Pregnancy

Welcome to the Pump House: Adventures in Fatherhood and Breast Milk Management

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A version of this post appeared on my blog years ago when London wasn’t even a year old. But I just tweaked it a bit, slimmed it down , and added here and there. I think it’s better now. Here it is…

Never in my wildest dreams, as I prepared for fatherhood, did I think I was going to spend so much time with lactation nurses, reviewing the intricacies of hand expressing (including motions), analyzing breast milk volumes, discussing engorgement, and just how much breast milk one could fit in a chest freezer.

A few hours prior to my meeting with lactation consultants, thinking there were three more months to learn these things, I didn’t even know lactation nurses existed. I knew that some babies were born prematurely, but I didn’t know my wife’s breast milk would still come in just as early as our daughter wanted out at 26 weeks gestation.

So it was that our 109-day stay in the neonatal intensive care unit (NICU) started with a crash course in breast milk. Within those first days of life for my daughter (London), my wife (Kate) and I spoke at great length with not just one lactation nurse, but several of them about breast milk and breasts, starting with a nurse asking my wife if she was going to pump breastmilk. Partly due to the trauma of the last 24 hours, and partly due to my complete lack of knowledge about breastfeeding, I had not thought a bit about breast milk or pumping. Kate was of a similar mindset at that particular moment, but we were both satisfied to know that there was a good chance Kate’s milk would come in. The early drops of colostrum, the nutrient-dense milk first released by the mammary glands, often come in shortly after the placenta detaches from the uterine wall, no matter the gestational age.

A couple of hours later a lactation nurse wheeled into our room something that looked like a medieval torture device. They were calling it the Symphony. They hooked Kate up to it and it hummed and sucked for 18 minutes. At the end of that first session, we could just barely make out two milliliters of colostrum. A few hours later Kate produced 2.6ml and then later that night 3.8ml. The next day, January 31, marked Kate’s first 24 hours of pumping. She produced 32.6ml that day, or 1.1 ounce. The lactation team handed us a log with the direction that we were to write down when Kate pumped, for how long, and the total volume.

We then received a DVD to watch, which would apparently help Kate get more milk by hand expressing and provide tips to alleviate the pain of engorgement. We were to watch it and return it to the NICU team afterwards. That same day, we popped the DVD into my laptop to watch some before going to bed. One minute into this educational video, the biggest breast and nipple either of us had seen appeared on screen. Kate laughed so hard she began to worry she might injure herself being only two days clear of a C-section. Everything hurt. If we continued watching, we put Kate’s health at risk. I slammed the laptop shut. Tears ran down our cheeks from laughing so hard.

Who knows who is responsible for making this particular lactation video, but may I make one small suggestion on behalf of my wife and all women who have recently had C-sections? Great. Do not make the first breasts on the video also be the largest breasts known to mankind. They should not be comically large, needing 3-4 hands to get them under control. In fact, this video is a danger to new mothers everywhere, they might literally bust open their gut laughing from it, like we almost did.

Thus, it fell on me to watch the lactation video alone, gleaning from it any helpful tips and then sharing them with Kate. She was impressed. It wasn’t like Kate’s breast milk volumes needed any help. Not long after London was born, I was spending part of everyday rearranging containers of breast milk in the chest freezer in the basement—the chest freezer we needed to buy solely to store breast milk. Kate and I would joke that I knew more about hand expressing breast milk than she did so I should print up some business cards and walk around the NICU offering my services to anyone who needed them. Hand Expressions by Bryce. Simple and to the point.

By day of life 57 for our little girl, Kate was producing 1,863ml a day, or 63oz of breast milk. To put that in perspective, London was fed a total of 800ml on day 57, the most she had ever consumed in one day. In fact, it took London a long time to drink as much milk in one day as Kate got from one 20-minute pump. A point was reached where no amount of rearranging the breast milk in the freezer would make room for more. I picked up a second chest freezer at Costco and Kate started to fill that, too.

