Kaitlyn’s Birth Part 1

WARNING: from this point on I may begin using medical terms relating to childbirth that may make some folks uncomfortable. I'm not going to be **overly** graphic, but there's no getting around what happened, so just be forewarned.

When most people who have not been through the birth of a child think about the process, they don’t really think too much about what comes after the baby comes out. Sure there’s the cutting of the umbilical cord, but other than that, its pretty much over right? I feel confident making this general assessment because I think I’m fairly normal and I didn’t think too much about it. Unfortunately that was when the real challenge of childbirth began for me.

Lindsey emerged from the process relatively unscathed - if you’ve seen the movie Baby Mama starring Tina Fey, you may have heard about some serious trauma women can suffer from the act of giving birth. Lindsey fortunately didn’t experience that trauma, however the placenta didn’t detach and come out on its own like it was supposed to. The midwife attempted to pull it out, first using the umbilical cord as a tether, and then reaching in and gently trying to pull it out. She believed that it was very close to coming detached but that it was just hanging on. After trying for a few min she decided that she needed to get one of the doctors to come and try. Once we moved beyond a completely normal birth it was her responsibiltiy to hand off to an OB/GYN.

The Trauma

The doctor arrived and gave us a choice: she could reach in and manually remove the placenta or we could have Lindsey put under anesthesia and have a D&C procedure done. Since our plan had been to spend some time together immediately following the birth and while a D&C is not a major operation, with the sedation it would really mess with our plans. During this discussion Lindsey was holding our still unnamed baby, and was still bleeding since the release of the placenta is a cue or part of the process for the blood clotting to begin in the uterus. Based on our desire to not lose our family time, and since the doctor counseled that while it would be painful for Lindsey to have the placenta ripped out by hand, she was clearly capable of managing a significant amount of pain and this shouldn’t be more painful than the contractions had been, we decided to have her pull it out by hand.

Lindsey hurried to try and hand me our daughter so that she wouldn’t have to worry about squeezing her too tightly while helping to push the placenta out, so the nurse quickly swaddled her and handed her to me. After several minutes of pulling - all the while Lindsey was still bleeding - the doctor asked someone to call the anesthesiologist to bring “something” to help the placenta let go. When I pushed them as to what this “something” was, they told me it was Nitroglycerine. Apparently in small amounts it behaves like a muscle relaxant which helps the uterus release the placenta. While they were waiting, and as Lindsey continued to bleed, the doctor decided to keep trying. At one point the doctor looked up at the midwife and asked her if she had called the anesthesiologist. The midwife said no and turned to the nurse, asking her if SHE had called the anesthesiologist. When the nurse said no, I started to get angry again.

The anesthesiologist finally arrived, and even after spraying the nitroglycerine under Lindsey’s tongue the placenta STILL didn’t want to release. When it finally did come, the doctor said she needed to do the D&C anyways because it didn’t look like it had come off cleanly and if they didn’t get it all out then Lindsey would continue to bleed. At this point the anesthesiologist pumped an anesthetic into Lindsey’s IV and she went into “twilight” land. They wheeled her out of the room and down the hallway to their operating room, and in the span of just a minute or so I was left standing in the corner of the room, holding my daughter, completely alone. There was a blood smear on the floor and bloody utensils and gloves and other things which I didn’t look too closely at sitting on a tray. As they had left one of the nurses said she’d be back to help me with the next steps for our daughter.

While I was waiting I wasn’t really sure what to do, since when I had asked how long the procedure was likely to be I had gotten non-commital answers. This was the same procedure that was done after the miscarriage, and that had been outpatient and taken about 30 min, but this clearly felt different. When I pushed for a more specific answer the anesthesiologist revealed himself to be an asshole by telling me “it could be 15 min or it could be an hour, does that help?” to which I curtly replied “no”. Standing and then sitting in the rocking chair alone in the dark room I was torn between respecting Lindsey’s plan for private family time and letting Lindsey’s parents who were still in the waiting room know what was happening. Fortunately my mother-in-law had gotten a little worried about what was taking so long (she had known we were actively pushing and approaching delivery) and so she wandered down the hallway towards the room.

