Kahlo's Birth Story | My Birth Story
Kahlo’s Birth Story | My Birth Story
CONTENT WARNING: This is a story about birth accompanied by photos of physiologic birth that some may consider graphic.
The way these events played out are so inextricably woven into my ego, convictions, and pride (both the good and ugly sides of all of those things,) that I have put off retelling them in written word this long - as if someday I would be so serenely at peace with this story, that one day I would be able to tell it without all its tangential justifications, vindications, or pretention. As if one day, I’ll be so at peace to the point of being indifferently objective to this story, as if one day I won’t hold on to the specifics of how these events played out with two white knuckled fists, both loving and hating this story, a story from which I emerged both triumphant and small. That day is unlikely to ever come. So, since I still feel this is a story worth telling, I’m going to have to swallow my dreams of how it should be told “right” and settle for telling it all “wrong,” with all of my stubborn presumptuous nature, pride, hurt feelings, and vulnerable humanity. Here is Kahlo’s birth story (and consequently, here is my re-birth story).
My first pregnancy ended in early loss that fell on unhelpful ears. Thus my husband, Alex, and I, mourned largely alone. This was my first initiation into how unimportant we culturally find the concerns of trying-to-conceive, pregnant, postpartum people. An entire new world opened to me I would’ve never otherwise known existed, like a secret society that no one asked to be a part of and no one actually wants to keep secret, but is told to in a many little ways that they must.
#Iam1in4 and #ihadamisscarriage turned into #pregnancyafterloss before I even emerged from my cloud of miscarriage grief. Kahlo was coming, though of course at the time I didn’t know who he was, and I had little faith that he would stick around either. Losing seemed more realistic than keeping. My midwife, Sara, aware that parents who had once lost a pregnancy can require extra convincing and care, gave us an ultrasound in her office at 8 weeks, but this did little to assuage what I was seeing as sensible skepticism. Hope for a successful pregnancy felt like I was being foolish and reckless with my own feelings, and I tried to go through the necessary procedures of early pregnancy with my midwife – diet recommendations, reporting sensations and symptoms, etc. all while still prudently squashing out any hopes or plans that might surface – as if anticipating another loss would make it easier to swallow if it did inevitably come. But trying to contain hope like that is like trying to hold water in your cupped hands, trying to contain imaginings and plans for an event that would entirely upend your life, if it were to happen, is akin to trying to get a stuck song out of your head. And, for me, trying not to plan for what could be, was a laughable feat. In any given instant, given any innocuous trigger, my mind could jet down a path of possibility all the way to a babe sitting on the beach in a floral bonnet to my offspring jumping around at hip height at her first Beyoncé concert quicker than I just typed it. My mind would likewise jet down the same path to a mere month prior, me miscarrying at my work as a wedding videographer, then crying out back behind the venue watching a thunderstorm approach, numbing myself to get through a joyful evening of love, beginnings, and frivolity. Bleeding in the public restroom, emerging from the stall puffy-eyed to the “Congratulations!” from an old friend from middle school, who was attending the wedding. Oh, she means '“Congratulations” on my business, I realize after a moment of blinked confusion.
One day, twenty weeks pregnant, on the drive down to Kalamazoo for meditation class, I expressed aloud to Alex how I wish there was some way I could just know for sure that this was happening, fully, and for real this time. At this point I was well past showing, I was almost near the end of whatever nausea I would be enduring for the duration of my pregnancy, and it had long since been announced, but my caution was still not ready to climb on board with the fact that a baby was indeed coming. Once we’d arrived, ensconced ourselves in the room upstairs bolstered plushily with pillows and blankets, I laid there my in shavasana modified for pregnancy and let the familiar voice of the instructor, and dear friend, Launda, guide me visually into a house in the middle of a clearing in a field, and inside the imagined house was to be someone we viewed to be wise and faultless. Naturally, Beyoncé materialized in my vision - serene, ethereal, impassive. We were told that the person we envisioned will take our hand. She did, and it was cool, soft, dry. We were told that the person we envisioned would lean towards us and whisper something in our ear. She did, and she said, “It is in you.” My mind jumped from shock that something actually was said to me in my head that my own thoughts didn’t intentionally materialize, to disappointment at how vague and general what she said was. I knew that this was merely an exercise in accessing your subconscious thoughts so therefore what was said did, in fact, come from my own self, even if I didn’t necessarily consciously think it, so of course, those words still coming from me, they couldn’t necessarily be words so wise beyond my capacity, but still, I had hoped for something a little more profound than, “it is in you.” But then, before my disappointment and confusion had a chance to finish its sentence, I had another abrupt mind jump to clarity on what the words meant. Two tears sprang up and fell out the sides of both my closed eyes at the meaning of the vague, simple, but true phrase. It was in me – both the answer to the uncertainty I was carrying around for twenty weeks, and a baby.
I left meditation class that night lighter, and whether it was the actual truth or not, I decided that those words would be my truth now, rather than the harsh, mirthless story of inevitable loss I’d previously piled on myself every time my heart wanted to get joyful, scared, or excited about becoming a mother. I stopped raining on my own parade and chose to believe Beyoncé, and set myself to work on concretely preparing for pregnancy and birth.
Solidly six months pregnant, we traveled to Texas, where Alex is from, for a baby shower with his family. We spent a portion of our stay in Sargent, TX, on the beach, and I experienced one of my now familiar nights of insomnia. This bout of insomnia was different – I didn’t feel restless or like I just wanted to escape into sleep. I felt at ease and I almost playfully explored the meditative nature of less-than-conscious insomniac thoughts. Kahlo Sol. A name materialized. Neither said or unsaid. Neither a voice or a self-manufactured thought. At once both fresh and familiar - my first time thinking this name in this incarnation, but as easy as if I’d uttered it thousands of times before. I kept it to myself for a moment, thinking. Alex and I wanted a traditionally Mexican name to honor his Mexican heritage, and we had been mulling over a few ideas, but nothing was decided on. I thought over everything I knew about Frida Kahlo, searching for why that name would come to me – Frida the famous, feminist, Mexican artist. Frida the queer. Frida the woman who suffered miscarriages of her own. Frida the political revolutionary. Sol (Spanish for “sun”) the sunshine to come after the storm that would make our rainbow baby (“rainbow baby,” the term for when a baby is born after loss.) I woke Alex, “What do you think of ‘Kahlo Sol’?” I asked. “Hm,” he grunted in half-asleep reply. He was silent for a long while, I thought he’d gone back to sleep or that maybe he hadn’t heard me. But before I could prod him again and explain that I meant it as a proposed name for our growing child he announced, “I like it,” resolutely. Like much of our parenting choices, sharing the decision to name our baby Kahlo Sol was met with a lot of raised eyebrow Oh!’s. Like much of our parenting choices, it didn’t make sense to many people but us. Unlike much of our choices, it was easy for me to ignore people’s opinions about our child’s name since I held in my heart a wry smile of truth that his name was bestowed upon me in some divinely mystical manner that I’ll never quite understand and don’t need to. Having learned what his name was another step towards accepting the reality of his prospective personhood, and I shed another layer of armored doom-expectations, and traded it in for a deeper vulnerability in connecting with the human I was incubating, Kahlo Sol Carmona-Holt.
I entered both pregnancies with no previous impressions to influence me. I never thought that motherhood would be for me, so I never closely observed those around me preparing for, and going through it. In truth, I’m embarrassed to say that I wrote the experience of motherhood off entirely as unfeminist, and an archaic use of a modern woman’s time and faculties (which is now hilarious to think about given that my entire life is now devoted to better supporting birthing people on their parenthood journeys.) This wrong and snobby way of thinking was a pendulum swung hard in the opposite direction of the notion I was raised with - that childbearing is a female obligation, an inevitability, the pinnacle of womanly existence. So, wishing to reject this culturally accepted story, I wrote off the option of childbearing entirely, similarly to how I had once done with marriage. And as I did with marriage, I had some (mostly internal) crow eating to do when my heart became curious about experiencing those aspects of the human condition in my own way. Perhaps I’m not the only one to think (or have thought) this way, because a quick glance at reproductive rights will show you that feminism only holds our hands so long as we don’t want to have babies, but after that we’re on our own (a concept that I’ve been able to further elaborate on thanks to the work of Kimberly Seals Allers in her book The Big Let Down.)
So my decision to plan for a homebirth with a seasoned and skilled midwife was one born entirely of exhaustive research, not a fear-based, flow-going, cultural expectation, “that’s just how you do things” kind of decision. The only thing that did prime me to make such a choice was my personality trait of never being one to accept things at face value. It’s common for me to look for the root of why things are done the way they are, then search for the root of root’s root. Annoyingly insatiable curiosity has characterized me from childhood, though if you were to ask my mother she would call it, “argumentativeness.” Regardless of what you’d call it though, this fact of my being has held true in my life from everything as big as organized religion to as small as what species-appropriate diet I should feed my cats.
