The Process of Emergence

It's been two weeks since Santiago's birth and I finally feel like I'm starting to re-enter the world.  I can't describe my emotional state over the past two weeks, for it would require taking so many conflicting emotions, pumping them full of steroidal intensity, and then mixing them into one explosive firework.

I found myself crying one morning because I felt my stomach rumble and realized it wasn't Santiago who was making my insides turn.  I felt such a tremendous sense of sadness and loss -- so lonely, empty, and alone.  I struggled to make sense of this feeling while simultaneously feeling such indescribable elation at having him on the outside where we can see him, touch him, smell him, and hear his screeches and murmurs.  How do those two emotions exist together?

The pain following the c-section, along with side effects of medications made me feel hopeless, miserable, and dejected.  How to reconcile these feelings with the overwhelming surge of love I felt when my son farted, shot pee across the room, or snuggled his head into my shoulder?

The pain, soreness, and tenderness associated with those first few days of breastfeeding made me scared to nurse my own son and dread those moments.  At the same time, I felt an indescribable urge to nurture him, provide for him, and give myself to him.

It's hard to comprehend how such intense highs and lows can exist simultaneously and I think that efforts to comprehend those contrasts only make them more perplexing and vexing.

I am starting to feel better though.  So many of the lows are diminishing in intensity or disappearing altogether, which leaves me more time to experience the emotions that I want to feel -- joy, love, awe, togetherness.

I think so many of those emotions began with Santiago's birth.  My sister suggested doing a birth interview as cathartic experience and so that I could look back on the experience in the future without losing perspective from the moment.  So below is my own recollection of Santiago's emergence into the world, which I hope will help me in my own process of emergence into motherhood.

Santiago's Birth

I started having consistent, relatively strong contractions on Saturday morning around 6am.  I emailed my sister with the news:  8 to 10 minutes apart and lasting anywhere from 45 seconds to 90 seconds.  Could this be the beginning of labor?  Contractions progressed through our Christmas tree cutting outing, a smoothie/iced coffee excursion with cousin Diego, and a romp with the dogs.

By 4pm contractions were stronger, lasting a minute, and coming every five minutes.  After an hour or two of this, we'd been told it was time to head to the hospital since I was likely to be 6-7 centimeters dilated.  By 7pm we were at the hospital and I was hooked up to the little machine that monitors baby's heart rate and contraction intensity.  The nurse examined the print out after a half hour of monitoring, proclaiming that the contractions were textbook and strong -- I was having two within a five minute period.  Based on the strength, length, and frequency of contractions, the nurse was as surprised as we were when she announced I was only one centimeter dilated.  My heart fell.  If it took me 13 hours to dilate one centimeter and contractions were as strong as they were, what would it take to dilate another 9 centimeters?

I should back up now and explain that Ernesto and I took childbirth education classes in preparation for labor.  I went into this labor super confident in my ability. And I thought I had genetics on my side.  My mom spent four hours in the hospital before giving birth to my sister and me.  Emily spent something like six hours in labor after arriving at the birth clinic with Isabelle.  My hips are wider than both of theirs, so I was naturally assuming that not only would I have a relatively easy, fast birth, but that the baby would come out even more easily given my gigantic pelvic girdle.

So when I heard one centimeter, doubt began to creep into my mind.  The nurse assured us that some women started slowly and then dilated five centimeters in an hour.  She left us, called our doctor, and we continued to work through contractions.  Two hours later, my doc arrived and examined me.  Three centimeters.  He gave us a smile, said it would probably be a long night, and that he'd see us in awhile.

They moved us to a private room and we spent the next six hours in a liminal state.  By midnight, we were both pretty exhausted and I told Ernesto to take a nap while I listened to a Hypnobirthing CD that my sister had given me.  It was super helpful and I was like a Zen master for the next two hours, completely surrendering to the contractions and breathing fairly easily through them.  I'd spend 20 minutes each hour in the shower, which helped tremendously.  By 2am, Ernesto was awake again and helping me through the contractions.  It was an amazing time where we were calm, working in tandem, and feeling so hopeful for Santiago's arrival.

While those hours were amazing, they were also cumulatively part of what had become a very exhausting and long labor process.  My back ached between contractions from tension and holding certain positions for long periods of time.  My eyelids felt like heavy weights constantly threatening to descend.  My legs were shaky and achy and sore.  More than anything, I wanted to sleep.

