This is part 2 of 4 of my stories about becoming a mom during my first year of surgical residency. I'm posting this to document. I'm also sharing because this story connects other experiences of motherhood that I share on this blog. Thank you for reading.
Three and a half weeks before Tobe was born, I went to my prenatal appointment for an ultrasound scheduled that week. I was on a schedule with frequent ultrasounds because my obstetrician’s office had forgotten to do my 20 week Quad screen for genetic abnormalities. So they were keeping a close eye on things with serial ultrasounds. At this appointment, the tech seemed very concerned. Next, we saw my Obstetrician who told us that the baby was measuring very small and that his growth had slowed down significantly. She sent us to the main hospital for more imaging studies and fetal stress test. She also said to expect a call from her. Before we got home, we got a call from our OB. We were instructed to head back to the hospital because the baby had to be born that day.
The doctor said his growth had slowed significantly and they were also concerned that he was microcephalic. I was devastated. I wasn’t ready. I thought we had three more weeks and what was this new bit of news? Macrocephaly? This was not in my plan and it didn’t make any sense that they were just finding this out. I’m not sure I fully processed the information that afternoon. I was already overwhelmed at the prospect of having a baby three weeks early. My mom was supposed to be with me when Tobe was born but she was still in Nigeria, at her mom’s funeral, because we still had three weeks to go!
So we packed my hospital bag and headed to the hospital to have Tobe. After we were settled in our room, monitors and IV attached, a Maternal-Fetal Medicine doctor repeated an ultrasound. Upon completion, he informed us that he didn’t think we needed to deliver three weeks early. Although Tobe’s growth had slowed, it wasn’t as bad as the ultrasound tech had initially measured. I asked him about the size of Tobe’s head, was he microcephalic? He said the measurements were showing that he was but he also added that it is not recommended to take head measurements in the third trimester of pregnancy . This close to the due date, the baby was so low in the pelvis so head measurements are notoriously known to be off. He formulated a plan to send us home with stress tests every other day and a visit to him every few days for repeat ultrasounds. He said he would schedule an induction if there was any new sign of fetal stress or further reduction in growth rate. My OB doctor said she wanted me to be less stressed, eat more, and stop working. She did say she wanted me on bed rest but I didn’t have any more time to take off. I had to save that time to recover and care for my child after he was born.
We went home. I now had a whole new set of worries. I remember crying, taking all of Tobe’s clothes out of his dresser and refolding them. I did this multiple times. Throughout my entire pregnancy, I had not been prepared for the possibility of a special needs child. I looked at all his ultrasound pictures, he looked normal and sweet. It didn’t make sense. I spent a lot of time on the internet reading about microcephaly. I worried everyday for those last three weeks of pregnancy. But deep down I knew that it didn’t matter if my baby didn’t come out perfectly. He was perfect to me and I loved every bit of him.
For those last three weeks, I had medical appointments every other day. My doctors decided that they were not going to let me go past that date. So plans were made for me to get induced. On the 21st of July, one day before my due date, we packed our bags the second time and headed to the hospital. This time my mom was with us.
We arrived the hospital, I got hooked up, IV was started, Cervidil was placed. I went to the bathroom less than an hour later and accidentally pulled the Cervidil out before it had time to take effect. It was close to midnight at this point so it was decided that I just have a good night rest and start over the next day. My mom went back to our apartment, Patrick tried to get comfortable on the hospital couch.
During the night, I started having contractions. I was planning on having the baby without an epidural. One reason for this decision was simple curiosity. I wanted the 100% authentic experience because I have always been in awe of the whole birthing process. Mentally, I had prepared myself for the worst pain imaginable. So when I started having contractions I wasn’t sure if it was the real thing. It was painful but being my first baby, I didn’t know what to expect. I asked my nurse, if she thought I was going into labor and she said she didn’t think so. After a few hours of fairly constant contractions, we decided that yeah, I was in labor.
At about noon the following day, July 22, 2016, my due date, I was in the throws of labor. I sent for my mother. I remember being barely able to keep my eyes open secondary to the pain, but I was so happy to have my husband and my mother with me. At one point the pain was so bad, I was at my limit. I remember thinking that it would be impossible to be in any more pain. I asked my nurse to check me to see if I was close to delivery. She checks and says that I was only 6 cm dilated. So that meant I potentially had a long way to go so I told her I wanted an Epidural. She then leaves to go arrange for me to get one. I was doubtful that I was only 6cm dilated. I felt like I had progressed much further than her estimate so I decided to check myself.
I felt my baby’s head. I was crowning.
I let my husband know and he hits the nurse call button. At this point I’m on my knees, on bed, pushing. I couldn’t help it. My nurse runs back in, asking me to lay back down. I tell her there was no way that was going to happen. I was overcome by this animal-like instinct to be on my knees. She asked me to stop pushing, because I was only 6 cm dilated and could rupture my cervix. I told her I was crowning. She checks and says, oh yeah, you are. She frantically pages my doctor and starts to put on a glove.
This is probably the most magical memory of my life. I was on my knees, my husband was standing beside my bed. I was holding him, hugging him tightly, pushing. There was a mirror behind me so that when I looked back and down between my legs, I was able to see my baby come out of me. I reached down and pulled him to me, holding my son for the first time. My husband held us both. I had become a mom. It all happened so fast. It was 2pm on Friday afternoon, on my due date July 22nd.
And did I mention he was perfect? My husband and I breathed a sigh of relief to see that he was perfectly proportioned. Through all of this we had been so anxious about the unknown. His head was normal size for his body. He also had a head full of hair. He was 6 pounds, 6 ounces, and so beautiful. The feeling immediately before, during, and immediately after the birth was incredible. The primal pain, the surge of emotions, and chemicals your body releases to make this miracle happen leaves you feeling out of this world. I have never been high but I imagine this was a magnified version.
Patrick was so happy and proud. My mom was crying the entire time. She had undergone c-sections to have me and my three siblings. She told me that seeing my son, her grandson, be born was her first time witnessing the birth of a child. It made it all the more special.
Our doctor didn’t have enough time to make it to the birth. My nurse might have only had time to put one glove on. The doctor made it in time to cut the cord, deliver the placenta, and stitch up the mess Tobe made on his way out. I was so proud that I went through the experience without an epidural.
Giving birth without an epidural is not for everyone. In some way it is senseless to put yourself through all that pain, but I wanted it for reasons I explained above. If you believe this path is for you, you can do it, you are strong enough for the pain. But it is important to keep an open mind. There is no trophy for putting yourself through all that pain if it becomes unbearable. If at any point you are in too much pain, it is okay to change your mind.
Keeping an open mind also applies to birth plans. Having a baby is a dynamic process. Your health status and your baby’s health status changes through pregnancy and labor. So it is okay to have a change in birth plan. An unforeseen induction or c-section is okay. The end result we all want is a healthy baby. It doesn’t matter how we get there.
Everyday, many women are faced with uncertainty about the health status of their unborn children. Some uncertainty is the nature of medicine. Medical tests give us valuable information and insight but sometimes a number or a test result can be difficult to interpret. All one can do in a situation like that is wait and keep loving your unborn child. I am so thankful and lucky that our son turned out healthy. He is growing up strong and it turns out he kind of has a big head. I’m for sure not letting anyone measure my future babies’ heads during my third trimester of pregnancy.