Once we settled on the decision to seek a midwife who attends homebirths (not yet knowing what this would mean for the amount of unsolicited opinions we would have to endure,) we spent significantly less time choosing one. The first person to come up when you google Grand Rapids midwife was Sara Badger, CPM of Simply Born Midwifery Services. I researched a few others, but Sara seemed like a good fit at face value and immediate connection, so I didn’t belabor the search process. Sara saw me through my first pregnancy, and guided me through my miscarriage, all before I was even officially a paying client of hers, so when I was pregnant again, she was already my solidified choice, and I appreciated the long, comforting prenatal visits, and the customized care she offered me knowing that pregnancy after miscarriage has some different requirements.
It took me some time to get used to the fact that Sara was never going to tell me what to do, and to let go of my propensity to want my hand held. I’d been to the doctor before, I’d been with my sister to some OB visits when she was pregnant, so I was used to pregnant women being told what was going to happen to them, told what to eat or what not to eat, being told (not asked) what was going to be done to their bodies or their babies, not being brought into collaboration on what course of action they wanted to take. Being an informed and active participant in my own care was a foreign concept to me. Every time I had a question, Sara had books and other resources to offer me, and she always offered her own balanced information – all of the information, not just the information that kept me making the easiest choice for her. When I pestered her enough (usually it would have to come down to, “Well fine, if you won’t make this decision for me, what would you do yourself?”) she would at most give me her professional opinion or some personal experiences. I had the time privilege that comes with being self-employed, in the mostly seasonal industry of weddings, to dive into the resources she led me to, and go down every possible research rabbit hole, every evidence-based article, every book, every podcast. To my surprise, I wasn’t overwhelmed by all this information – I was energized by it. I would simultaneously have my world rocked by evidence-based practices, then be in a world of outrage at every non-evidence based practice still in the rotation of what birthing people are up against. I’d be in awe at the simple, revolutionary notion that people can birth the babies they grow, then in a rage in hearing all the stories wherein that possibility was unnecessarily medically interrupted. And therein lies the duality with which my own story forced me to build a nuanced relationship with, the duality my ego will probably forever grapple with after my story played out the way that it did.
With Sara’s educational resources I went through most of my pregnancy feeling firmly confident in the decisions Alex and I were making, about managing my pregnancy (or often lack thereof), plans for birth, and plans for how we would raise Kahlo as well. But confident in our decisions is not the same as confident in conversation with your average, everyday skeptic – both stranger and friend, both folks who’s reactions and opinions roll off with ease, and close ones who’s reactions and opinions plant explosive seeds to be combusted over time. Over these ten months, I learned the sensitive art of prefacing our decision to have a home birth with quantifiers like “heavily researched” “informed choice” “evidence based” “right for us” as a learned defensive and offensive mechanism against the “risky,” “reckless,” “selfish,” or “diva,” accusations, either overt or implied, that always, always followed the “planning to birth at home” reveal. I learned how to smile, nod, falsely thank, and even futilely educate my way through people’s doubt and distrust thinly veiled as concern. I learned to stop expecting respect, because the expectation of it only fueled the rage of never getting it. I learned to stop being offended when friends approached me with more incredulity than curiosity. I learned to don the armor of motherhood conversation - starting with the explanation before you even answer the question. I learned to expect the assumption that I just must not know all the information, rather than to expect that people in my life might credit my intelligence enough to inquire about the information that I had learned that perhaps they didn’t yet have. And by “I learned,” these things, I actually mean that these conversations instead populated the cacophony of my insomnia, and still do. These ghosts of conversations, real or imagined, ground on a static loop in the restless darkness of 3 am wakefulness. In the daylight, I could try and rise above close friends turning into internet trolls making fun of my decisions, but in the subconscious lucidity of insomnia torture, I wrote and rewrote and rewrote this very story that I’m telling now. I wrote these words hard, through rage-cry clouded eyes, I wrote these words soft, approachable palatable - inane. I erased it all. I kept it all. Words that hold my righteous rightness as well as my worst fear and failure come to life. Because two things can be true at once, but very few know how to hold both, myself included.
If my first pregnancy, that we did plan for, had come to fruition, I would have been due early May, on Mother’s Day that year – just before our wedding season really got in full swing. But Kahlo’s estimated due date was Saturday, July 15th, right in the middle of the full-swing of our wedding season. Up until July 8th, we’d been careful not to do anything labor inducing because we had a wedding that day, a big one that we were doing florals and videography for, and I fretted about going into labor before that date (or worse, on that date,) pretty much my entire pregnancy. There was a full moon on July 8th, and I just couldn’t get it out of my head that I was going to go into labor early on that date. This wedding was on the other side of the state, so if I happened to go into labor at the wedding, it wasn’t as if I could just leave and go home, I was two and a half hours away from home. (And this the exact scenario is where being a business owner isn’t exactly always a privilege, because there is no calling in sick in our line of work once you’ve made a commitment. I’ve filmed weddings through illness, while actively miscarrying, through walking pneumonia, even through the loss of loved ones.)
I did, blessedly, make it to and through July 8th, still one person – huge and hobbling, but just one person still. After finishing the floral portion of the job, and leaving Alex with our assistants, my sister Brianna, and our friend Krista, to finish off the videography, I drove my parents’ big Astro van back to their house where we were staying, and cried out my relief that Kahlo and I made it past that date I worried over so much.
That night, I was up during an intense thunderstorm with the insomnia that had come to characterize my pregnancy. Instead of fruitlessly attempting to get comfortable enough to let sleep wash over me, I went and sat out on my parents’ porch, watching the thunderstorm, drawing the obvious but still poetic parallels between the huge, beautiful, scary force of nature that was the storm, and the force of nature my body would very soon undergo (or rather, that my body would conjure) itself. I had a not dull, not sharp – just nagging, pain in my upper belly that radiated around and felt like back pain. I thought this was heartburn, or a sore back from my mom’s stiff bed, or just the fact that I was 39 weeks pregnant, or maybe a combination of all those things. This pain was not alarming to me at the time, and it had faded by morning. I doubt I even mentioned it to Alex in the morning.
So on Wednesday, July 12, 2017, four days after successfully completing the final job, and three days before Kahlo’s estimated “due date,” we felt safe to do those labor inducing things, (i.e. we had sex.) And it did, indeed get things going, and I started having contractions afterward. Being that we were planning a homebirth, this was not a cause for alarm, but rather a giddy cause to start tidying up the house and checking things off our to-do list. Alex mowed the lawn and vacuumed the house while I serenely worked through my easy contractions on the couch. We went to the farmers market to keep things moving and there were times where my contractions were enough to make conversation difficult. A lady I was purchasing tomatoes from remarked how ready to pop I appeared and asked me which hospital I planned on birthing at (a question that I’d come to realize was oddly common for strangers to ask, even though, because of my unique answer, I found this to be a personal question.) I, of course, didn’t care to go into specifics with this stranger about all of the reasons and research that led us to deciding that a homebirth was right for us, but I also wasn’t ashamed of our decision so it seemed silly and unnecessary to lie, so I said, “Actually, we’re planning to birth at home with a midwife.” She then went on to exclaim how she could never do that, she was too afraid of the pain. I was mid-contraction for nearly the entirety of this conversation and just wanted her to finish my transaction so I could take my tomatoes and go.
At 11:50AM that Wednesday, I texted my midwife, Sara:
“I’ve been having regular, manageable contractions for about
two hours now, roughly 5 or 6 minutes apart, but I haven’t been
religiously timing them. No other signs yet, haven’t passed a
mucus plug or broke water. Just wanted to let you know! I’ll let
you know if it turns into anything more.”
But by 3:46PM I texted Sara again saying:
“I’m thinking things have fizzled out for now! Still having
random contractions, but they’re really far apart and not as
So given that the excitement had faded and it didn’t appear that things would be progressing anymore today, we called my sister Brianna, often utilized as our second shooter, over to our house to do one last maternity photo session before Kahlo’s imminent debut. In some of the photos you can even see my belly changing shape during the random contractions I was having. We took it easy the rest of the night.
The next evening, I was already experiencing a mild pain in my abdomen, reminiscent of the pain I’d experienced the night of the thunderstorm, when we decided to try another labor inducing activity – spicy food. Alex made an overly spicy curry, that almost immediately hurt and that pain in my abdomen from Saturday night returned full force, just the same as it was but stronger – a burning, nagging, constant kind of pain that radiated all around my upper abdomen and back. So this spicy curry lead tush's to falsely confusing the pain in my abdomen with heartburn. We were up on and off throughout the night trying to quell what I thought was heartburn and (yay!) and early sign of labor starting. It simply felt like I desperately needed a back rub, and whenever Alex tired himself out rubbing my back, I rolled myself against the wall using a rubber lacrosse ball.
