Friday, April 04, 2008

A Baby Story...

People have been asking what happened during Maya's birth that made it "not as planned", so here's the whole sordid tale. Most of it was great, just the last few hours or so where things went south quickly...

Around 6 AM Steph woke up with regular contractions. I woke up shortly after and we discussed her contractions before I left the house for a life insurance physical. By the time I returned, the contractions were coming regularly, every 10 - 12 minutes or so. This is usually referred to as "early labor".

I called work and let them know I was taking the day off to be with Steph in case this was "it". We then headed down to Memorial Park for a walk along Peachtree Creek with the dogs. Slow, steady contractions continued as we walked. The dogs definitely knew something was going on, you could just tell by the way they were acting, but of course they had no idea what was yet to come.

We then made a run up to Muss & Turner's to see my cousin Todd (aka "Muss"), his wife and one of their children over lunch. Throwing caution to the wind I had the M&T version of a sloppy joe and some fries. Good stuff indeed, especially since I haven't eaten that kind of food in more than a month! (Yes, Greg, Molly, et. al, I ate unhealthy, fattening food and I enjoyed it!) We had a leisurely lunch before heading down to the OB for an previously scheduled appointment. At this point we are indeed in early labor, and Steph was 1.5 cm dilated. The doctor advised us we're probably be parents in 24 hours or less...

Apparently, much less than 24 hours, as we would soon find out.

We called our doula to let her know our progress and headed home to labor. Things started progressing quickly. Contractions became stronger and closer together over the next few hours. We were in contact with our doula a few times as we waited for the magical "contractions spaced 5 minutes apart consistently for 1 hour" which signifies the change into active labor and the time at which we're supposed to call the doctor's answering service and head to the hospital.

About 20 minutes into timing contractions which were about 5 minutes apart, Steph was having real pain. My wife is tough, she has put up with a lot of painful things in her life, but she was really struggling. I was at a loss for what to do to help her. Feeling pretty helpless I called our doula. She gave me some advice to have Steph labor in the tub which we did, but the pain continued to grow and the timing of Steph's contractions grew shorter, coming every 3 - 4 minutes. I felt completely helpless, there was nothing I could do to relieve her pain. Both of us were in tears at this point. The dogs felt equally out of control. Java was barking and Lucy had a very worried look on her face and tail between the legs. Oy!

I called the doula again for advice. She questioned our technique for measuring the timing of contractions and questioned the amount of pain that Steph was dealing with. Neither of us felt as if she was being helpful or truly engaged with us at this point. When we both stated our intention to go to the hospital, she gave us a choice: she could meet us at Piedmont Hospital (~45 miles from her home) or we could call after Steph was "checked" by the doctor. The question was clearly loaded, she did not feel as if we were as far along in labor as we were. The question was put in such a manner so as to make us choose the latter option, which we did. She's the expert, after all. We were made to feel as if we were most certainly being overly concerned and would probably be told to go home once we arrive at the ER. We were both made to feel completely stupid.

We headed to the hospital as quickly as I could get Steph dressed and in the car. All together that took 45 minutes, 30 minutes longer than it should have. Steph, being herself, was apparently hanging up towels we had used and depositing plates in the sink on the way out the door. Always straightening something up, I swear. The car ride was horrible, thankfully its only 4 miles! Steph was writhing in pain next to me with each contraction. I was trying to keep it together, driving through the tears and trying to ensure we actually made it to the hospital without any accidents. We dropped the car with the valet at the ER and Steph was wheeled up to the maternity ward, checked in and in a hospital bed within 5 minutes. The staff at the hospital was great and efficient!

Steph was close to 6 cm dilated and having contractions about every 3 minutes, we were definitely in active labor! And we've been receiving very bad advice from our doula. I called the doula and told her to get her ass down to the hospital IMMEDIATELY. She replied it would take her 60 - 90 minutes! When I told Steph, the hospital staff laughed and said we'd be parents long before the doula ever arrived. What a comforting thought...

Labor continues, doula or not, so Steph and I had to be a two man team. I was working with Steph to keep her breathing steadily through an oxygen mask while the staff gave her an IV and hooked her up to various monitors. The doctor on call, whom we had seen earlier in the day, came in and was clearly not pleased with the situation, our lack of doula and my retelling of her advice. Not pleased, at all. (The next day, we had a 30 - 40 minute open ended discussion with him about our choice to use a doula as well as things his practice can do to serve pregnant women more effectively. It was very nice of him to spend that time with us.) Quickly we progressed to Steph being fully dilated and ready to give birth. On the instruction of the maternity ward staff and doctor we started really pushing, trying to have a natural birth as we had both intended. Steph had always intended to try birthing Maya without drugs, I think she was beginning to reconsider that decision. However, we were way too late for that. After 30 minutes or so of actively trying to give birth, Maya was struggling, her heart rate was decelerating and she was clearly in distress. (We'd find out later that the placenta had abrupted, i.e. prematurely pulled away from the uterine wall, causing distress for the baby. Had we waited at home any longer, the outcome might have been quite different.)