For the months London was in the NICU we rented a Symphony pump, which at the time retailed for $1500-2500, and kept it in our bedroom. We started to call it the pump house. When at home, Kate disappeared every three to four hours to spend some quality time with the Symphony. As all moms know that schedule wreaks havoc on sleep and work responsibilities, but Kate did an excellent job. I did what I could by waking with her every time throughout the night, assisting in bottling of the milk, labeling and recording volumes, washing pump parts, and then delivering milk to the freezers in the basement. So, at our house, at least two times a night, Netflix and chill was swapped out for Netflix and pump.

As Kate tapered off the pump, we were just filling up the second chest freezer and the lactation nurses understood why Kate was putting an end to pumping. She had developed a reputation in the NICU as a super producer. At London’s discharge, on May 19th, 109 days after she was born, the NICU staff wrote messages to us. One of our favorites from the lactation team wrote, “Your mom was a rock star with pumping. She could have fed three babies in the NICU!”

Next week, London will be six-months-old and I can thaw breast milk from three months back. And right now it’s lunch time for the little girl, to the chest freezer I go.

On My 10th Father’s Day

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This could be my last summer as a full-time stay-at-home dad. As much as I need and crave time away from my kids, after less than 96 hours without them, I miss them dearly. Their squeals, laughs, pitter patter of small feet, noises from the kitchen as I wonder what they’re helping themselves too. Even sometimes their cries, when the silence without them feels like a suffocating blanket of absence.

Being alone is very nice. More time to catch up on the projects you’ve been meaning to do. A lot more time to read that book catching dust wherever you last set it. And an abundance of time to binge the newest buzzy show. There is just a lot more time to busy yourself with work, entertainment, things. And you can do all of it with minimal interruptions or, if you prefer, in absolute silence.

But after a little bit, after you get a taste of all those things that you were missing and that you have now done, there’s something else. There are questions in the quiet. Is this all there is? If this was life all the time would I get sick of it? Would solitary pursuits give way to success, self-absorption, or both? Would I feel like I am missing out on something? Would I get lonely or would my spouse be enough? Would she get lonely? Even questions about my far flung end arise. Will we arrive graying and wrinkled at the end of our lives wondering what could have been? Who are we missing? Who could be by our side now as we live our last days? What being/s will we never know because we do not have a child? I feel like the what-ifs would continue stacking up and then it would be too late.

What I don’t spend time doing is wondering what I could give to the world or to society if I did not have kids. Sure, it could be something great, but would it be as awe-inspiring, humbling, and as terrifying as having created a life? No. As holding the smallest hand in the pad of your index finger? No. As head-spinning as bearing witness to how fast the early years of life fly by? No. As proud a moment when you see your child shed a bit of your imprint on them to become someone wholly new, someone independent from you, but still your heart? No. As terrifying as the moment you realize they will spend many, many years on this Earth without you and you won’t be able to rush to their side anymore at the first sound of trouble, pain, or loneliness? I mean, the sadness of that thought could be enough to drive you to never have a kid, but it’s only a thought that parents can truly understand. And, by then, it’s too late. That is the risk we take. And there are big risks, but I know the answers to the questions above. Sometimes they get a little hazy and I feel the what-ifs rush in, but then I get a few days away from all their smiles, noises, questions, innocence, and imaginative everythings and the answers crystallize again into a sharp relief against a life without them.

I know I could give nothing to the world more precious and more important than them. I know the questions in the quiet would eat me up, but I know the answers to them and, for that, I am grateful.

Happy Father’s Day.

Just the Two of Us

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London and I sat in the sun on a warm February day. We took chalk and colored our_BKP8247 respective patches of concrete and bricks. There was no breeze, a few clouds, and a welcoming burst of warm Colorado air in the waning winter.

I colored stripes. London seemed more interested in collecting all the chalk and moving it from one location to another and then she would peel off to grab another rock to drop down the drain cover.

There wasn’t anything particularly extraordinary about our activity that morning, at least, that is what I thought at the time. But later that day I found out Kate was pregnant. A blessing, indeed, but I almost immediately recalled the simple morning I had with London, the hundreds of simple mornings. The two of us drawing with chalk, taking a break with her, and sitting on the brick wall at the end of the alley. Just the two of us. The  two of us.