I woke up the next morning completely fine, weary from the lack of sleep, but sensation-wise, like it had never happened. It felt like a weird dream, but I decided to switch to a bland, spice-less diet for the day just in case. Once evening approached, around dinner time the pain would creep back in before I even laid down to go to bed, and by the time it was actually bed time I was in the same state as the previous night – fitfully sleeping, in immense pain that was unrelated to my (mild, but still randomly occurring) contractions. I would force Alex to wake up and rub my back. My contractions had nothing on this pain. I could watch surges come and go with the shape of my belly changing, but the upper abdomen pain was constant, untouchable. It felt like I just needed to move around, crawl out of my skin, but no massage or yoga position alleviated it. I’d eat light things like almonds and blueberries thinking I just needed something on my stomach, but for the most part I was too nauseous to eat much of anything, and I times I had flu like symptoms, cold sweats and achiness. Eventually I’d felt bad that I was keeping Alex up too much, and even though I was exhausted from another night of no sleep, it hurt more when I was laying down. So I got up out of bed and rolled the lacrosse ball on my middle back up against the wall. I disrobed and got in front of our large mirror in what was our meditation room at the time (now Kahlo’s room,) I lit a bunch of candles around me and observed my immense belly, breathed deeply, and tried to instill the words “strong,” and “capable,” and “ powerful,” into my psyche in a way that would make me believe them. 9 months worth of research and building myself up with positive affirmations still doesn’t really have anything on a lifetime’s worth of cultural conditioning that birth is an inherently medical and emergency event that requires the help of drugs or a doctor. So even now, I was at the point of needing to see it to believe it. I tried to remember the thunderstorm that was powerful and scary, but wholly natural. Even though I didn’t feel like I was taking these early signs of labor like a champ, I still felt like a goddess as I observed myself surrounded by all the tiny flames. I didn’t want to go back to bed, remembering the pain that wouldn’t let me sleep anyway.
By 4:21AM (now technically Friday) I sent Sara a series of texts. By now my texting was compromised and I kept accidentally hitting send before I was finished:
“Been having a bit of a rough night – started having heartburn, indig…”
“Indigestion and upset stomach early this evening, accompanied by a
back ache that wouldn’t go away”
“Still having contractions, relatively sporadically, but more frequent
within the past 4 hours or so, been trying to sleep, but the back pain does
not go away during contractions. The pain is all around my stomach
front to back just below my rib cage so it feels like I can’t take a deep breath”
“Since going to bed around 11, I’ve also been experiencing nausea and getting
the chills (diarrhea since earlier this evening too, but bowel movements
haven’t seemed to improve the stomach/back pain)
“I can’t recall eating anything that would have caused such a severe upset
stomach. I’m having a hard time telling the length and frequency of
my contractions because the pain is const…”
“constant rather than coming and going”
“Any advice on how to settle my stomach and alleviate this back pain?”
“(Sorry for the onslaught of messages, I kept accidentally pressing send.”
I did not expect her to reply right away because I know she silences her phone at night and if you’re in active labor you need to call to get through to her. Part of me did not want to get through to her at 4am because I felt like I was being a baby about what was mostly normal early signs of labor. I felt like if I couldn’t handle this pain, then what was I going to do once labor really started when my contractions actually became painful? But she replied by 6am asking if I’d tried getting in the bath.
“We did not, I had Alex massaging my back all night though and
eating a little bit of blueberries got me not-nauseous enough to
sleep and that must’ve worked because I just now woke up from a
hard sleep with no more flu like symptoms and no more pain.
But that was awful, is all that normal?”
She replied saying that it was definitely a harder start to labor than most but all still within the range of normal for now. She suggests hot baths, hot tea, drinking lots of water, and rest.
I had a massage scheduled for 11am that Friday hoping that a professional could alleviate what Alex as a willing participant, but ultimately an amateur, could not. Friday night was met with the same pain easing its way in during the evening, and in full force throughout the night, but I got in the tub, for literally hours, because it actually alleviated the pain nearly entirely, and the pain came back as soon as I got out. Eventually I had to get out of the tub because I was too tired (even though I tried to sleep in the bath tub, to no avail.) The symptoms returned. I joked that it was like having the whole Pepto Bismol commercial of symptoms – nausea, heartburn, indigestion, upset stomach, diarrhea. But now, after having relayed those symptoms to Sara last night and not having any new information for her, I didn’t bother her with my symptoms again. Again, I woke up Saturday morning with the pain mostly alleviated – this was my due date!
But that Saturday night (now technically Sunday morning,) the pain was back and somehow even worse. I constantly changed positions because I felt like I couldn’t sit still, the pain had me crawling out of my skin (again – this was not the pain of contractions, which were still coming and going here and there without me noticing much.) I tried to breathe through the pain but I couldn’t even inhale completely. I tried the magical bathtub again but it had somehow lost its magic and that didn’t work anymore, the constant pain persisted. I asked Alex to call Sara and relay to her what was going on – everything was the same but it was all just much worse and more intolerable. I was in tears, and moaning in pain. I was feeling defeated, and pissed that I was going through so much pain that I thought was a precursor to labor, but not actually doing any of the work of labor for me. Alex called Sara (I asked him to do it because by now speaking was an immense effort,) I think around 4AM and relayed to her what was happening. From my perspective, hearing Alex speak to Sara on the phone was a very benign version of the events that were actually occurring in my body, so it came out basically just repeating what I’d texted her at 4am two nights ago. He hung up and I cried in the tub, with my arms propped up underneath my head on the ledge. I sobbed that he did not convey the severity of the situation and now it sounds like we just called her in the middle of the night to relay the same damn information that we had two nights before. Since he didn’t explain any further, Sara didn’t have a different diagnosis or different help to offer, but I wasn’t going to call her back to weepily squeak some pained words out that would likely be the same thing Alex said – which just proves that it wasn’t his fault that he didn’t know what the hell was truly going on in my body, neither did I.
So at 8:14AM on Sunday morning, July 16, 2017, (after maybe 3 total hours of sleep for me, maybe 4 total hours of sleep for Alex, and about the same amount from the previous nights as well,) I texted Sara myself:
“Hi Sara, thank you for answering last night and I’m sorry that
at the time I could not speak for myself to properly convey the
severity of what’s going on, so I wanted to more accurately describe
my symptoms to see if you deem them a red flag for anything
more serious than just severe gastrointestinal upset. I have had
excruciating pain in my upper abdomen (underneath my lungs, front
and back pain, but above my uterus for the most part, at times
the pain is surrounding my uterus and it feels taught and heavy, but
not necessarily contractions, which I am still having occasionally)
for going on 4 days straight now. The pain is exacerbated by any kind
of movement, any attempt to engage my ab muscles, and by both
taking a deep inhale or exhale. At the same time, my body feels like it
needs to keep changing positions even though no amount of stretching
or “working it out” helps and the act of moving at all is very painful.
The pain is alleviated by seemingly nothing (a bath yesterday afternoon
felt nice, I tried it again last night with no such luck again.) I have
completely changed to an acid reflux-friendly diet, just as of yesterday
though, and been taking Tums and papaya supplements, I’ve tried sleeping
with my torso elevated – none of these measures seem to touch it. I’m still
feeling nauseous, mostly from how painful it is. The two things that give me
solace are that Kahlo is still moving and that my stomach sounds all gurgley
all the time, so that gives me hope that this is truly just the craziest, most
intense upset stomach I’ve ever had, but I’d be lying if I said I wasn’t
worried that it’s something worse because this pain is so severe and relentless.
I’m also concerned about going into labor like this, completely physically
depleted, physically unable to take deep breathes, and going on very little
sleep now. Does any of this sound like signs of a more serious problem?
If I had to rate the stomach pain I would say 5-7 during the day and 8-10
(and in tears because of it) during the night.”
She replied back immediately saying that her biggest concern was me going into labor so exhausted, and advised me to go into the ER to check it out, just to be safe, and told me that Spectrum Women’s Health would be the best to go to. When I told Alex what Sara said he asked me if I really wanted to go, and I said, “Yes, I really do.” He said, “Right now?” And I said, “Yes, right fucking now.”
Alex and I got in the car, unshowered, and unready, we didn’t even take anything with us but my purse, and we drove to Women’s Health Center of West Michigan downtown – this was not the place Sara told us to go, but every time we typed “Women’s Health Center” into our GPS this is all that would come up. I called Sara and asked her for directions from where we were to where she meant for us to go, and she instead told us to come to her birth house and that she’d meet us there, and she’d check me herself.
We were all at the Birth House together by 9AM. I could walk around and the pain was indeed not as severe as it was at night, but this time instead of the pain subsiding in the morning and feeling like a bad dream, I was decidedly not going to wait for another night of hell to inevitably come. I could even walk upstairs to the bed. First she checked me (it was actually my first time throughout my entire pregnancy having a vaginal exam) and it was painful and made me bleed slightly. She said I was 2 centimeters dilated (and 80% effaced I think?) and that he had dropped. I know that doesn’t sound like much, but I was happy that those painless contractions I’d been having since Wednesday were in fact doing some work. Then she removed her gloves and started pressing around my belly where I was complaining of the pain. I was surprised when she did actually locate a source of the pain – to me it felt like the pain was radiating all over my belly and back by now, to me it didn’t feel like the pain even had a specific source (later, I would learn that this is called “referred pain.”) She frowned at this mysterious upper right quadrant pain, and said that given the location of the pain, she suspected either gallbladder issues or that it could be my liver. And she said there was this really rare and unlikely, but serious, condition called HELLP syndrome. She reiterated how rare and unlikely it was, as to not scare me, but because of the location of the pain, and how serious this syndrome is, she opted to send me to the hospital just to rule it out. She advised that if they run their tests and it all comes out just looking like I’m in labor (albeit, a really shitty start to labor) then to tell them that I’m planning a home birth and that I’d like to go home. She has a close, good relationship with the hospital in the event of transfers, so she called Spectrum for us to give them a heads up that we were coming, what was going on with me, and sent them over all the information she had on me and my pregnancy.
