dream team.
Ada made it. She cried. We got her cleaned up, and I was taken with her to our recovery room. Skin to skin followed until Liza made it into the same space, and then we put babe and mother together.
Thank you to Elianna and the rest of the labor and delivery crew, you were amazing. A huge thanks to the rest of our nursing staff, including Brittny, Tricia, and Deb. Names are fading a bit now, and I am forgetting for example the name of the first nurse who took care of us when we made it to our little room on the sixth floor. My memory holes are mostly due to the sheer number of people who helped us. Three folks from lactation, a new main nurse every 12 hours, CNAs, housekeeping, and crew from nutrition, not to mention regular checkups from pediatrics, obstetrics and anesthesiology. It took an army to get Ada here. I am still slightly shocked at how kind and supportive everyone was, no matter how stressful — or late — the hour.
Now, the rest. Now, helping Ada grow up into the kind and brilliant person we know that she will be. I am just glad to be past birth. Hug the people in your life who went through it. We don’t deserve their sacrifice, and we’re only here thanks to their bravery.
Wow wow wow! Little Ada is a precious gem. I'm sorry that the process was so harrowing, but you're right, Liza is a badass. I hope her recovery goes smoothly. Your comment about Sonos share price was so classically Alex, hilarious.
Congratulations to all three of you!
I remember how scary decels were, and we didn’t have anything like what you went through…so major props to you, dad, for your part keeping everything level. And that picture of your skin to skin with Ada is everything. There is no feeing like it…enjoy every second. (Even the not so enjoyable ones)