I at once felt overjoyed at the thought of my family growing and mourned the days of London and I coming to an end. She is my life’s greatest work. My family is my greatest joy. If I don’t write about them, then why write about anything else? More to come…

We’re Ready

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About two weeks before London was born, I was talking with a mom of two kids and telling her about the baby girl that we planned on welcoming into the world on May 4th (or sometime around then). When I finished up sharing my exciting news, she had a question for me, “Are you ready?”

“Yeah, I’m ready,” I said.

“No. No, you’re not,” she replied.

For some reason this exchange, between the parent who is in the thick of it and the expectant parent, is commonplace. And, I would be willing to bet that expectant fathers get this response more than expectant mothers do, but I am not bothered by that. I am bothered by the response, “No. No, you’re not.”

Obviously, I recognize that this response is, in part, a weak attempt at humor. What appreciation I have for that humor though is wiped away by the response’s other message, one that seems to imply that my wife and I, one, did not know what we were doing when we decided to make a baby and, two, that prior to that decision, we did not think about what we were getting into or taking on.

Of course, no one knows for sure what they are getting into when they decide to start a family. We certainly did not know that five months to the day that we found out we were expectant parents our little girl would arrive. We did not know that London’s prematurity meant that I had to stay at home with her. We did not know of how deeply we would love our child. We could not have imagined our lives changing so much in the span of six hours on the night of January 29th.

But we did know something before London was even a whisper. We knew that if we moved forward with our desire to start a family we were embracing the unknown in a way we never had before. Within that unknown, there sure was the possibility of having a preemie. There was the possibility of a miscarriage. Really, the possibilities are endless and that is a frightening thought, especially when you become a parent.

For the chance to love someone more than ourselves; for the opportunity to have our hearts leave us and become a little human being, these are joys that trump the unknown.

For that mom who said, “No. No, you’re not,” who knows what surprises and challenges came her way in parenthood, but, she must know, and so must other parents who tell expectant parents that they are not ready, that, indeed, some of us are.

How’d This Happen?

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A couple of weeks after we returned from our beach vacation last summer, Kate expressed to me that she thought she was not pregnant (we had been trying for a couple of months). She was deeply saddened by this, even starting to worry about us having fertility problems. I did my best to calm her, telling her that on average it takes six months of trying after coming off the pill before the woman becomes pregnant.

Two more weeks passed. In the days before Kate’s family arrived (on August 30), Kate told me that something didn’t feel right. Hearing this from Kate, along with her smelling “horrible smells,” which I couldn’t get the faintest whiff of, I encouraged Kate to just take a pregnancy test to confirm that she wasn’t pregnant. This was on August 29th, the same day we received a box of pregnancy tests from my sister, who had officially decided her childbearing years were behind her.

On the 30th, I woke up around 6:15 in the morning. I noticed Kate wasn’t in bed, but that wasn’t unusual. I sleepily walked into the bathroom to pee and right as I started, I heard Kate’s loud footsteps. She was running toward me and yelling, “Wait! Wait!” When she got to me she shoved an empty and clean peanut butter jar straight into my stream of pee and yelled, “I need some of your pee!”

In Kate’s other had was one of the pregnancy tests from my sister. I was not quite with it yet that morning so I just thought she was seeing if they work properly, although with a level of excitement I did not expect. As my brain warmed up in those few seconds the obvious reason for her behavior came to me. She had already taken a test, it came back positive, and so she was testing the accuracy of these pregnancy tests due to their expiration 18 months ago.

My test came back negative (surprise!) and Kate explained to me that she had taken one before I woke up and it had been positive. She had her doubts though because she read only that morning about how expired tests were not be used and/or trusted. Nevertheless, we had one positive test. Kate even tested the tap water. Negative. Kate said she would try to get in for a test at work.