We drove to the hospital, Alex dropped me off at the entrance while he went to go park. I was scared of the hospital, scared of what it meant that we were there, so I didn’t want to go in without Alex, but there were no benches to sit on, so I ambled around in discomfort and anxious fear. I imagine most people arrive at the hospital, maybe nervous, but mainly excited that they will meet their baby soon. But for us, being at the hospital could only mean that something was wrong, and I was not at all excited to be there. Once Alex finally did meet me at the entrance, we went in together and it was empty in there except for us and the front desk people, who looked up at us expectantly, already suspecting who we were and having everything ready to go for us after Sara’s call, with a room ready to admit me to just around the corner.
I got into the hospital robe, was immediately hooked up to the fetal heart monitor, blood pressure cuff, the whole bit – all of the things that made me feel like a sick patient, not like a healthy, capable, birthing woman. I relayed all the symptoms I’d been experiencing to the nurse upon her prompting and watched my contractions rise and fall painlessly on the monitor. After all of the nurse’s initial intake, two doctors arrived and I had to relay all my symptoms again. Their concerns were the same as Sara’s, so they told me they’d be doing a blood test to determine what steps needed to be taken next, if any. The blood test came back indicating that I had a platelet count of 44 (they told me 44 - in retrospect I think this was them abbreviating 44,000 platelets per microliter of blood.) A normal range is 150,000 to 450,000 platelets per microliter of blood. They told me that my liver enzyme counts were on the high end of the range (high is not good.) They told me my hemoglobin was on the low end at 11, (normal is 12-15.5 grams per deciliter for women.) All that to say, that they were diagnosing me with that really rare and unlikely thing that Sara and the doctors suspected – HELLP syndrome. To give you an idea of how rare it is, my doctor’s were reading the information about this diagnosis to me from their phone, not reciting it from learned memory. It has only been a diagnosis with a name and a prognosis since the 80’s. HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platlet counts – named after the three main features of the condition. A liver is not like a kidney, it’s not a solid mass, but rather encased in a membrane. And due to my elevated liver enzymes, that relentless, excrutiating pain I had been experiencing, that I thought I was just being a baby about, was actually the pain of a liver that was close to bursting out of its casing. HELLP Syndrome is a cousin of pre-eclampsia, but I exhibited no other signs – no protein the the urine, no high blood pressure, no swelling – only this intense, relatively new development of severe upper-right-quadrant pain indicated that anything was wrong. The only thing that could have diagnosed me sooner was a blood test, but even that isn’t a routine third-trimester procedure even if I had been in the care of an OB, unless there is reason to think you might need a blood test, and up until four days ago, I’d been nothing but a pristinely healthy pregnant person, never exhibiting any signs of anything even remotely alarming.
I give my doctors so much credit. Aside from politely, gently telling me, “Brittany, you’re very sick,” they treated me very delicately and for the most part, they kept the scary severity from my mindset at the time of diagnosis. They told me that the only treatment for HELLP syndrome is to deliver your baby ASAP, and that they were going to leave the room and deliberate on what the best way to go about that would be. I asked them what the options would be, mainly concerned with whether or not Alex would get to remain with me if I had to have a cesarean. They told me that the options were either an emergency c-section under general anesthesia, or vaginal birth with an induction. If they decided on the former then no, Alex would not be allowed in the room. I was mentally willing them to leave the room to do their deliberation, because as soon as the door closed behind them I dissolved and wept. Alex held me. It was official – my idea of my beautiful, serene, safe, empowered home birth was not going to happen and my worst nightmare – a hospital birth under emergency circumstances – was our new reality. I still believed in the truth that pregnant people can safely birth the babies that they themselves grew. But apparently not me. And the moment that the door shut behind the doctors the mourning washed over me – holding the duality of gratefulness for the availability of medical assistance, but raging against its necessity in my condition, childishly, exhaustedly wallowing in the indignant, “why me?” of it all.
They came back, and didn’t outright tell me their decision for some reason - I think this is because they were about to tell me that they were going to induce me and that I wouldn’t be allowed to have an epidural, and perhaps they thought that would scare me. In reality, an unmedicated vaginal birth was the one part of all of this that I had actually been preparing for. After explaining to me the induction process, I paused – I was concerned about induction, I’d learned that induced contractions can be far more severe and painful than the contractions that your body produces naturally. I turned to Alex and said, “I don’t want to go through all that just to end up with a c-section anyway, should we just opt for the c-section outright?” At which point, my doctor’s interrupted and clarified – actually, after their deliberation over my blood test, no, a c-section was no longer an option. The lowest platelet count you can perform general anesthesia surgery at is 50K, and as you remember, I was at 44K. A non-emergency c-section was off-the-table too for the same reason that an epidural was now off the table – with HELLP syndrome there is a severe risk of hematoma, a blood clot that could develop in my spine if they were to administer the spinal epidural. So a vaginal birth with no epidural was now the only option and an induction of graduated Pitocin drip would be administered to speed things along since my condition was growing more and more critical the longer I stayed pregnant.
But I had blinders on, and I didn’t hear any of that – all I heard was that I was going to get the vaginal birth I wanted, and I was, if you can believe it, happy and relieved about that. I was even excited that I wouldn’t have the option of an epidural because I thought “all the better not to tempt me with it!” It didn’t sink in until later that I didn’t have any other options. Retrospectively, I would thank the perfect alignment of the stars that I was planning this homebirth, that I was not planning on an epidural, because that surely would’ve scared the shit out of me had they told me that I couldn’t have one, if an epidural had been something I planned to rely on. The “no epidural” didn’t daunt me, and thankfully, there was horrible cell phone service in that particular corner of the hospital, so all of my attempts to google HELLP Syndrome were fruitless. I say “thankfully,” because the first thing that comes up when you google this condition is, “a very rare and life-threatening pregnancy complication,” and thanks to my doctors, my blinders, and my natural birthing preparations, I was relatively naïve about the severity of my condition, and wasn’t really given any time to let fear sink me, because I was swept up and away into the plan B of L&D.
By noon, I was admitted to my birthing suite, where I was met with an aspect of how they would medically manage my condition that they’d kept me mildly in the dark about – magnesium sulfate. Or maybe they did tell me about it, but sugarcoated just how shitty it would really make me feel, my doctor just called it a “nasty drug.” Along with HELLP syndrome comes a high risk of seizing (caused by potential blood clots making their way to the brain.) But even though this drug is life saving and was necessary in my case, that didn’t mean it wasn’t a bitch. The magnesium sulfate made me feel like a hot, wet dishrag – I couldn’t hold myself up, I was burning up, and I had double vision unless I put a hand over one eye. You also can’t eat food or drink water at all on this drug, even ice chips were only allowed in the most minimal of moderation because of how magnesium sulfate reacts to water. All I’d had to eat that morning was a Larabar, and the three previous days I’d barely had an appetite for anything, so I was birthing on empty.
So here I was, in my laboring bed, burning up, covered in cold wash cloths, cotton mouthed, starving, with the fetal heartrate monitor on, a blood pressure cuff on, IVs of magnesium sulfate and Pitocin drip hooked up to my left hand, and periodically these large cuffs attached to both of my calves that inflated and deflated alternately to stimulate blood flow to try and prevent blood clots. It’s pretty bleak scene compared to my plan – surrounded by candles, my birth affirmation stones, my cats, my belongings, my carefully curated, but simple birth kit. But, this is also the point in the story where some lightness enters, because it’s where our chosen team started to arrive.
Alex and I were resolute that we only wanted our carefully chosen professionals present for our homebirth, but once shit hit the fan, that plan went out the window. My mom had already had one foot in the car those three days, but was already almost to Grand Rapids when I texted to tell her we were on our way to the hospital. She texted telling me that she was on her way to my sister Brianna’s house and would only come once we gave her the, “okay.” Brianna was planning on bringing up our “hospital bag” (very meagerly and unthoughtfully packed since we hadn’t really planned on this part, it was just a back-up,) so I told my mom that she could come with Brie when she came to bring the bag. My bag had nothing in it for me and Alex, no clothes, no contact solution, no toothbrushes or deodorant – just cute cloth diapers, some cute baby outfits, and a plan B birth plan printed out. On a whim a few weeks prior, I had curated and printed off a cute birth plan complete with illustrated icons (that I found on MamaNatural.com) representing our wishes in the event of a hospital birth. It was a brief, simple way to convey all of the interventions we were hoping to turn down, and conditions we’d like set for our birth, and it was a lifesaver because instead of being a long diatribe on our wishes that the nurses would scoff at or ignore, they actually thought it was cute and easy to read without taking up too much of their time.