From in the dark room as I looked out into the hallway and saw her, it seemed that she was looking right at me, so I called her name. As she came into the room and her eyes adjusted she asked me what was happening. I explained as best I could that they were doing a D&C and she got my father-in-law, brother-in-law, and sister-in-law, although I couldn’t tell you if she left to get them or called them. I spent most of this time staring at my daughter and rocking in the chair trying to keep my eyes as clear as possible.

Eventually, a new nurse came in to help with my daughter. She needed to be washed still, and she had never had her security tag placed around her ankle, and neither Lindsey or I had our matching security bracelets put on yet. This nurse was very matter of fact and seemed oblivious to the blood on the floor and the trauma that had caused it although the tray covered in bloody tools and gloves had been removed by another nurse. She took my daughter, washed her, had me take pictures, measured her, put her back into my arms and took a photo of the two of us, and recommended that we give her a bottle of formula. I declined since I knew that Lindsey felt very strongly about the importance of breast feeding. During this we got the first update from the nurses about Lindsey’s status. The D&C had been completed successfully and everything seemed good. Sadly this was a false alarm.

They had barely given us this update when there a page went out over the hospital intercom regarding some sort of issue and assistance required. We didn’t notice or recognize it, but this was the news that Lindsey was having trouble breathing. We learned that she was coughing fluid up and so they needed to intubate her. The OB/GYN staff was confused by this as she had seemed to be fine initially after the D&C and this was a very unusual reaction to a D&C. After being intubated we then learned that she was still having trouble breathing and so they ordered an immediate chest x-ray to try to understand what was happening. The chest x-ray revealed that she had a pulmonary edema. Yes its as scary as it sounds, its fluid in your lungs where it doesn’t belong. At this point they decided to move Lindsey to ICU and I was reeling. I was still just sitting in the rocking chair holding my daughter trying not to lose control. Before they moved her to ICU they had me come and see her, I think the thinking was that I should get a chance to see her in case I didn’t get another chance.

Seeing her lying on the bed covered in blankets, with tubes coming out of her mouth and fluid coming up some of those tubes was almost too much. I knew that I needed to be strong for her, so I leaned close to her, kissed her on the forehead and told her that our daughter was beautiful, that she had done an amazing job, and that she wasn’t allowed to leave me. One of the nurses said something about bringing our daughter in too and getting a picture and that was when I did finally lose it. I left the room so that Lindsey wouldn’t see me (although I know now she was stll under the effects of anesthesia enough that she doesn’t remember this) and kept my head down. Again the most powerful thing I can remember feeling is anger. I looked around and saw plastic pamphlet holders of some sort on the wall just outside the door to the room they had Lindsey in. I seriously considered pummeling them - my hands had become fists at some point and didn’t seem interested in unclenching - but I did a quick mental calculation and realized that they were too small and thick for my hands to stand any chance. I wandered back into the room and saw a much more attractive target for my anger, the very large windows. I leaned into the window on my fists enjoying the feel of it bowing slightly but I couldn’t bring myself to try to actually break it. My sister-in-law admitted later she had a moment’s worry.

Now I could no longer pretend that Lindsey would be back shortly and able to breastfeed our daughter, who still did not have a name. The pushy nurse said we didn’t have a choice, she needed to be fed and I agreed. Somewhere during this time - the exact timeline is obviously a blur - my daughter was laying in her cradle or being held by my family and the nurse brought back announcement certificates. I’m sure that in a normal birth these are an exciting delivery, as they use the picture that is taken immediately after washing your baby and print it out on the certificate. For me however this was a tangible reminder that I might be leaving the hospital as a single father and I was hanging my head with tears running down my face.