Around 3am I was back in the shower when I felt a "pop" and knew my water had broken.  Ernesto and I celebrated and Ernesto ran to tell the nurse, who told us that labor would likely progress more quickly.  Not more than a minute later I had the next contraction and it was worlds different from the contractions I had previously experienced.  This contraction was so intense, so painful, and so all encompassing that I lost all memory of Hypnobirthing, relaxation techniques, or breath.  It was simultaneously the most embodied and out-of-body experience of my life.  I had never been so aware of my body or what I was feeling, yet the pain was so overwhelming that I simultaneously found myself viewing the situation from afar, as if to separate my mental self from my physical suffering.

Never in my life did I imagine that a human body could consciously endure that type of pain.

I had previously told the nurse that my contractions pre-water break were about a 6, where 1 was no problem and 10 was the worst pain of my life.  After experiencing the first post-water break contraction I quickly had to revise my scale.  The previous contractions felt more like a 2 on the scale, and the new contractions felt more like a 99.  Or if I had to stick to the 1 to 10 scale, then the previous pain was more like a 0.005 and the newer pains were more like a 9.9.

I thought I might be in transition -- that period when the cervix dilates from 8 to 10 centimeters that many of my female friends have told me is the only part of labor where they felt they might lose control.  Despite the pain, I was hopeful.  I could manage another 20 minutes or hour of these contractions if that was it, right?  I was doubtful that I would even hold on that long.

I looked at Ernesto after that first contraction and tried to catch my breath.  I was about to express to him my hope that such strong contractions must signal transition when the next contraction hit, about 30 seconds later.  I was still in the shower, semi-screaming, and clawing at Ernesto like a desperate animal.

When I used to teach introductory anthropology classes, I always stressed to students that humans are animals and that accepting this basic truth could drastically change one's perspective regarding ecological interactions.  Never in my life have I felt more like an animal than in the hours following my water breaking, but  I felt less like a primate and more like a rabid dog.  Ernesto became my world, my punching bag, my hope, my home.  I crawled on him, clung to him, clawed at him, and tried to hide within him.  Anything to escape the pain.

I think I made it through three contractions before panting for an epidural.  Ernesto relayed the message to the nurse who set out to find the anesthesiologist.  The nurse also told me she'd need to do another exam prior to the epidural.  I gritted my teeth as she did the cervical exam through a contraction and let out a whimper of desperation when she said I was only 4 centimeters dilated.  FOUR CENTIMETERS!  How can it take 21 hours to progress four centimeters?  Why was I having such intense contractions with so little dilation?  If things were this bad at 4 centimeters, what on earth would transition bring?  These were the thoughts that led to my undoing.  The remaining contractions I experienced pre-epidural were epic.  I had lost all concentration and focus.  All relaxation techniques seemed absurd and so unrealistic.  It was a sense of hopelessness I hope never to experience again.

The next hour was a blur as we waited for the doctor.  The nurse encouraged me to get back in the shower, which I wouldn't do without Ernesto.  We were still in the shower, Ernesto's back being wrenched in every direction imaginable, when the anesthesiologist arrived.  I didn't even bother to dry off.  I went hobbling to that bad butt naked and dripping wet.  The doctor was very kind, trying to explain to me how I needed to bend my back in order to inject the epidural.  But I couldn't really hear.  The contractions were so close together that I was too distracted to listen and it was clear that he would have to do the injection during contractions since they were coming to quickly.  He was able to inject the numbing agent without problem, but inserting the epidural was more challenging.  I kept moving, causing the needle to slip and medicine to go shooting through different parts of my body.  I don't know how long it actually took for him to successfully inject the epidural, but when I felt it work it was one of the most surreal moments of my life.  And possibly one of the best.  To have relief from such excruciating pain is something of a miracle.  My teeth chattered, my muscles spasmed, and I was dripping sweat from the pain, tension, and relief.  But I was smiling.  I'm not the touchiest person in the world, but once the epidural was in place and I was lying in bed, I looked at that doctor, put my hand around his waist, pulled him close, and started petting him as I thanked him over and over again for helping me.

I spent the next two hours trying to release all of the attention that had accumulated over the previous hours.  I was exhausted.  I had been exhausted before my water broke, but the last hour had really taken its toll.

By 5 in the morning, my OB was back, surprised that I was dilating so slowly.  He did another exam and I was up to 6cm, but Santiago has missed the "wave" and failed to drop when my water broke.  He was still sitting very high in my uterus and the doctor was doubtful that my cervix would fully dilate, or that he would drop down.  He said he'd give me another hour to work but that if nothing significant changed it was time to do a c-section.  At that point I didn't care.  I just wanted a healthy baby.