First to arrive was our midwife, Sara. She swept in the room with a different air about her than I’d ever seen from her before – not quite frazzled, but not quite her casually confident usual self either. We were no longer doing this thing on her turf, and she was having to morph from the roll of observant birth facilitator, to a doula-esque advocate for us, to make sure what could go to plan of this birth did. She wordlessly hugged me, refreshed the water on my cold wet washcloth, and poured a few drops of some essential oil on the wash cloth and pressed it back onto my head. She got caught up with my doctors and nurse and her tone with them was familiar and colleage-esque. Her presence made me feel like this wasn’t completely out of my hands, like it had felt before her arrival.
Shortly after Sara, our birth photographer, Amy, arrived. She had texted me literally on our way up from our intake room to the labor and delivery room saying that she’d had a dream last night that I had a baby boy, so she just wanted to check in and see how we were doing since she was maybe planning on heading out of town for the day. After a series of grave, vague texts from me not knowing whether or not she’d be allowed to come anymore, I eventually did ask her to please come to the hospital. When she arrived she cheerily, perplexedly asked, “So why are we here?” We all filled her in and she nodded and got to work on settling into a spot in the room and blending in.
Next my mom and sister arrived. In addition to my feeble hospital bag, Brianna had pilfered through my birth kit to bring what she thought might still be useful. Sara read over our cute birth plan and we talked about what would and would not still be allowed – for instance, I was already bed-ridden, not being allowed food or water, and hooked up to a fetal heart rate moitor – but certain other things like delayed cord clamping, no circumcision, no bathing the baby, etc were still things we could make happen, we’d just might have to fight for them a little bit and babysit those requests since they go against hospital’s typical protocols.
Next my brother-in-law, Vango, arrived in our room with my sister’s kids, Leo and Lilli, for a brief stint. When Lilli greeted me the levity faded for a moment and I wanted to cry. She looked at me from a distance, clearly scared, and afraid to even touch me hooked up to machines and miserable looking as I was. We all reminded her that it was just me, that I was okay, and that she could hug me if she wanted to, and thanks to Amy’s lighthearted entertainment, the kids warmed up to the situation quickly.
On the journey from the downstairs intake up room, and up to my labor and delivery room, I went from 2 cm dilation to 5cm, all with very little sensation on the part of the contractions. And this was before I was even induced with the Pitocin drip, so fortunately things were moving right along well all on their own. I think I have this fact to thank for the induction taking so well. Like I said, I was fearful of the intensity of induced contractions, but the amount of Pitocin started low, and they increased it very gradually, and since I was already in active labor, it was effective in my case. Upon admittance to my birthing suite, my nurse joked that I was going to get to exercise my natural labor skills just like I wanted (though none of this was natural, unmedicated, or at all what I wanted.) And I think when she said that it was with the slightest hint of, “here you go crazy lady, you’re going to get all the pain you desire.” But I didn’t have time for that to get under my skin. In order to work through my contractions effectively, I had to concentrate, and I had to concentrate on every single surge, every single time. Sometimes I didn’t properly focus, breathe, and relax my muscles, and I paid for that distraction during those contractions. Those were the contractions that felt like they got out of hand and I ended up fighting them rather than working with them, but I could always try again next contraction, and I did. Each contraction I would learn what I needed for the next one, even though I couldn’t voice it during the actual surge. Luckily, Sara often knew what my body needed/wanted during the times I couldn’t speak for myself, and she would press hard on my lower back, or suggest positions and that was very helpful. Alex remained connected to me via hand, forehead, or massage during every surge and soothed me after them. My mom and Brianna took turns holding my hand and perpetually fanning me like a tropical queen because of how hot the magnesium sulfate made me. The same nurse that commented that I was going to get the birth vaginally without pain medication like I wanted, also eventually commented her surprise at how “well” I was coping with my contractions. Often times what the TOCO read on the machine monitoring my contractions was the only indicator for her that I was contracting at all because I would become very quiet, close my eyes, focus on loosening my jaw, unclenching my fists, and concentrating very hard on breathing deeply and fully, becoming as limp and receptive to the progress of the contractions as possible. They would rise and fall, they were not sudden and, even though they felt like it sometimes, they were not long. I always got a break. And they were not a mysterious, or even surprising pain like I’d been experiencing in my liver for the past four days. In a way they felt like a culmination of all of the period cramps I hadn’t been missing out on for the past 9 months – that familiar ache that every menstruating person already knows. The surges would just grow in spurts of intensity, rather than the dull, constant pain of period cramps. While I don’t think that anyone does either a “good” or “bad” job of coping with the contractions, I had, after all, prepared heavily for this part. I’d like to say it was my body’s innate wisdom, but when put into this unplanned-for territory, tapping into and honoring the innate wisdom on one’s body becomes easier said than done, and I was grateful for all the hours I’d spent reading and preparing to get myself through each contraction.
I was incredibly thirsty and hungry. Most of the time when women are deprived of food and drink during their hospital births, they are hooked up to IV fluids, so they aren’t actually dehydrated, but because water “doesn’t play nice with magnesium sulfate,” (doctor’s words, not mine,) I was actually quite dehydrated and I needed to stay that way. Periodically, Sara would take pity on me and sneak me a small lump of cantaloupe. For the most part everyone present kept to themselves, observed, or did what I asked when needed or took turns fanning me or refreshing my cool wash cloths. Amy had brought her computer to get some work done during the downtime I think. Sara sat quietly, patiently knitting Kahlo a hat while observing my progress. The nurse came and went to reset my fetal monitor every time I moved or was helped to the bathroom. I think now on how the fact that any position-change required the nurse to come in and reposition my continuous fetal monitor would be enough to deter most birthing women from moving at all – conditioned as we are not to be an imposition to anyone – but because I was preparing for my homebirth, where I would be the queen of this birth, I moved where I needed to, or where Sara suggested, and I even refrained from expending the energy of an unnecessary apology when the nurse came in to re-affix the monitor. Vango took the kids to the vending machines to get snacks, but eventually took them home before Aunt Sissy torn her hospital gown off, and because as far as they were concerned, birth was relatively boring business after they discovered it could be several more hours before they got to meet their cousin. Even though it was on our birth plan not the have my water broken, the doctor wanted to do it to help things move along. I allowed it, but requested that they cease vaginal exams for the sake of checking progress now, only if they were absolutely necessary. At no point did I feel like I needed to know how “far along” I was, nothing I could do about it anyway, and I didn’t want to be discouraged if no “progress” had been made in my doctor’s eyes from check to check. It took the doctors using an ultrasound to discover that Kahlo wasn’t facing the ideal way (it appeared to me that Sara already knew this) and Sara convinced them to let her guide me through positioning during my next few contractions to avoid them trying to turn him themselves.
I was on the cusp of transition around golden hour. The nurse (sorry I keep calling her that, she was actually named Karen, and despite her earlier comment that I perceived as snide, she was actually very nice,) Karen got the “okay” from my doctor’s to let me have one half of a Luigi’s Italian Ice and asked me what flavor I wanted. This sounded like the most divine, refreshing possibility in the whole wide world, and I was just as excited as a 5 year old would be about a Luigi’s Italian Ice.
I slowly savored my lemon Italian ice between contractions, and then their ulterior motive with offering me this treat exposed itself as I was immediately overcome with the need to wretch, and the convulsions that racked my body as I vomited helped promote me to another phase of labor. I was in transition, and Sara calmly informed me as I was quickly jumping into another contraction, that was this time accompanied by the urge to push, that if I wanted to go to the bathroom by myself, now was probably the last time I’d be able to, and just as she said that I uncontrollably peed all over the table as my body pushed for the first time.
From here, I only remember things in snippets, as this is when I turned from serenely laboring queen, to loud birthing warrior. I asked if I really had to be wearing this stupid hospital gown, and began tearing it off before I got an answer, leaving me completely nude except for all of the many ways I was hooked up to IVs and machinery. From my research, I’d learned about the loss of modesty phase of labor, which is one of the many reasons why I was opting for no one to be invited to our home birth except the professionals, I didn’t want to feel like I needed to hold back or cover up. The desire to be unclothed was also heightened by how damn hot I was from the magnesium sulfate, and how non-sensibly designed hospital gowns are for birthing people. But by the time I was actually at this point, I didn’t give two fucks about this display or who was there to see it. I was cognizant of how many people (soooo many peopllllle) were in the room, but I didn’t have the presence of mind to ask for less of them, or to ask whether they were all really necessary right now. At times, I felt like a zoo animal being observed, but this didn’t deter the progress of my labor like I worried it would, perhaps because of the increased Pitocin by now.
I no longer had my own suggestions or desires of my body in regards to my positioning, so I was grateful that Sara kept suggesting helpful positions. For two contractions I labored on my knees, but this was a huge effort to stay up, because the magnesium sulfate made everything an immense effort. I was on my knees and supported by Alex for one contraction, but that was even harder to hold my positioning. I was on one side for a few contractions, then rolled onto my other side for a few contractions (all of these were Sara’s suggestions to help turn Kahlo to be facing the optimal direction, but I have no memory of what order these positions were recommended in. I probably wouldn’t even remember any of this part if it weren’t for the photos.) Ultimately, I was laying on my right side when he finally started crowning. They asked me if I wanted to reach down and feel his head, and I did, and everyone laughed when I exclaimed that his soft head just felt like “more vagina.” I forget how many contractions I spent with him just crowning, but I wasn’t expecting to be done yet. I knew about the “baby tango,” how they’ll be down and crowning during your contraction and push, but the scoot back up a little during the pause, so I wasn’t discouraged that it was taking multiple pushes to get him out, however this THIS was where birth finally felt greater than me. Crowning – the ring of fire – I finally said, “Fuck! I can’t do it!” Sara assured me that yes, I in fact could, and I was. Everyone was encouraging, but I asked for the one form of medical pain management my condition would allow, nitrous oxide, (which is not technically a pain reliever, but it does help you not care so much about the pain while you’re breathing it.) They did ask me if I was serious about the nitrous oxide and I said, “yes.” I think I remember seeing them bring the machine for the nitrous oxide in the room, but by then it was too late, and I’d forgotten that I asked for it anyway.