The nurses quickly gave Steph drugs to stop her contractions, unplugged all of the wires from various monitors and in no time Steph was whisked into an emergency C-section. While we had both intended for me to be there with her during the surgery if possible, due to the emergent nature and the need for immediate sedation, I was not allowed to be with her. She was rolled into the OR for sedation and surgery.

I was left in a room. Alone. Crying.

I had no idea what was going to happen to my wife or my baby. And there was nobody who could tell me.

15 minutes passed, it seemed like an eternity.

During this time I managed to compose myself enough to send an emergency text message to my cousin asking for help. I finally got myself together enough to call him as well. Todd hopped in his car and headed my way. This was the longest 15 minutes in my life sitting alone, without anyone there to support me in my time of need. Nurses came in and out of the room where I was alternating between sitting alone crying and pacing a hole in the floor.

Connie, one of the nurses, came out to get me. We had a baby! I was so stressed out I almost forgot to ask her if we had a boy or girl! Connie helped me get dressed up to go into the OR and lead me in. Seeing Steph laid out on the table, cut open with people still working on her made my heart sink. That was a very scary sight, the image is one I don't think I will ever get out of my head. It was only then that I learned that she was OK and would be out of surgery soon.

Then I saw Maya! She was being tended to, cleaned up and having her APGAR scores checked, etc. I stood there in shocked silence, camera in hand, gazing at my newborn daughter. I continued crying. I could barely get myself together enough to take a picture. I didn't say anything until someone asked me what her name was. Somehow I managed to get out "Maya Simone" before falling back into my dumbfounded silence.

Maya was ready to be moved to the transitional nursery so she should could finish being cleaned up, weighed, measured and have her footprints taken. (Side note: I have an extra set of her footprints which I will put to good use soon... more on that some other time.) She was put into a bassinet and I got to wheel her out of the OR and down the hall with two nurses in tow.

As soon as we exited the OR I looked up to see our doula. We exchanged few words, but my message was clear: "Go home, your services are not needed." Steph had already been through most of a vaginal birth and a C-section without the support of the person we hired for support! What else could she do? How much more bad advice did I really need?

While waiting on Steph to come out of surgery I made some important calls to let family know what was going on. Shortly afterward, Steph came out of the OR and into a recovery room. I got to give her the good news about Maya! I showed her the pictures I had taken kissed her and told her she'd get to meet Maya soon. My cousin, Todd, showed up shortly thereafter. Finally I had some support! I was so relieved to have a shoulder to cry on. He stayed with us for a few hours to help with Maya - Todd is a master swaddler! - and be there for both Steph and I.

In the end, everything turned out OK, even if not exactly as we had planned. Mom and baby are healthy and happy. While the experience was not as planned or expected, there were some things that the doula could not have changed, specially the abrupted placenta. However, the doula failed to deliver services that were promised. We decided to request that all fees be returned to us. This was a conversation neither of us was looking forward to.

After consulting the doula's contract this morning to understand our rights, I spoke to her. I was unimpressed by her unwillingness to negotiate with me on a refund of her fees for her negligent behavior and lack of support during labor. After an unsatisfactory and argumentative response from the doula, I called the owner of the doula service directly in order to express my dismay.

The owner and head doula was much nicer and more accommodating. She listened to my concerns, gave me a chance to share my recollection of the events on Wednesday night and recognized that our doula did not provide acceptable service. She also indicated that she had already discussed our birth with the doula and given her a "talking to" about the way in which she presented our choices with respect to coming to the hospital. With the help of a labor timeline guided by my cell phone records and photographs, we have been able to document exactly what happened during Steph's labor, when we contacted the doula, etc. Based on our discussion and the details provided the owner of the service has agreed to refund all fees associated with Maya's birth.

We are quite appreciative of the owner's willingness to work with us and her recognition that we did not receive the quality of service that she expects from her doulas. In deference to her and the services her company offers, I have chosen not to name either the doula or the doula service.

I don't know how differently the evening might have gone had we received the expected service, but I am still very happy with the outcome: a beautiful little girl who has already stolen my heart.

1 comment:

Greg said...

So busted, haha