The pushy nurse took this opportunity to try and comfort me by putting her hand on my knee and running it up the inside of my leg in what I’m sure was not intended to be a grossly inappropriate touch - but it was. I was suddenly not on the verge of weeping but very sternly and if I’m honest a little derisively telling her to “get her hands off me” at which point she jerked her hand away. I know that she was trying to be kind, but it was really quite inappropriate. In a way now maybe I should be grateful as it definitely put me into a different mood. Then she asked me if I wanted her to feed my daughter the bottle of formula, to which I again sternly replied “No. I don’t want you give my daugher her very first feeding.” As I think about it now it sounds harsh, but the woman had gone from being coldly efficient and behaving as if nothing was going on, to being intimately familiar with me and it was jarring to say the least.

Somewhere throughout this process I had taken a moment to call my parents, who had left for home before we had reached the pushing stage. My dad is a children’s pastor and had responsibilities at church that morning. When he answered the phone all I remember saying is something like: “please come back. Lindsey is in ICU.” and he said “we’re on our way” and I hung up. I didn’t realize it at the time but I hadn’t mentioned anything about the baby, and it wasn’t until he walked into the room and saw me holding her that he knew she was ok. During this time our pastor, Pastor Steve, had arrived. I learned later that they cancelled the 9 AM traditional service we hold so that he could be there with us. We settled in and I started to feel a little bit better. I was still holding onto my daughter, not letting anyone else hold her. One of the things that I knew Lindsey was really looking forward to was seeing the looks on her familiy’s faces when they got to see and then hold our daughter for the first time and so I think I was trying to hold on to a little piece of that moment by keeping her close to me.

Invariably my daughter did what newborns do - everyone in the room heard it - and while they all assumed it was gas I assured them that it was indeed more than gas, I had felt the force of it hit the diaper. That first diaper change didn’t go as smoothly as I’d like, but with my mother-in-law’s help we managed to get it changed with only a minor wardrobe malfunction. With my family all present, and our pastor present we took a moment to pray. I couldn’t muster much in the way of words, but what I said out loud to God was “Don’t, take her”. In my head I added a very loud and defiant f***ing between the don’t and take. Not long after we prayed a nurse came in and told me that I could go see Lindsey in ICU, so I left my daughter with my family and headed out.

ICU

The scene when I walked into Lindsey’s room in ICU was the most terrifying thing I have ever seen. Up until now I had been mostly angry with a decent amount of fear, and a whole bunch of sadness mixed in. But now, I was staring at the stark reality that my wife might not make it. If there had been cameras rolling the footage could have been used easily as part of an ER episode. There were machines with alarms blaring, and the room was full of people running around checking on those machines and changing things, and there was my wife, thrashing around on the bed frantically. I’m not a doctor, and I never played one on TV, but I am observant and most things are digital now which is definitely my area of expertise, so I quickly figured out that her temperature was over 103 degrees, her blood pressure was WAY too high, and her heart rate was over 200.

A large part of why they had asked me to come was because Lindsey was fighting the intubation so much that she had to be restrained, and they were still having trouble working on and around her. I found a small sliver of space next to her and touched her hand and started talking to her, telling her I was there, that they were trying to help her and that she just needed to stay calm. She clearly wanted the tube removed, but that was also clearly not an option as she was still coughing up fluid. While I was standing there I heard one nurse ask another to connect a tube for her, it was something to do with the ventilator. The other nurse replied that there wasn’t any room, she couldn’t get near enough to do it. When the first nurse asked again, more insistently this time, the second nurse once again stated that she couldn’t reach to help. This didn’t make me particularly happy, so I took a large step away from the bed to clear space and in a very clear and stern voice said “here, get in there!”. For a moment, probably only a second, the conversation in the room immediately stopped and every set of eyes turned to look at me. I think they were all deciding whether I was losing it and needed to be removed. I maintained eye contact with the second nurse and gestured to the spot I had just vacated, and she stepped in and connected the tube. The conversation in the room resumed and everything continued.