I was expecting to push his head out and then wait for another contraction to push out the shoulders and body, but they “helped” him out so once his head popped out he was out in one fell swoop. “Helped” is in quotations because they had to press down on my perineum to rush him out like this, which caused a 2nddegree perineal tear, so I’m salty about that unnecessary intervention. Of course, there is no way of knowing, but I’m convinced that if I were able to push him out gently in my own time, perhaps I wouldn’t have torn. I also had “labial lacerations,” which meant there were tears on my labia, they just weren’t deep enough to require stiches. Labial lacerations on both sides, 2nddegree perineal tear - I felt all of those acutely, potently, and I dreamt about that feeling for the next three nights, that feeling would randomly come back to me in vivid flashbacks. I pushed for 54 total minutes, which is actually relatively quick for a first birth, and it honestly felt even quicker. If I were to guess I probably wouldn’t said it felt like I pushed for 15-20 minutes.
You might be wondering – but wait, the baby is out right? What about the baby!? Aren’t you just on cloud 9!? I don’t know if it was the magnesium sulfate, or all the other drugs, or the surprise that he was out already when I expected one more contraction to push out his shoulders, but I was in befuddled shock when they put him on my chest, and I did not get that initial rush of oxytocin that made me only have eyes for Kahlo and not notice anything else. I looked over and saw Alex crying – clearly the weight of Kahlo’s arrival and the relief that labor was over had hit him full force in a way it hadn’t hit me yet. I was being given oxygen periodically immediately after he was out.
It was a part of my birth plan for home for Kahlo to not be put on my chest right away, actually, but rather for him to be laid in front of me, to have a moment to absorb that he’s here, and mentally, spiritually transition from pregnant woman to mother, then pick him up once I was ready to step into motherhood. I remembered that this was my plan, and I picked him up under the arms and looked at him, trying to let it sink in – that it was all over (little did I know, shit was just beginning, in every way possible.) I kissed the top of his head, tried to smell him. The only thing I could say about him was remark on how big his hands were (which was the first thing everyone noticed about him, actually.) Retrospectively, I feel so much more “aww” for that first face I remember, because how square his mouth was as he wailed for the first time, is still how his face looks when he cries, his mouth becomes one, big, pouty square. He was born at 11:16pm on 7.16.17.
Once most of the blood was wiped off on him and vernix rubbed in, they worked on getting my placenta out. I wanted to deliver it naturally, but they didn’t want to wait, they tugged on it, and were working on helping me deliver it. They rushed it out only for them to take their sweet, sweet time in stitching me up. Spectrum is a teaching hospital, and as such, a student does the stitching while a resident guides them. There was local anesthetic administered, which hurt itself obviously, but even after that I could still feel the pinching and tugging of the string while they stitched me. The person doing the actual stitching did not appear to know the terms the resident was telling her. We all overheard, “Now you’ll connect that to the apex… no, no, that’s up here.” Me, Alex, my mom, my sister, and Sara were all tense and frowning as our confidence in his student dwindled. We were all annoyed that this was an emergent birth, where the delivery of the baby and placenta were rushed, but then let’s pause for a half an hour to let this student learn on my body, a body that desperately needed to begin recovery more so than normal births. My self-censoring had returned, so I didn’t have the courage to just ask the resident, “Can you just do this please, so we can be done with it?” On the upside, the bright surgical light they used to stitch me up, finally gave Amy some good light to photograph by.
My recovery room was the same as my delivery room, so luckily I didn’t have to go anywhere yet. Sara was hands on about helping me initiate breastfeeding since my arms were limp noodles and Kahlo’s 8lbs 1oz felt impossibly heavy. She ensured that all of his initial stats that could be taken on my chest were, she was the one to weigh him, and she made sure Alex got skin-to-skin time with Kahlo once we’d tried breastfeeding, and that’s where she and Amy took off. I knew my mom and sister would be staying for a while longer, but I still didn’t want Sara to go, even though by now it was close to 1am, maybe later. She felt like my only connection to this experience remaining within my control, and without her I feared for my ability to speak up for myself if and when the time came to go against hospital protocol.
My particular immediate postpartum experience was something of a nightmare – not in the dramatic sense, but in the fearful, first person POV sense. When I was wheeled on the bed to the room where I would complete my hospital stay, I remember being relieved that I got to keep Kahlo, snuggled up to my skin as they rolled us together on the bed, I just expected to be separated for the ride. Once I was in that room though, the parade of tests began – each one wheeling me out of the room, Alex holding the baby he didn’t expect to be alone with yet, truly unsure if I would come back after each test.
They had to determine if my condition was subsiding now that Kahlo was born, and they had to make sure that my liver hadn’t burst during labor like it was threatening to with that immense pain during my labor. The first was a CAT scan. I was rolled by my postpartum nurse, Illanit, (who was so sweet, and incredibly integral to me establishing breastfeeding, but she didn’t know how to steer a hospital bed for shit, and it felt like bumper cars, my arm above my head to trying fruitlessly to keep my IVs from tugging out of my arm) down to the radiology floor, 7 floors below labor and delivery. At this point, I was still on an IV of magnesium sulfate, and I would have to stay on it for a full 24 hours after delivery (that’s right , STILL no food or water yet,) but for the CAT scan I needed to have a contrast flowing through my system. With two men on either side of my they used the blankets to lift me onto the CAT scan bed. They removed the magnesium sulfate drip, and then, no longer hot and limp, I was cold and violently shivering. They replaced that IV with the contrast, and the radiologists warned me that it would feel like a warm rush, maybe even feel like I peed myself – they were right, that’s exactly what it feels like. I’m a mild claustrophobe, but I didn’t see any way I could protest this procedure nor did they ask if I was claustrophobic to give me an opportunity to say “yes,” and once all of the preparations were complete I began my slow descent into the CAT scan birth canal, feeling a sudden empathy for my sweet babe who had just himself squeezed through a dark tight tubular vessel. I was closing my eyes, fingers crossed that my face wouldn’t fully submerge, because if my head submerged into the small tunnel I didn’t think I could be held accountable for the panicked scramble out of the machine that would inevitably ensue if my head became contained as well. Thankfully, the machine stopped just as my neck was submerged. Then it began its work, a centripetal whirring of the machine around my upper abdomen. My stomach felt hot from the radiation. Once done, I was birthed back out of the CAT scan, then it was another bumpy ride with Illanit back up to my baby and my husband to await the results.
The results showed a stable and recovering liver, but near the top of the picture, just out of sight of the scan that was taken, lay mysterious air pockets, almost as if my lungs were leaking air around my heart. I was wheeled down to radiology again, same whole rig-a-ma-roll of uncomfortable sensations, giving my “I love you” to the same fear-stricken Alex as I was wheeled out again. I had to go into the machine further this time, since now they needed a read of the condition of my heart and lungs.
Back up in my room with Alex and Kahlo we learned from this most recent CAT scan that there were in fact air pockets surrounding my heart, which perplexed everyone. They speculated that perhaps this is a normal anomaly in birthing women, perhaps everyone develops such a thing after the immense strain of pushing, but no one usually has a CAT scan immediately after birth. They now needed to do an X-Ray to see if they could detect a leak.
Wheeled down to radiology again. “Goodbye, I love you,” again. Bumpy ride, laid out facing the bright ceiling lights passing by again. Tugging IVs again. Violent shivers again. But for this X-Ray, I would have to drink the contrast, not get it hooked up to my IV, since the idea was to discover any potential leaks, they would need to take a video X-Ray to chart the course of the contrast, should it could leak through any potential holes. I didn’t know this before it was happening to me, but the other people in the hospital who aren’t working in labor and delivery, don’t necessarily know anything about why you’re in their department or what has happened to you. The men in radiology were only radiologists, they had no bedside manner, and they treat you about as coldly as the teenager you order your burrito from. I needed to be upright for this X-Ray, but I couldn’t stand because of my strength-less-ness caused by the magnesium sulfate still in my system. For some reason, postpartum I had somehow even less strength than when I was birthing, I couldn’t even sit on the toilet to pee without someone holding me up and supporting my torso fully. The radiologist callously didn’t understand why I couldn’t stand up on my own, and said as much. Even with nurse Illanit explaining the debilitating effects of the magnesium, he still seemed like he thought I might be putting it on. Nevertheless, I was eventually lifted by two men onto a table that would then slowly tilt my body into almost standing. If I’d thought that the CAT scan was a surreal Matrix nightmare, things somehow got even more science fiction feeling. It can’t overstate how surreal it is to be in my blue silky, button-up pjs with flowers on them, surrounded by machinery that feels more like science fiction than medicine, and indifferent radiologists just checking me of their list, after just having undergone the most primal, messy, and utterly human experiences of my life.
