(Continued from Part Three; or, read Parts One and Two.)
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Dear Judah,
Now that we’ve just finished telling your birth story to a group of Bradley birth students tonight, it’s time to finally tell the end of your birth story, and the wondrous, amazing beginning of your marvelous life.
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A nurse wheeled me into my Labor and Delivery room at about 3pm. The space was large and sunny. As I stood up from the wheelchair, I again felt that dripping sensation of leaking amniotic fluid, but turned pale when I saw that it was actually blood all over the seat and floor. Panicked, I asked the nurses, “Um, is this normal?”
They smiled and nodded. “Totally normal. We’ll take care of it.”
I got settled into my bed as best I could, my arm captive to the IV line. A contraction would roll over me, my belly tightening, tightening, tightening and then it would peak and then blessed, sweet release. I winced and focused on my breathing. I could have three approved visitors at a time: my mom (your Obachan), my mother-in-law (your Nana) and my sister (your Aunt Yuko). Larry had reached out to my dear friend Natalie, who was in the process of driving down from Long Island to swap out with my sister to be there during the actual delivery.
My nurses were very friendly and I gave them each a copy of my birth plan. My first nurse was especially accommodating: “You don’t want any medication for pain? Done. I won’t even bring it up again.” More contractions, but sporadic. I was too focused on breathing through them to time them, but I could tell they were erratic. Larry and I continued to FaceTime and Skype: he in Tokyo, me in Voorhees. He helped coach me through contractions – I would develop this tunnel vision as I focused on his face in the palm of my hand: his unshaven beard, his already-exhausted look of nervous excitement, his yellow jacket.
After about 4pm, my memory of time gets a little fuzzy, so I’ll try to recount things in order as best I can.
A NICU neonatologist came in. I had Larry on Skype on my laptop as we held a virtual transcontinental consultation. It was only then that we understood that Judah wouldn’t be coming home with me when I discharged from the hospital.
“Wait, so how long will he be in the NICU?” Larry asked over the computer. The neonatologist looked at the screen and then at me, as I breathed through another contraction. “We never give a definite timeline until we’re able to examine the baby after he’s born and even then, we tell parents to plan to stay until the original due date.”
I did some quick math; I didn’t need to see the computer screen to know the look on Larry’s face. “You’re saying he could be here as long as FIVE WEEKS?” he asked, incredulously. The doctor looked at us with apologetic seriousness. “Possibly, yes.”
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At some point, I had to hand copies of our birth plan to my mom and mother-in-law, so they could be in the loop should I be unable to communicate clearly. It was only then, after months of speculation and guessing, that they each finally learned what your name was going to be. They both cried and praised your dad and I for picking such a unique, strong name.
* * *
I sat on a birthing ball for about 15 minutes. My IV made it difficult to maneuver around and to be honest, I felt like the contractions hurt worse sitting on the ball. I made it through two contractions on the ball before I was like, “Yeah no.” So I tried squatting in place. That position helped tremendously as I felt like my center of gravity wasn’t at the mercy of a big purple bouncing ball. I looked like some strange yogini sitting in this balanced squat as I closed my eyes and moaned through each contraction.
The admitting doctor who tried to induce my labor came in again at about 5pm to check on how I was doing. I was definitely contacting, but again, they were sporadic, following a rhythm that made it impossible to time because I was so focused on simply riding each wave of tightening pain.
“So it’s been a few hours. I think we should get that induction drip starting,” she said, with paperwork for me to sign in hand.
Larry was on the phone and asked me to turn the phone to the doctor. “No, I don’t think so,” he said to her. I explained that I was clearly laboring and that we wanted to let the labor progress naturally; there was no need to speed it up.
“Well, my shift ends in an hour and I want to see a lot more progress before I leave,” she threatened.
Without batting an eyelash, Larry and I stared the doctor down: “Good, then we can revisit my next steps when the next doctor gets here.”
“She’s just going to tell you the same thing,” she countered.
“I’d love to hear it from her directly. I think we’re done here,” I said dismissively, turning my attention back to Larry as he coached me through another contraction. Exasperated, the doctor left. I never saw her again, thank G-d.
With the shift change at 6pm, the doctor who would deliver you (Dr. Goodchild) stopped by to assess my progress. Labor was definitely moving along, but I refused any cervical checks unless absolutely necessary. She offered induction, but was willing to let me wait another couple of hours. I got a new nurse at the shift change, too – Kathleen. She confirmed that I wanted an unmedicated birth and like the previous nurse promised not to bring up medication unless at my request.
I went for a walk with my mom around 7:30pm to see if we could kickstart my contractions a little more. I remember distinctly taking a few selfies around this time to document my labor progress. The last picture I took was around 7:44pm. That’s when shit got real.
The contractions were getting much, much stronger and lasting longer. Obachan and Nana each tried to help in their own ways: Obachan wanted to hold my hand or rub my head while Nana kept asking me if I was sure I didn’t want something for the pain. I snapped.
“NOTALKINGNOTOUCHING!” I shouted, exasperated. Hands flew away from me and the room fell silent except for my strained breathing and long, guttural groans. My contractions were beginning to rise in an intensity that left me feeling like I was being dragged behind myself, like I needed to catch up.
At one point, Kathleen came in to check on me. I was writhing and on the verge of hyperventilating; I couldn’t get comfortable. She told me to focus on her face and we had come to Jesus moment: “Keiko, I need you to get your breathing under control. If you want to have this baby naturally, you need to get your pain in check right now.” Her sharp tone snapped be back into the moment, to bring me mentally ahead of the pain instead of a fighting captive to it.
I felt like I was going to throw up. It was when Kathleen handed me the bean-shaped barf dish that I resolved to do whatever it took NOT to throw up.