I spent the day doing some last minute errands and getting ready for our company to arrive, but I could not stop thinking about the possibility that Kate was pregnant. I thought about it all day until the afternoon when Kate got home and set a bag on the counter, telling me it was a card and book for Kendra (her sister) and her boyfriend. She then nervously walked straight out of the room, but added that I could look at the card and book. Flipping the book over first, I saw the title, something about the first year of fatherhood. In a daze, I looked at the card, not even reading the front, flipping it open, saw that Kate had already written in it and signed, “Kate and B.” In my current state, I still thought that it was a card for Kendra and Jake and that Kate had already signed it for us, Kate and Bryce. I didn’t even read what else she had written._BKP1683

I ran to Kate, who stood at the doorway to our room and asked, “Really?”

“Yes,” Kate said through tears and a joyous smile. I hugged her close and lifted her off the ground.

Kate said something about reading the card and I told her I hadn’t. Oops. I ran over to the kitchen and read it. “Cute as a button” graced the cover. Had I bothered taking the split second to read the card, I would have known that it was a card for us. I truly felt sad about botching her efforts to tell me. The daddy book made it pretty clear though. The rest of the afternoon we basked in the news and finalized how we were going to share it with Kate’s family.

Toward the end of our family dinner that night, I stood up and signaled to everyone that I wanted to take a group picture. Once I had all of Kate’s family in the frame Kate commenced with a countdown, “One, two, three, we’re pregnant.” I had the camera take a burst of pictures, catching everyone’s reactions. The first picture didn’t record any remarkable changes in facial expression.

_BKP1684In the next picture, my father-in-law is looking at the ground. He doesn’t look disappointed, but it does look like the weight of the news, that in nine months he would become a grandparent, is hitting him pretty good. Next, my brother-in-law, and Kate’s sisters are all looking at Kate with huge smiles. Kate’s mom is looking at Kate, still, amazingly, holding her wine glass. And in the next photo, pandemonium.

I set the camera down and joined in. Kate was making her way over to her dad to hug him. He was as happy as anyone there, but still, his first question was, “How’d this happen?”

The rest of the evening is sort of a blur. I know we discussed what we knew about the pregnancy at that point. Four and a half weeks along. Due May 4th. The next nine months were pretty clearly laid out. We thought.

Life Goes On, But Something Was Lost

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“I love you, my child. My Child. Still can’t believe it all. Wishing you were still safe inside me and that I could feel you. I miss you, little girl. Be strong.”

– From a letter Kate wrote to London on January 31, 2014. London was one day old.

 

I start today’s post with this quote because in a few sentences Kate conveys the sense of loss mother’s have when they have their baby so early. Sense of loss is somewhat misleading (London was stable in the NICU), but Kate knew and I knew that the safest place for London and also where she would still be developing the best was lost. That was not the only thing lost though. A full-term pregnancy was now just a dream.

Kate was just starting to look pregnant when London arrived. Our closet was full of maternity clothes waiting for months 7, 8, and 9. In fact, the day we got home from the hospital I helped Kate up the stairs and followed her into our room. Shortly thereafter, I heard Kate in our closet and walked in to see what was going on. Kate stood staring at a rack of maternity clothes with tears running down her face. I listened to Kate and held her. Seeing Kate so sad about not getting to wear these clothes even made me cry.

As a father, I do not know the sense of worry and loss a mother has when, without any warning, the human being growing inside of her is out over three months early and exposed to a world she wasn’t supposed to see until spring. But now, having a wife who has gone through that, I have a decent understanding of what that is like.

The sense of loss manifests itself in a variety of ways. One of the strongest, at least in the first week after London was born, but one that also fades over time, is how painful it is to see pregnant women who are full-term or damn near close. To be honest, both Kate and I hated seeing very pregnant women for a while. We were comforted to know this is completely normal. In the two days after London was born, we received a slew of emails, calls, texts, and cards from people who wanted to let us know that they were praying for us and for London. A few of those contacts had preemies themselves. And in one particular email, a mom wrote, “you will hate seeing very pregnant women.” She nailed it. We both did. One of the first days out of the hospital we went to Baby’s R Us to stock up on some breast pump supplies. There were couples everywhere and it seemed like every single woman was about to pop. It was extraordinarily tough. I ran out of dagger eyes to give.