Now, after roughly 14 hours without food or water, the first thing my cotton mouth was going to get to taste was the contrast. If you’re unfamiliar with contrast, it is a viscous, purple dye designed to do what it’s named after – contrast certain structures in the body from others, so they distinguish themselves from other things in the picture, so the doctors know what they’re looking at in the X-Rays and CAT scans. It tastes bitter, metallic, syrupy sweet in the worst kind of way, and it tastes decidedly not like food - at least not human food. And on an empty stomach and with a cotton mouth, it was all I could do to prevent myself from throwing up long enough for them to get the read. Then I had to drink it again, just to ensure they got a proper read. I gagged this time, probably from knowing exactly what to expect this time and dreading it, but nothing came out.
A kindly radiologist who was helping dismantle the elaborate situation required for me to get this X-Ray and get me back into the bed asked me why I was there, and for the first time my brain formulated the statement that I hadn’t yet registered as true, “I just birthed a whole human out of my vagina without pain medication,” I said, giving him more information than he asked for.
These scans were not in rapid succession like how I just wrote them, but spread out over the whole first night of Kahlo’s life as we’d have to wait for the results to come back in between. There was also an EKG administered, but I’m not even entirely sure why, and that fortunately was able to be administered within our room and was much less uncomfortable than all the other tests. In the meantime, there is no time to rest for the person who has recently birthed in a hospital, especially not one with the risks my particular case held. Illanit, bless her, had me using little suction cup things on my boob, swiping whatever minuscule colostrum came out into Kahlo’s mouth, hooking me up to a breast pump, trying to stimulate my milk coming in with little to no reward. I couldn’t hold the pump at my breast for more than 5 minutes before my arms would shake and fall limply at my sides. I hadn’t prepared for the possibility of my milk not to coming in in a timely manner, as I’d been leaking onto the bedsheets since I was 17 weeks pregnant. But magnesium sulfate, like I said, doesn’t react well with liquids, and it’s actually the drug they prescribe women who don’t want to breastfeed or who want to stop breastfeeding to dry their milk up. Illanit was a one-woman circus seeing more to me than the baby, knowing that Kahlo was in superb condition, being fully baked a day past his due date as he was. She juggled trying to kickstart my milk production with routinely checking my vitals, and asking me questions – I needed to be closely monitored as I was still at a high risk of blood clots and seizing. At one point I was talking to her holding one hand over my eye so their wouldn’t be two of her, and in her thick Israeli accent she brusquely asked, “What’s that, why are you holding you hand over your eye?” I told her it’s because I’m seeing double if I don’t. She chastised me in an endearingly maternal fashion for not telling her sooner. As she clucked about how vision changes are a calling card for the onset of a seizure, I tried to assuage her that I’d been seeing double the whole time I was one the magnesium sulfate, and it was because of the drug, likely not because a seizure was coming, but I promised I’d tell her if anything changed or if I started seeing white spots or flashes.
Every four hours my blood needed to be drawn to monitor my counts to see if they were improving (hoping for lowering liver enzymes, higher platelet counts, and higher hemoglobin, among other things.) I already have small, hard-to-see veins and the events leading up to labor and the IVs during labor left my arms more bruised than a drug addict, and the bruises made it even harder to find a useable vein to draw blood. I entered the hospital needle-averse, cringing and looking away for each poke, and now I was as indifferent to the pokes as a pincushion. Each phlebotomist that was sent every four hours was always different, some better than others. One time an older women who self-proclaimed that she’d been doing this for years, failed to get one of my veins and admitted that she wouldn’t be able to do any better than that within her scope given the state of my battered veins, and she left and sent for someone else to come give it a try.
The blood tests were not revealing what we would have hoped. Though my liver enzymes were remaining stable and slowly lowering, my platelet count was not improving and my hemoglobin dropped drastically during labor from 11 to 8, more than they thought it would, threatening the need for a blood transfusion.
My mom and sister left to go home and get some sleep around 4am, and we were alone. At that point, the tests weren’t over, so sometimes Alex was left completely alone with Kahlo – a scenario that had never really crossed our minds. I thought I’d be there to show Alex how to use the cloth diapers, how to dress a newborn, how to hold him, etc. I was vegetal and incapable, so Alex was thrust into fatherhood for all intents and purposes, alone. The only thing I had to offer Alex at the time was something to be worried about and meagerly uttered advice on how to soothe our newborn.
At some moment between tests and interrupted sleep and privacy, the three of us dozed off, Kahlo swaddled in one of those clear plastic hospital bassinets on his back, me in the bed and Alex on the sofa bed, but Alex woke with a start to Kahlo choking on his own saliva (breathing still being new to the little one.) It woke both of us up. Alex, scared shitless, picked him up held him to his chest and lay down with Kahlo, resigning himself to the fatherhood fact that he’d just never be sleeping again.
The pediatrician came to check all of Kahlo’s stats. She said he had the lowest bilirubin she’d ever seen (which is a good thing,) perfect APGAR scores, all of his reflexes were on point, and there were zero concerns in regards to Kahlo’s health. He was, in essence, perfect, but we already knew that (not to say that any baby is possibly imperfect, but I’d just pushed out a human, let me call him perfect, okay?) I attribute this supreme health he was in to the nutritional guidance given by my midwife throughout my pregnancy, but also to the midwifery model of care, which allowed Kahlo to bake till past his estimated due date. There was nothing that an OB/GYN would routinely do that would have let on to my condition any earlier than we all discovered it, being that I had no protein in the urine, no swelling, and normal blood pressure – I had none of the signs that they routinely check for to find this condition early. Utterly bewilderingly, it was only the late onset of upper abdominal pain that gave my condition away. If a blood test had been administered prior to being in labor (which is not a routine procedure in the third trimester even with an OB, unless there is a reason to suspect a problem, but let’s just give it a big “IF”) if there had been a blood test administered in my third trimester that happened to detect my condition early, then I would have been induced before I was in labor, before my body was ready and before Kahlo was ready – a process I’ve seen turn into cesarean often. I think about it often how if I’d somehow been on that path it would have likely landed me with a preemie, and Kahlo’s health and safety might have been less than optimal or worse. And it was the fact that I was already in labor that allowed the Pitocin to take so smoothly and swiftly, and allowed me to be able to safely deliver vaginally. I, paradoxically, needed the hospital and its resources to survive my own birth, but I also needed to have been planning for the unmedicated home birth, which kept me nutritionally healthy, curious about and in tune with what was going on in my body, and kept me pregnant for as long as possible for us both to be safe and alive today. We are extremely lucky for me to still be a part of my family today, and it would have only taken one different decision is either direction for that not to be true.
In the morning after Kahlo’s birth, it was becoming apparent that they were not going to let me get away with trying to get my milk to come in on its own time, and were discussing supplementation. I asked if donor milk could be used, to which they replied that there needed to be a medical indication to get access to donor milk. So we asked if they’d allow us to use it if we procured it on our own, which they confusedly obliged to.
Alex left the hospital to go the nearby house of a student midwife, Brooke, who worked with Sara. At the time, her youngest daughter was 9 months old, and she still had some frozen milk from Maeve’s earlier weeks. Here, Alex had his own surreal experience – leaving me, Kahlo and the confines of our present reality and emerging out into fresh, summer, morning air. He called his mom down in Texas, broke down to her about all of everything that had happened from his own perspective, rather than just intermediate texted updates, and asked her to come up from Texas to support us during this time. She was on a plane up to us by that evening.
Once Alex procured the donor milk, a lactation consultant came in and taught me the cross cradle position where I squeezed my boob like a sideways hamburger and held Kahlo across my lap by the shoulders. I had no idea how much effort and bodily manipulation would be required in the early days of learning breastfeeding. Despite reading many books, reading about a bodily function is entirely different than doing it yourself, and the learning curve was steep, with equally steep stakes. Kahlo had a tongue tie making his latch difficult, in the hospital they wouldn’t allow Sara to cut it right away, and my milk still wasn’t coming in. The lactation consultant showed me how to use a supplemental nursing system, a thin tube that was fed by a bottle of donor milk, that tube was then threaded into the side of Kahlo’s mouth once he was latched, so we were both still learning to nurse, my milk was getting signaled to come in, but Kahlo would still get fed. Sounds simple, but it wasn’t. It required all of me, Alex, and my sister to coordinate the mechanics of this thing, and additionally I was using a nipple shield since Kahlo’s tongue tie didn’t allow a deep latch. Once we’d get it all hooked up, we would all watch, riveted, as the milk made its way past the numbers on the tiny tube, fingers crossed that the milk would make it to his mouth before he got too tired, and sometimes he would unlatch – him tired, and us discouraged. At times my mom gave him a bottle of donor milk, most of which he’s usually throw up instantly since we hadn’t yet learned about paced feedings, and because my mom’s desire to feed a newborn trumped her knowledge of his stomach only being marble-sized.
