Forget the Waiting Game

Humans love patterns. I don’t mean a Scottish plaid or a pink paisley (although those of course have their place in the world), I’m thinking more of the repetitions and unrandom occurrences that permeate our lives from which we derive meaning, seek comfort, glean knowledge, etc. Some play Sudoku, reveling in combinations of numbers, or look to discover new patterns in math, Fibonacci sequences being old hat and all. Others love fractals, genetic sequencing, a field of clovers, the lines that a purebreed dog is supposed to exhibit, whatever strikes their interest and fancy. There are patterns of things and histories and people out there to suit every interest. And beyond patterns there are trends, or pattern forecasting, if you will. Once we start talking statistics, it’s a whole new world of hit and miss—is this thing a pattern or isn’t it? can we count on this pattern to continue?—and though experts may collude that a given pattern is definitely, absolutely, perfectly true, well, I think we all know better.

Here I turn to pregnancy. Show me a woman with a 28-day cycle and I’ll show you thirty more who cycle in a different pattern, or via no pattern at all. (They live with an annoying label of “irregular.”) If Western medicine loves a broad pattern on which to base its practices, women’s reproductive systems are the proverbial fly in the ointment. All of science still fails to understand how the start of labor is even triggered. Is the uterus like, “I’m done?” Is it a sign from the fetus? A signal from the placenta? Somebody’s hippocampus? Ted Cruz? Despite all of the not knowing going on, we are presented again and again as hopeful parents to be with the same ill-fitting narrative: most women will experience X. If a given woman experiences X+2 or even Z, that’s on her.

We’ve  seen Susanne get some symptoms of pregnancy and not others, some for a longer or shorter duration than the Mayo Clinic’s book suggests will happen, and she’s had different experiences over both of these pregnancies. Why do these things change or vary?

Who the hell knows?

But given that we don’t know so incredibly much, maybe we could all brace ourselves a little better for the unexpected. Hey, it’s just a suggestion.

I’d gone to bed early last Tuesday night, after running around for a few hours managing a fundraiser for my organization that was spread across more than half a dozen restaurants in town. Susanne’s mother had arrived a couple of days earlier in anticipation of a pre-due date delivery. She’d rebooked to come a little early. Good thing, because the night was about to get chaotic.

Susanne called out to tell me she’d gone into labor. Our bags were already in the car. I fumbled into my street clothes and we whisked away to the hospital. I may have run a red light or too (but I checked the intersections first). We got to the delivery ward at ten until midnight. It had been a total of twenty minutes since her water had broken.

We asked for the birthing room with its own private tub. There’s another room that has a Jack and Jill tub access, and the least desirable room comes only with a shower. The ward was quiet, so they obliged. I saw two, maybe three nurses in total. I set our bags in the corner of the room and Susanne settled onto the bed and we waited for the nurse to arrive.

She was nice, if not a bit overly chatty. In the world of computer programming there are “terse” and “verbose” programming styles, and as people go, she seemed to be set on “verbose.” I learned a lot about our nurse as she worked through Susanne’s medication list and allergy history. By the end of a fifteen-minute triage, I knew how many kids she’d had herself, her religion, age, and favorite beverage. She noted somewhat wryly that Susanne hadn’t had to do any heavy breathing through their conversation, making me wonder for one brief moment if it had all been some kind of planned ruse to keep us talking that long as some kind of unconscious benchmark of Susanne’s labor.

Turns out, she was not in fact sixteen steps ahead of us.

She set up the telemetry equipment for reading the baby’s heartbeat and gauging Susanne’s contractions; the monitor would tell us and the nurses’ station how intense the contractions were, how far apart and of what duration each of contraction and rest period. Our nurse, the only person we’d worked with until this point, told us they would monitor Susanne from the front desk for half an hour, and then she’d give the overview to our doctor, who was of course, at home. At this point it was about 12:30AM.

It didn’t occur to me that we’d never been left alone during Susanne’s labor with Emile, not for a moment. There are a lot of things that go through one’s mind when waiting for a baby to emerge into the world, and wondering about who was in the room with us just wasn’t one of them, until it was kind of blindingly obvious that we were on our own. But for the time when the machine scratched out heart rate and other data, Susanne and I just talked with each other. We were so behind on names if it was a boy. We went through our list again:

Connor? I liked it, Susanne didn’t.

Gavin? Susanne liked it, I didn’t.

Cole? We both liked it but weren’t over the moon about it.

My back started hurting, so I moved to a rocking chair. It would have been so easy to close my eyes and nod off, because it was dark and quiet outside. Susanne even suggested I take a quick nap. I loathe quick naps, but I appreciate that they can reenergize someone for a little while. Coffee drinks are definitely my preference.

The nurse wandered back to our room to tell us she’d spoken with the doctor. All of the medical people who’d looked at the telemetry had agreed that Susanne was in mid-labor, and could carry on like this for hours. Emile had taken 15 hours from the start of labor to his delivery, and needed assistance at that. Nobody saw any sign that this next baby was in any hurry, other than the fact that Susanne’s body was well ahead of where it had been with the last pregnancy. For us, we weren’t spotting a pattern, but we were acting like that one data point would lead the way for understanding this labor.

Human understanding, however, is full of hubris and folly.

The plan according to the doctor was to see how Susanne was doing in another four hours, or 5:30AM. If she hadn’t progressed then maybe they’d put her on pitocin and get the contractions going. Susanne, for the record, had a no-pitocin-without-an-epidural, because LAST TIME the anesthesia had never come. And she wasn’t interested in establishing the pattern of painful natural childbirth. But as the nurse pointed out, this would be right around when the anesthesiologists would come on shift for the day, so the timing could work out well. Emphasis on could.

The nurse asked if Susanne would like to try the private tub, and she said yes, so she went about to fixing a beautiful bath with hot water and lavender bubbles. I considered jumping in myself (but not really). Off came the monitoring devices, and Susanne looked blissful to sit in the water with a towel under her head. It was like spa day. Again our nurse left, saying she’d give Susanne half an hour and then would come back to get her out.

timed contractionsBut soon after we were left alone again, the contractions started heating up. I asked Susanne to tell me when a new one was starting and I began timing them on my iPhone. If the contractions before that were four minutes apart were no biggie, what did this new timing cycle mean?

Two minutes apart. Susanne barely had time to catch her breath before a new one would crash into her and crumple her uterus.

“Do you need an epidural now,” I asked, having no clue what was happening.

“I don’t know,” she said. I reminded her that it was her prerogative, but in the instant of hot tub and pain and middle of night fuzziness and impending baby, we were not perhaps the best decision makers. Then Susanne started shaking all over, and we stopped worrying about pain medication.

“You did this with Emile, too,” I said, trying to reassure her. She nodded. We’d thought it was muscle fatigue, but apparently it is transition from labor to delivery. We didn’t know that in the dark room by ourselves, we found out about it after the birth, from our doctor. Because we need patterns so much we’d taken a baby class before Emile, read piles of pregnancy books, watched documentaries and videos, and done our best to learn what we would need to know. We were hoping to be informed. Somehow in all of this information we missed or weren’t exposed to the data point about tremors and transition. We were calm because we didn’t know, and we could have bought more time for ourselves but didn’t.

I was still timing contractions, watching the cycles shorten. Susanne turned to me and looked grave.

“I really feel like I need to push.”

What I thought was WHAT THE HOLY HELL HOLY SHIT! What I said was:

“Don’t do that.”

I pulled the nurse cord out of the wall. Susanne was breathing hard. When the nurse showed up to the room, that’s where everything went off the rails.

More later.

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Categories: Family

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