Being bothered by the sight of very pregnant women was the product of our envy during those early days. I remember I would see a couple who is clearly having a baby very soon and think, damn, they’ve got it so easy. They really have no idea. Look how they’re wandering the aisles at Baby’s R Us without a care in the world. Of course, our attitudes have since changed and I no longer think that those soon-to-be parents had it so easy. Having a baby is a lot of work, no matter the gestational age at birth. However, if having a full-term, healthy baby was exactly the same as having a preemie, I would be lying to you and severely devaluing our experience, the experience of thousands more, and the NICU and everyone who has ever worked in one.

I am so sensitive at times to other people’s feelings that it took me a long time to realize that even though this is our first time around with a baby, I know it has been more difficult than if London had been born full-term. Sharing that in the months since London was born and even now, I feel sort of like a jerk because it boils down to me saying, “Well, we have had it quite a bit harder than you.” I know that can sound like I am devaluing the difficulty of having a full-term baby, but that is not my intention. I am just trying to speak truth from our experience and that of the other parents in the NICU right now, who also know that with the littlest life they were blessed with comes the most terrifying and stressful days of their lives and the knowledge that although life goes on, something has been lost.

London’s Birth: Part XIII, That time I cried in the shower

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*This is the LAST post in an ongoing series. That’s good, because had I gone on a bit further I would have exceeded my knowledge of Roman numerals. Scroll all the way down or click to part I to get to the beginning.

Kate was able to sleep for an hour and a half after we got back to the room. I stayed awake and waited for Kate’s sister, Kendra, to arrive. She was driving down from Laramie. I know she got some sleep the night before, but it was minimal and she was not willing to wait another three hours for her parents to get to Laramie on their way to Denver. She would be showing up around 12:30. That is when London had another care time. I was back taking some pictures of London at 12:34pm. I took the first video of London. It’s a 15-second clip of London lying there, chest moving up and down incredibly fast as the vent pumps air into her. Her sternum and ribs are clearly visible. She is so skinny. Her eyes are still fused shut at this point. Her arms are out to tIMG_3101 - Version 2he side, they both have lines in them.

After London’s cares I went back to Kate’s room and Kendra had arrived. Kate was filling Kendra in with the details of the birth because when Kendra arrived she didn’t know that London had been born. I had been waiting to go home to get us clothes and everything else we might have brought to the hospital in three months when we were planning on having London. Now that Kendra was at the hospital, I could do that.

I told Kate my plan and she gave me a list of things to bring back. We were saying our goodbyes when she added, sort of jokingly, “Are you going to go home and break down in the shower?” I smirked, but as soon as she said it I knew that probably was where I was going to break down.

Once home, I grabbed some food. It was after 1pm and throughout the night all I had eaten was a small bag of salt and vinegar chips and a Monster energy drink. I was not as famished as you might guess though; I had more pressing issues than needing to eat over the last 15 hours.

I packed up a couple of bags for the next night and day. I looked in the mirror. I badly needed a shower and sleep. My eyes were bright red and a little puffy. Sleep had to wait, but at least I could try making myself presentable. Into the shower I stepped, and there I cried.

If you’ve ever been around someone who has just lost someone very close to them in a tragic, sudden way, you know how they cry. It is a heart-wrenching sob, which racks the body. This was the kind of cry I had in the shower. It lasted five seconds but then I composed myself and took several deep breaths because I had not lost someone. For me, Kate, and London, life was intact.

Prior to this moment, I had just wept, but finally getting to be alone and having the time to come to grips with the last fifteen hours launched me into a private expression of fear, sadness, gratefulness, and joy. Fear because there were times during the night I thought I would lose my wife and then at other times I thought I was going to lose my daughter. Sadness because I was mourning not having a full-term, healthy baby, one who did not face an arduous months-long stay in the NICU, where there are no promises. Gratefulness for the professionals who saved the most precious people in my life. Gratefulness for modern medicine. Gratefulness for health insurance. And joy, because after all that happened the night before, I was still a husband to an amazingly strong, smart, and beautiful woman and now I was a dad to a baby girl who I felt like I knew so much about so soon after her birth because of the way I had seen her fight for her life. All this had been building up and now emotions were overflowing.