“You seem pretty uncomfortable,” she began. I expected her to offer me medication, but instead she wanted to do a cervical check. I was well in the early stages of transition and was a touch irrational. I frantically mumbled something about infections and she said, “I think you’re farther along that you think, sweetie. We need to check and see.”
I barely remember the cervical exam itself but I remember Dr. Goodchild proclaiming triumphantly, “You’re six centimeters dilated!”
I was ready to cry. “Only six?” I said tearfully. “I still have four to go??”
Kathleen smiled, “Since you’re so early and the baby isn’t full term, you probably won’t need to go the full ten centimeters – this baby’s coming pretty soon!”
Transition was intense. The contractions kept coming, one on top of each other. I felt freezing cold and then ripped the covers off of me. I couldn’t get comfortable no matter how I moved, limited by my IV and the fetal monitor across my belly. There was a moment as I stared at my bed rails, my knuckles and hands white as I gripped it as hard as I could, droning a hummed moan through clenched teeth and closed lips as it seemed like the contraction was never going to peak:
I need drugs. Fuck me, I need drugs. The thought was as clear as day.
And then – the contraction peaked and I knew I had a few seconds of denouement before the pain would rise again.
“You can do this, you’re almost through the toughest part.”
It was Larry’s voice, on my phone. He was still there. I got my second wind and allowed myself to be carried along the currents of pain, like bobbing waves in the ocean.
At some point toward the end of transition, my IV blew. When I least wanted to be touched or to focus on anything other than getting through each contraction, an anesthesiologist was called in to put in a new IV on my other arm, as I still had one final dose of antibiotics to receive. Amazingly, he got it in with little difficulty.
Another contraction welled up over me. I squeezed my eyes shut so tightly I could see stars, feeling tears singe along the edges of eyelids. As the pain peaked, I screamed with a closed mouth, moaning as the pain receded. I braced myself for the next swell of pain and then –
Nothing. No contraction. I broke out in a cold sweat and opened my eyes.
I had made it through transition. I had a few minutes to breathe and readjust myself when I felt the overwhelming urge – no, primal need – to push. “I feel like I have to push,” I whined to anyone who was listening. Kathleen had been there, as had some other nurses, prepping the baby receiving area this whole time. “Alright, let me go get the doctor and let’s have this baby!”
Dr. Goodchild came in and I remember the lighting changed dramatically. The lights were dimmed around me while a special series of overhead lights were lit up on the business end of things. Obachan took my left leg. Nana took my right leg. Natalie had arrived just in time and stood at my shoulders, a hand on my left shoulder and a hand on my forehead.
I heard Larry’s voice in the background; I don’t know who was holding the phone.
“Keiko, I have to go,” I could really hear the fear in his voice for the first time all day. “I’m on the plane and I still have signal but they have to close the doors and taxi for takeoff. I have to go, I’m so sorry. I have to go. I love you. I love you…”
I don’t know if I said I love you back to him or not or if I merely said it in my head.
Dr. Goodchild walked me through the basics of pushing, instructing me to grab my legs and pull back with each push. I looked at her doubtfully. “But I don’t wanna hold my legs, I’m tired!” I whined.
“Yes I know you’re tired but you have to hold your legs,” she said. “Now you’re only going to push on each contraction and we’re going to try to push three times with each one. We’ll count to ten. You’ll want to inhale as much as you can, hold your breath and push for ten, then blow it out and do it again two more times,” she instructed.
I felt another expulsive contraction coming as she was talking. “Can you please stop talking for a minute?” I asked, trying to center and focus on everything she was saying.
The first few pushes weren’t productive. “Don’t push with your face,” she cautioned. I had to close my eyes to focus on the muscles I needed to activate. “There you go,” I heard her say. “That’s it. Keep pushing!”
I remember asking for something to drink. “Can I please have some water?” I begged. I had been screaming through each push with my mouth closed and my voice was nearly gone. My throat burned.
“Mom, go ahead and give her some ice chips,” Dr. Goodchild said to Obachan. My mom went to place some ice chips into my mouth. I looked at my mother and said with what breath I had left: “Just give me the fucking cup.” I drank what melted ice water there was, ready to cry from the relief to my throat.
I could feel you moving through me: literally, through me – but was unsure of the progress as I pushed. It wasn’t until I heard gasps from both mothers and Natalie whispering, “Oh Keiko…” that I knew your head had cleared. Dr. Goodchild did a quick suction and clear as day, I heard you scream before you had even finished your exit. In the next push, your shoulders cleared. You were still howling.
The sensation of physical and emotional relief as you finally left my body is almost indescribable, but a muscle memory I can never forget. I threw my head back and let out a sigh of relief. With my next exhausted breath, I asked frantically, “Is he okay?”
My mom cut your umbilical cord as Dr. Goodchild offered her the scissors. I could hear your cries but couldn’t see you; I asked for my glasses back. You were weighed and measured as the nurses performed your Apgar tests.
“Can I see him?” I asked, to the flurry of activity around me. “Can I hold him?”
Kathleen gently handed you to me. You were wrapped up like a little burrito with a tiny hat. Your fingers were so tiny and I marveled at your eyes, so alert and looking around at all the commotion.
“Hi there, Judah! Hello,” I said softly, smiling. Our eyes locked for a moment before you took these long blinks, your eyes searching at all the light and sound of your first moments of life topside. Your tiny fingers grasped my finger, holding tight. I kissed your tiny nose.
You were perfect. Absolutely perfect.
Just before 11pm on Mother’s Day, after eight hours of active labor and four long, difficult years of infertility, you had finally arrived.
Welcome, welcome and hello, my little one.
* * *
Continue to the epilogue: Afterbirth.