Hospital life was perpetual pokes, tests, and feedings or attempts at feedings with arms that couldn’t even hold my own baby, and tiny fists clutching at my IVs and struggling against all of the machinery and hospital staff interruption. Sleep was short, shallow, and therefore dream-full. Now that I could see his face and picture him perfectly, I dreamt of Kahlo’s face squishing through the birth canal in a corkscrew. I’d have flashbacks, dreaming and awake, of the tearing that I felt acutely as I’d made my final push. Unlike our spacious, warm looking delivery room, this room had cold tones and a window that looked out directly at a brick wall. So between the brick wall and the stunted sleep, I had very little grasp on what time it was or how many days had passed, so my memories on this immediate postpartum period is an amalgam of all I know that happened during my hospital stay, not in perfect chronological order.
Even though I’d been texting her, updating her on all of the tests I was undergoing, keeping her in the loop, Sara also visited some morning, and I cried when I saw her, so relieved to see signs of my comfort zone. We decompressed about how the birth went, she too mourned the loss of our plans. She said, “but you should be immensely proud of yourself. You could’ve died.” To which I replied, “Oh don’t worry, I’m very proud of myself.”
That evening that marked a full 24 hours since the birth also meant that I could now start to be weaned off the magnesium sulfate, slowly, not all at once. It was a triumph the first time I could hold my own self up on the toilet. And the first thing I ate was bone broth and an enormous take-out beef shank from a nearby restaurant.
Despite my protein and iron rich meal, my counts weren’t improving, (I think the lowest they ever let my hemoglobin get was 6,) and I was put on a calcium drip in my IV, and it was decided that I would have two blood transfusions. As acquainted as I now was with certain hospital procedures, I didn’t have high hopes for what was in store with this one, but damn – blood transfusions are amazing! It is what I would imagine using cocaine feels like. Between being fully weaned off the magnesium sulfate and the blood transfusions, I felt suddenly and swiftly restored and vital with full usage of my faculties again, and I was ready to get the hell out of the hospital, and get to the comfort of my home where I (correctly) suspected my milk would have no trouble coming in. I could also now feebly aid in the routine care of my baby now, finally.
At some point a doctor came in, who I’ll never forget. OBs were routinely coming in and checking on my condition, receiving updates from the nurses and test results, deciding what to do with me next, but most of them I don’t remember. They were nice enough, but Dr. Moser is who sticks out in my memory. He had a sweet bedside manner (literally, he sat on the bed at my feet,) a kind smile, and an unrushed demeanor. He was familiar with Sara, greatly respectful of her work (I later found out that the feeling was mutual) and knowing that I was her client and would be seen to by her postpartum relieved him greatly, and he even let me go home a day early knowing that I was in her care postpartum. In his own words, “Sara’s clients tend to be more informed, more involved, and more in-tune with their bodies and symptoms.” No wonder I liked him so much – it was the first time since being in the hospital that someone didn’t look at me sideways when I said that we had planned a homebirth. Since he didn’t seem in any hurry, I felt comfortable enough to ask – what the hell is wrong with me? In reality, I worded it more like, “What actually is HELLP Syndrome? What is/was actually happening in my body? Could I have done anything different during my pregnancy to have prevented this?” (That last one – typical woman code for trying to find the way in which this was my fault.) Dr. Moser’s response was clear and in laymen’s terms for the most part, but not at all dumbed down or condescending. His response was comprehensive, thorough, and characteristically calm and unhurried. This is what I remember of the information he gave me, but in reality it was more conversational that this, as he left room for me to interject or ask questions:
“We don’t know much about HELLP Syndrome, as it was a recently discovered condition. It’s a close, more severe cousin of preeclampsia. However, from what we know, we think that HELLP Syndrome is caused at conception – when for some unknown reason, the fertilized egg doesn’t get a perfectly close attachment to the uterine wall, which causes space between where the placenta passes nutrients back and forth. This space between the placenta and the uterine wall causes your body to have to work harder than normal for you to nourish the fetus. This isn’t a problem until late in pregnancy when the larger fetus starts having more demanding nutritional requirements, and since the body always takes care of the fetus first, it is at the cost of depleting the mother’s own nutrients, which is why your platelet and hemoglobin counts were low. So that’s why HELLP Syndrome isn’t necessarily detectable until late in the third trimester. So no, as far as we know, there was nothing you could have done to prevent this. There has been some research to suggest that maybe this is caused by an initial rejection of the father’s DNA, so now that your body is acquainted with your husbands DNA, it is possible that that could reduce your risk of developing HELLP Syndrome with subsequent pregnancies. We know women who are between the ages of 23-28 are who are most at risk for this syndrome, so waiting until you’re older will reduce your risk of this happening again. But we also know that you statistically have a 25% chance of developing HELLP Syndrome again, despite those other risk-lowering factors.”
We went back and forth for a while, him genially negating any ideas I had about how I could have prevented this or dietary ways I could force myself to heal from this faster. I think what I appreciated most about Dr. Moser is that he didn’t pretend to know anything he didn’t actually know, and was apologetic that there wasn’t enough information about this condition. All my life and in my pregnancy experience, I’d been used to doctors who treated me like a child, had egos they had a hard time fitting through the door, and scoffed at the idea of patients also having valuable information about their own bodies, let alone having preferences about how they’re cared for. It was refreshing to experience a male OB who treated me respectfully, like a co-collaborator in my care, and it healed a part of me that was previously closed off to that possibility, and forced me to check my preconceptions about what an OB can be.
We still had some time to wait until discharge. Time to wait until the kind woman would wheel me nervously nursing Kahlo out to the parking garage, and whisper to me what a good mom I’ll be - me not knowing what she meant because I didn’t yet know that it was “brave” to nurse your baby in public. Still time before wheeling past all of the hospital people, doing hospital things, who didn’t know, couldn’t know, (didn’t they know?) that the world stopped turning for us right now. We had time before we’d learn just how unprepared we were, despite all of our over-preparedness, for the difficulties that would come with being home, with a new human, learning how to feed that human, and recovering from a traumatic birth, impossibly all at once. For now, we had time before I’d throw things against the wall in sleep deprived, postpartum anxiety frustration at the lack of outside understanding of or empathy for our mental and physical state, lack of acknowledgement for the hell we’d just been through, the lack of, lack of, lack of. Time before we’d get to cracked, bleeding nipples, time before having to go back to work and having to ride a bike before I felt fully healed.
For now, in the room that faced only a brick wall, it was easy for the outside world to not start its turning again yet. For now the gash in the universe through which we, together, brought forth Kahlo into the world, was still an open wound. One which we delicately teetered on the edge of, edge of life, edge of death – all three of us falling, breathlessly, unbelievably, luckily, onto the side of life.
Since Kahlo’s birth, I’ve learned much more on the ways in which my birthing experience and the fact that I’m alive to tell the story had maybe more to do with privilege than with the “luck” I ended this story with. I’ve learned that hospital employed lactation consultants have success rate quotas they need to meet – priming them to give their time to low hanging fruit, and despite my myriad of breastfeeding challenges, I was a very determined, hippie, white woman, who had already planned to breastfeed and clearly had the support of my family and community. I didn’t need to be educated about breastfeeding’s nutritional benefits and one could easily judge by the familial support I had around me that I would figure breastfeeding out one way or another. Racist assumptions as well as low breastfeeding rates among the Black community (caused by and now perpetuated by valid historical trauma,) make Black mothers not the same low hanging fruit I was and because of this I have learned that statistically Black mothers are often passed over or not given has much time and resources by the hospital lactation consultants. Since my birth, I’ve learned that women who should have better chances of surviving birth than I had often end up dead after an otherwise safe and uneventful delivery from racist medical neglect. Black women die at 5x the rate of white women in labor and in the first year of their baby’s life for reasons that have been proven to be cause directly and indirectly by racism. I’ve heard directly out of the mouth a now widowed Black father that he was told to his face, “Sir, your wife just isn’t a priority right now,” as he pleaded for the same kind of care and attention for his wife that I was given liberally. Care that I was given as a Medicaid patient, who hadn’t had a single prenatal visit (at least not one that the medical community would recognize) in my entire pregnancy, one who didn’t even personally know the OBs that cared for me on the day of my birth. Since my birth, I’ve began pursuing my doula certification and I’ve done so seeking an anti-racist approach to my education, so as I wrote my own birth story, I wanted to weave this information and these truths into every aspect of my story, to provide the very present, but underrepresented, flip side to my coin. But I ultimately chose not to include that throughout my story because this is just that - my story. And therefore the story of medical racism cannot fit here, in the birth story of a white, cis-gendered, straight, married woman. But it is this same education and information that has made me reinterpret the final statement of my birth story, luck vs. privilege. Because just as important as what happened in my story is what didn’t happen – and what didn’t happen, is deeply more informed by a system that trusts me, listens to me, and prioritizes me as a white woman at the expense of others. Despite the difficulties of my birth experience and the times I felt unheard or mocked, I received anything I requested, I was tended to swiftly, I am still alive to tell the tale, and my baby is still alive. Yes, the “stars aligned” in a very specific, unique way for that to be true, but a big one of those stars that had to align was indisputably my privilege.