I finished getting ready, grabbed the bags, and went to the hospital. Took elevator D to the fourth floor, Neonatal Intensive Care Unit. Settled into a chair next to London. Accustomed myself with my new home. Closed my eyes. Took a deep breath and exhaled. Opened my eyes and started an entirely new phase of life in the NICU.

London’s Birth: Part X, Into the NICU

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*This is another post in an ongoing series. Scroll all the way down or click to part I to get to the beginning.

Right outside the double doors the charge nurse introduced herself. She guided me through a winding path of at least sterile-looking hospital hallways. Now was as good a time as any, “Can I get a new mask?”

“Of course,” she said, stopping at a counter and getting me one and several tissues. I pulled my mask away and took a peek at the inside, not a pretty sight.

I followed the charge nurse to a pod. Each baby in the NICU we were walking into stays in a pod, not a room necessarily, but more like a cubicle with walls nearly to the ceiling. We walked the length of the NICU, took a left and there was London, skinny, vented, cleaned, and holding on. The doctors kept telling me she was receiving surfactant, which is a mixture of fat and proteins made in the lungs, but preemies are often born before their lungs can produce enough surfactant. The mixture coats the alveoli, or air sacs in the lungs, and this prevents the alveoli from sticking together when the baby exhales. A nurse said London’s lungs were like a hardened sponge right now, not ready for life outside the womb.

I stood there for five to ten minutes, all the while an occasional nurse and doctor would tell me about what they are doing or what they plan on doing. I did not retain that much. I was just locked to my daughter and I was in sort of an emotionless state, unable to fully register the last six hours. I was thinking enough to take my phone out and snap a picture of her. I was hesitant to get close. I had the same feeling I had earlier in the OR, stepping up to the bedside and taking a picture of London meant I was getting closer to her. I was letting my guard down. I was starting to realize that five and a half months ago we embraced the idea of creating a life we ultimately had no control over. The unknown and deeply frightening future belonging to my daughter was coming into sharp focus. I took two quick pictures. London with a full head of hair turned to her left, eyes fused shut, gaping mouth with the endotracheal tube snaking out of it, monitors on her chest, blood pressure cuff and pulse ox on right arm, umbilical chord clamped shut, plastic covering her lower body to keep it humid, and a nurse’s blue-gloved hand holding her legs down. I said a quick prayer when I took the picture, please God, do not let this be the only picture I get to take of her.

Sometime later, the team was prepping London to place a peripherally inserted central catheter or PICC line and an umbilical catheter. They told me it was a good time to go check on Kate because they would be working for a while. I thought that sounded great. I took a picture of London’s pod number, “Pod 3, 423,” not knowing if I would be able to find my way back or if I would need that information later on. I started stepping away from the pod and realized I had no clue where Kate was now. Someone took me to a room, which looked like it was used to just house patients in limbo who might be fresh out of surgery and do not have a room to go to. There were four hospital beds and four curtains, but none of them were drawn. Kate was the only patient there. She looked great to me because she was still here, conscious, and strong, but she looked amazingly tired, which is to be expected. I know I looked like hell. We chatted about London and where she was placed in the NICU, what they were doing to her, her weight and height. 2 lbs, 6oz and 14.75 inches long.

London’s Birth: Part IX, What’s her name?

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*This is another post in an ongoing series. Scroll all the way down or click to part I to get to the beginning.

Throughout the operation there were tears slowly dripping from my eyes and my nose was a leaky faucet. I was aware that my snot had flowed through my mask and even in that moment I was mildly annoyed with the thought of having to ask for another mask. I would ask later, when the time seemed right. Until then, I tried to minimize the flow of tears and snot.

It may sound like my eyes were wandering once my daughter was out of Kate, but they weren’t. I glanced for split seconds here and there, but my eyes were essentially locked on the little human being in front of me. Vented now, the doctors seemed a little more relaxed with her and ready to move. They told me where we were going. It went in one ear and out the other. I would follow them anywhere. They started to roll my daughter a bit, making for the double doors I had come through to enter the OR. They halted for a second, one NP turning to me and asking, “What’s her name?”