By 6am I hadn't dilated any further and Santiago hadn't dropped at all.  The call was made to do the c-section.  After prepping me and wheeling me into the operating room they strapped my arms down like a mental patient.  I understood why after they injected the anesthesia, which caused my teeth to chatter and my arms to shake uncontrollably.

The saintly anesthesiologist stayed on my end of the curtain through the c-section, explaining to me what was happening and what I would feel at different points during the delivery.  When it was time to pull Santiago out he told me I'd feel strong pressure when I exhaled, and indeed I did.  I could feel them prying the little guy from my body.  As they were preparing to extract Santiago, they told Ernesto to come take pictures.  Ernesto said he could hear Santiago crying before they had actually removed him from my body.

They removed the drape for a few seconds so I could see him be delivered in a way that strives to mirror what a woman might see who gives birth naturally.  I don't remember much of that moment.  I was so overwhelmed, so relieved, and so confused by the little writhing, crying creature in front of me that I couldn't process much.   I don't know how much time passed before the pediatrician returned with a cleaned up version of Santiago for me to examine.  I only got to see him for a minute or two before they whisked him away to the incubator to warm him up.  I laid on the operating surgeon, listening as the two doctors chatted away and stitched me up.

The doctor told me that Santiago was posterially positioned -- meaning that his spine was directly against mine, which makes labor much more painful and delivery more difficult as a much wider circumference of the head emerges first.  The doctor assured me that between my dilation issues and his position (both his failure to drop and his posterior position) that it was incredibly unlikely I'd have delivered naturally no matter how much time they gave me or whether they'd tried to induce me.  I felt a bit better.

From the operating room I went to recovery, still shaking uncontrollably and incredibly cold.  I was so tired, but so desperate to see Santiago.  I knew if I fell asleep the nurse would let me sleep, which would only prolong my initial moments with him and delay further his first feeding.  So I struggled to stay awake, shivering and smiling so the nurse would think I was okay.  She wasn't fooled.  She made me stay in recovery for 90 minutes.  My only consolation was that I knew Ernesto would not let Santiago out of his sight or touch.

As they were wheeling me out of recovery, back towards our room, a nurse approached with a little white bundle.  I didn't understand what the nurse was giving me until I saw Santiago's face emerging from the tightly swaddled bundle.  And in that moment it didn't matter that I'd labored for 24 hours without success, or that my body was a giant knot, or that I had a huge incision in my pelvis, or that I was ridiculously tired.  All that mattered is that I had this tremendous gift in my arms and that he was healthy, strong, and perfect.

Since then I've struggled with recovery.  The c-section wasn't something I bargained for and I hadn't properly researched recovery strategies in the event of a cesarean.  It's been a long two weeks.  The pain has been intense.  The fatigue a complicating factor.  The breastfeeding a challenge to figure out.  But things are getting better.

I still can't pick Santiago up on my own, or change his diapers or clothes, or stand up with him, but I've realized that I don't have to be able to do those things to be a good mom or to love my son.

It helps that I have an amazing partner and in-laws to help with this transition.  Ernesto changes diapers, adjusts Santiago for feedings, removes him after feedings, and changes his clothes.  Aside from providing so much care to our son, he's taken care of me too.  He's brought me my food, my water, and my medicines.  He's dried me off after showers and helped me change my clothing.  He's positioned the step stool and held my hand so I can get in and out of the car.  He's rubbed my back when I feel nauseous and sat quietly with me when I just need someone near me.


After two very intense weeks I can draw several conclusions:

* I married an amazing man who has proven himself to be a very devoted partner and spectacular father.
* Ernesto and I somehow managed to produce a perfect little healthy baby boy
* Wide pelvic girdles mean very little if everything else isn't functioning in tandem
* My opinion of epidurals has changed drastically.  My friend Jennifer ended up getting an epidural and I remember she felt sheepish about the decision, but also said it was a top 10 decision of her life.  I concur, but don't feel sheepish.  That level of suffering can't be good for anyone.  The amount of stress hormones being released through the body when in that much pain surely has a negative effect on the baby that is equal to, if not more detrimental than an epidural.

So here we are, two weeks post-birth, caring for this precious little gift of a person.  And here I am, thinking that if there is a God, then it surely must exist within Santiago.  And in the end, a gift like Santiago is worth all of the c-sections in the world.