Ultimately the doctors determined, after doing I believe an ECG as well as a sonogram of her heart that the blood pressure, temperature and most importantly heart rate were all a result of the trauma to Lindsey’s lungs, and not caused by an underlying heart issue which can sometimes occur in women but only be exposed during the stress of childbirth. With a special PICC line installed which allows them to pipe an IV directly into her heart, they were able to deliver aggressive medicine, medicine which they couldn’t introduce into a standard IV because of the damage it would cause and the delay it would have on its way to her heart. I had to leave the room while they did that procedure, and by the time I was able to come back in later her heart rate had come down and she was stable - the room was dark and quiet, no machines blaring loud alarms. It felt like we had turned a corner but she still had fluid in her lungs and was having the ventilator breath for her.

That afternoon we met with the pulmonary specialist who had been called in that morning and was “quarterbacking” Lindsey’s treatment in the ICU. He told us that since she was young and healthy and since they had eliminated any underlying heart issue he believed that her chances of a full recovery were good, but that he expected she might need several days even up to a week on the ventilator. Little did he know that less than 24 hours later she would in fact be breathing on her own and shortly after that able to be discharged to a normal Mother/Baby room.

It would take the rest of the week before we were able to be discharged, and that time at the hospital was anything but easy. Between Lindsey being very weak from the trauma, her milk supply being temporarily halted before it had even begun, and our daughter Kaitlyn Denise being very colicky, we didn’t get much sleep. But the three of us were together, and Lindsey had survived.

Thats the second thing that I was most thankful for this year, that God didn’t take my wife. That he in fact allowed her to heal dramatically faster then any of the doctor’s most optimistic predictions.

Recovering

We had a lot of nurses and doctors who were very helpful, in particular Lindsey’s OB/GYN who came back into the hospital that Sunday morning because she had heard about what had happened and she wanted to review all of the charts and make sure Lindsey and I were getting everything we needed. She was heading to USC on Monday to drop her son off at college, but she gave me her cellphone number and got mine so that we could stay in touch, and the next day while in southern california she sent me several texts sharing updates she had received and generally staying in touch.

As far as understanding exactly what caused all of the trauma to Lindsey, we’re still not sure, and at this point three months later I don’t think we’ll ever know. The first explanation which we heard was that it may have been a rare reaction to the blood transfusion Lindsey had received. From the time she completed delivery until the time they started doing the D&C and started giving her blood she had lost 4 units of blood, which is quite a lot. However they did tests looking for the indicators of the rare reaction, and they all came back negative. The only other real theory that anyone at the hospital has been able to share at this point is that she may have just received too much fluid in too short a period of time. Between the blood transfusion, the other IV fluids she was receiving, and the apparently 2 bags of pitocin she was given during the D&C it may have overwhelmed her body leaving nowhere for some of the fluid to go but into her lungs. While I wish I knew better, and we will definitely continue to ask questions so that we can know what kind of risks there may be for a future pregnancy, right now we’re focusing on our perfectly beautiful baby girl.

The last thing that I said I was most greatful for at the thanksgiving table was the support of our family and friends. If my in-laws hadn’t been there when I was receiving the progressively worse news about Lindsey’s condition, or if my parents hadn’t been there through the rest of the day and then stayed the night in the hospital with me and Lindsey so my in-laws could go home to sleep for a few hours and shower before coming back on Monday - my mom spent the entire night in the ICU with my wife so that I could spend my daughter’s first night with her, and if it wasn’t for the strong arms and hands of our pastor and his wife, of the many friends who came to visit, and the words of encouragement and love I don’t know what I would’ve done.

When I was in the moment during the situation I couldn’t do anything but keep my head down and plow through it, dealing with each challenge as it came up. But looking back on it now I can see that God placed the right people in the right places to help keep me upright and then when I desperately needed food and sleep but wouldn’t give in to those needs in the right places to help me entrust my wife and daughter to them. I’m still struggling with the anger I feel towards God for allowing this to happen in the first place, but I can’t possibly deny his presence in helping us to get through it, and no matter how terrible it was, the prize of our beautiful daughter who we have been praying so desperately for was definitely worth it all.