I had not yet imagined when I would announce to those present in any room the name of my daughter, but if I had, it would never have crossed my mind that this would be how I would introduce her to the world. “Her name is London,” I announced. It sounded weird giving a name to her at this stage because when your child is born this small and fragile, they almost seem like a science experiment. I had started to become aware of a disturbing, but natural protection mechanism that sets in when you see your preemie like this. I wanted to protect myself from her in a way. I didn’t want to become so attached to her just in case I lost her in the next hour, but giving a name to her instantly made it harder to keep my distance.

London and the team working on her started moving out, rolling right by Kate’s face and slowing down a bit so she might possibly get a glimpse of London’s face. I saw Kate strain her head to try to see her baby before we went through the doors. I stopped and gave Kate a huge kiss, an exchange of tears cheek to cheek, and a word about how London is vented. I also checked that I should keep on walking with London and the team. Kate nodded yes and I was off through the double doors with an “I love you” and one last glance at the amazing team sewing up my wife.

London’s Birth: Part VIII, 18 People

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*This is another post in an ongoing series. Scroll all the way down or click to part I to get to the beginning.

I confirmed with Kate that I was to go be with the baby now. We kissed. I told her she was doing great and walked to the foot of Kate’s bed where the doctors had placed my daughter’s very small bed.

In front of me was an impossibly small baby girl. To call her a baby is not quite accurate. She looked more like a very, very small, skinny human being. There was no fat on her and she had none of the cuddly attributes that full-term babies have. There were seven doctors and residents attending to her, looking for signs of breathing, mostly. They seemed to poke and prod here and there with their hands and a few tools.

Immediately to my left, Kate was on the operating table, with her incision still wide open. I didn’t stare long, but I felt comfortable looking at the incision and the tissue and organs that were being rearranged so they could settle back into place. I turned my head ninety degrees right and continued to watch the doctors revive my daughter. I saw them prepping a blade to start the intubation when another doctor informed me that was exactly what they were being forced to do. She said this was very common. She was tall, had blond hair, and I remember a minute after my baby girl arrived on her miniature bed, she referred to her as a him. I clarified, “It’s a girl, right?” She looked again, “Oh, I’m so sorry.”

My daughter was successfully intubated a moment later. Her head and neck seemed impossibly flexible for the doctors to place the blade and insert the endotracheal tube. I looked left to Kate again. A nurse walked right in front of me carrying a metal dish with a big red blob in it that had what looked like puncture wounds. It was the deflated, tragic looking placenta that had prematurely detached from the uterine wall, aka placental abruption.

The OR was highly organized chaos to my uninitiated eyes. I took a moment, counting all the people in the room saving my wife and daughter. Eighteen. It was the beginning of a deep, new appreciation for the professionals around me. I was learning in the quickest and most explicit way possible that the quickest way to my heart was to save the two people dearest to me. It was early to have this revelation because I didn’t know if everything was going to turn out fine, but I still felt like I would love and cherish these people for the rest of my life because of their effort here.

London’s Birth: Part VII, 27 Minutes Later

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These posts are in reverse chronological order. Read earlier posts first. They can be found by scrolling all the way down or clicking the links provided here: Part I, Part II, Part III, Part IV, Part V, and Part VI.

The only time I have ever seen a C-section setup in an OR was on ER. Well, in that respect, the set of ER got it right. Kate’s neck and head were peeking out from a curtain draped across the top of her shoulders. There was a nurse standing to the right of Kate’s head. There was a chair positioned to the left of Kate for me to sit in. I walked over and sat in it. I gave her a kiss. We exchanged “I love yous” and I sat down.

At this point, we didn’t have to discuss whether or not I would watch the baby come out or whether I would go be with the baby once she was out. Just a few days ago at home over dinner we had talked about what we would do in the case of a C-section. I said I would sit by Kate and would want to be present for everything. We agreed that I would go be with the baby once she was out of Kate, if Kate was clearly doing okay. I also expressed interest in seeing the baby being pulled out. In hindsight, it is incredible that we had this discussion already.

When seated next to Kate, I couldn’t even see the doctors working on her lower body. Kate said all she felt was pressure. I could see Kate’s head and shoulders shifting up and down and left to right on the bed as the doctors peeled away the layers, pushed things to the side, and cleared a path to the uterus.

The urgency of the C-section and the speed at which it all happened was astounding. I was not next to Kate long before the nurse next to her spoke up, “They are about to pull her out. Do you want to look?”

“Yes,” I said. The nurse would tell me when to stand up and look. “Okay.”

“Alright, stand now if you want to see,” she said.

I hesitated just for a second or two, perhaps not quite ready to see what I was about to see, scared to see what I was about to see, or just trying to register the moment. I’m sitting by my wife behind a curtain and on the other side is the rest of my wife’s body with a significant opening in it from which they are pulling out this human being we made, our daughter, who will be in my thoughts for the rest of my life no matter what happens in the next few minutes, hours, or days.

I rose from my chair and saw two doctors lifting my daughter up out of Kate. My daughter’s foot, the last part of her touching Kate, was just slipping the protective casing that had collapsed around her. Nothing could have prepared me for that view. It was beyond beautiful and it literally took my breath away. My legs gave out a bit and I had to sit down quickly. I was crying and Kate was looking at me expectantly. “She is the most beautiful thing I’ve ever seen,” I reported. We smiled through our tears. It was 4:02am, twenty-seven minutes since I had texted my dad, saying we were going to the OR.

London’s Birth: Part VI, At the Doors of the OR

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Parts ONE, TWO, THREE, FOUR, and FIVE of this series should be read first.

The walk to the operating room was extraordinarily difficult. Dwelling on a worst-case scenario was unavoidable at times. Kate occasionally cried while she was being pushed toward the OR. The doctor told us that they would do their best to use local anesthesia so Kate could stay awake and so that they wouldn’t have to intubate her. I was told that I couldn’t come into the OR until the team had determined what type of anesthesia Kate would need.

At the huge double doors to the OR I had to say goodbye to Kate. No other goodbye I’ve had in my life had been that hard. How long was I saying goodbye for? I didn’t know for sure. Five minutes? I hope so. Five hours? I hope not. Five days because they had to intubate her and then there were complications? I don’t know how I would have gotten through it. But there was also the question in the back of my mind, for forever? The team pushed her through the doors and I was alone in this barren anteroom with two chairs and a couple of carts with masks, gloves, and other sterile clothing.

I did not expect to be alone at this point. I thought someone might stay with me. I sat down on one of the two chairs. At this point I continued praying, which I had not stopped doing for a while. It felt more like begging at this point or, more accurately, making demands of God. I sat with my head in my hands.

In a few minutes the doctors were attempting to place the epidural. Kate was screaming like she was being cut open. The trauma of having an emergency C-Section at 26 weeks coupled with the pain of the needle is enough to make any woman scream. I didn’t know what sounds to expect from the OR at this point, but that was as much as I could handle. Still seated, I think I may have been rocking back and forth at this point, still with my head in my hands.

The doors to the OR were to my right. A few doctors went through them once they got gowned up. Some of them wore clear shields that covered their whole face. One knows exactly what these are for. They’ll protect the doctors’ faces from splatters from cutting my wife open, moving aside some organs, and pulling a little human being out.

A doctor came through a different set of doors to my left. As she gowned up and scrubbed in she spoke with a healthy dose of authority, giving me a one-minute crash course on 26-weekers. “They have an 85% survival rate,” she said. That is higher than I thought it would be, I thought. “A common complication is with the eyes. It’s called ROP. It can be fixed with laser surgery,” she continued. And with that she walked through the doors. She was just very matter of fact and did not give me a parting “goodbye” or “see you in there.” But I completely understood. She was going into the OR to save the two most precious people in my life. If I could have sped her up somehow I would have. Godspeed, Lady.

A few more minutes passed and a different doctor came out of the OR with good news. “Kate is on a local anesthetic and doing great. You can come in now.”