NATHANIEL'S BIRTH
Nine short months have passed since Nathaniel's birth. He is a sweet-natured baby, very placid and incredibly patient. Just like his father. There is no hint in his nature of his traumatic birth. As we are natural family planners, and my cycle was very predictable, I knew at only three weeks that I needed a pregnancy test. My husband (Gh) and I were overjoyed when that faint pink line appeared on the test. This would be our fifth child; two in nappies and all under ten. I began to brace myself for another long sojourn through pregnancy. My due date was 7th January, 2003. At sixteen weeks, I took those first few official pregnancy steps and visited an obstetrician recommended by a couple of close friends. They did tell me that he was a little 'laid back', but all the same, they thought he would suit me. Boy were they wrong! Yes, he was very pleasant and relaxed. He, however, required me to strip down to nothing for the initial examination. I clutched anxiously at my bra hoping to keep some semblance of dignity but alas that was to go with the rest of my attire. Some women might feel fine about this form of 'thoroughness', but for me, having nursed people and respected their vulnerability, I was not at all impressed. So, after consulting a midwife friend, I transferred to another obstetrician (Pob). He seemed just fine. Apart from my routine discomforts and sleeplessness, my pregnancy had coasted along nicely. There was no sign of the blood pressure problems I had in previous pregnancies. I recall more than once saying to Pob 'There's got to be a catch'. And there was. At thirty-eight weeks, Pob remarked that I was carrying high, as usual. But he seemed to stop and rethink. A quick ultrasound confirmed that my baby was breech. I knew immediately that this would mean my first caesarian section. I cried from shock, from fear and anxiety. Pob meanwhile found the necessary paperwork. I filled out the forms and even went straight to the anaesthetists' rooms, all the while in a state of disbelief. I had not counted on major abdominal surgery being a part of my baby's birth. The c.section was booked for the end of that week. I went into hospital the evening before, as I was quite anxious. I knew that a caesarian section wasn't to be undertaken light-heartedly and it pains me now to hear of women requesting this proceedure for convenience or to avoid the pain of birthing. That night, a final ultrasound estimated my baby's weight (wrongly as it turned out) at 11 lbs 1 oz. And of course he had turned! After some discussion with Pob, we decided to go ahead with the c.section as planned, because of the unstable lie factor. The alternative was to wait a week or more in hospital. The next morning I woke at 6.30 and was promptly seen by a rather bleary-eyed anaesthetist. Pob came in soon after and felt my abdomen. He now thought that baby was transverse. I was becoming more and more uptight by the minute. Gh was with me the whole time and was quietly reassuring. Down in theatre I was pleased to meet the assisting doctor, who was a semi-retired obstetrician. His name was always mentioned with great reverence and affection. I felt some comfort knowing he was there but I still had a great sense of unease. As the spinal anaesthetic was administered, I was able to look out a window. I remember seeing a woman walking her dog over vacant land. I longed to change places with that woman. I was soon brought back to reality when my blood pressure suddenly went up. It was brought down with some pharmaceutical intervention and I immediately vomited. Gh arrived soon after, dressed in his glamorous theatre gear, and was seated beside me. The procedure began. You make me feel like a natural woman (ha ha) was playing in the background. Pob was telling us what he was doing step by step. Suddenly there was nothing. No music, talking - nothing. The only thing I remember was the occasional mumble from the obstetricians. I really have no idea how long it was until my baby was born. They didn't give me my baby right away. A pediatrician whisked him aside. Pob popped his head over the still-raised screen to explain what had happened. Apparently as he cut transversely through the wall of my uterus, he had severed an unseen venous sinus. It was about the size of two thumbs put together. I had suddenly started to haemorrhage. The older obstetrician assisting later told me that in all his years of practice, he had never seen so much blood. In order to stop the bleeding, he had to make another incision to get my baby out quickly. This second attempt failed, so the only option was a vertical, or classic cut. Pob was then cutting blind due to the large volume of blood I was losing. He went on to explain that on the second attempt, he had actually cut my baby. My beautiful Nathaniel was born on 3/1/2003 and in pain. He sustained a 12 cm laceration across his lower back, as he was in breech position at delivery. He would need surgery that afternoon to suture the wound. His respirations were slow after birth ( apgar scores were 5 and 7), so he needed oxygen for several hours. He weighed 9lb 5 oz. So much information was hurled at me in a very short time. First, I was told of the haemorrhage and my babe's laceration. Then Pob told me about the vertical incision. This meant no more vaginal births. Next I was told that Nathaniel might need to be sent to a city hospital a couple of hours away for his surgery. He would need a general anaesthetic and we would be separated. All this information was given while I was still in theatre. I remember feeling confused, dazed and just wanting my son to be OK. I was soon able to hold him for the shortest time. After some quick photos, they took him away from me again. I didn't get to breastfeed him in recovery as planned, and he didn't get his first bath for another six weeks. A lot of joy was taken from me. I don't blame anyone. It's just that it didn't seem the same as my other babies' births, no matter how difficult or frightening they were. Gh was quiet and detached. It was his way of coping, and I understood that. But even now I feel guilt that we didn't feel elated as little Nathaniel entered the world. We did with our other babies. For him there was only shock and concern. Pob spoke with us in recovery; he seemed genuinely upset and worried. He apologised, and it was easy to forgive. I told him it wasn't his fault. And I still hold to that. After spending an eternity in recovery, unbearably itchy and with uncontrollable shaking, I was wheeled back to the ward and shown Nathaniel in the Special Care Unit. I have been asked by some to try and explain how I felt at this time. But how does a mother describe her feelings at such a moment? Perhaps 'devastated','helpless' or 'shocked' would convey something of my pain, but in truth these words seem hollow and inadequate. I was a mess. Surgery was planned for the afternoon, and as it meant the risk of a general anaesthetic, Gh and I decided to have Nathaniel baptized. This was a big decision. Usually our baptisms involve a whole day's celebration with many friends and family. Nathaniel's rite took place in the Special Care Unit with only a nurse present. I was in bed recovering and Gh was dealing with four children at home. Just another joy that was taken from us. As it turned out, Nathaniel needed only a caudal anaesthetic, for which I will always be grateful. He went to theatre five hours after birth. I'm a little vague on details - everything seemed so surreal at the time. There were moments when I had forgotten that I'd even had my baby. Yet another issue to feel guilty about. I didn't get to see him until late in the evening but I was allowed to breast feed then. One wonderful blessing was that I had plenty of milk for my new arrival. I had been comfort-feeding my two year old right through the pregnancy (despite my protests and threats to wean him), so my milk supply was fine, and Nathaniel didn't have to feel the pain of hunger. Pob came to see me several times that first day. Each time he updated me on Nathaniel's progress. He didn't disappear and let others cover for him. He was diligent in his care. I'll always remember his final visit that day. The worry and devastation that he was feeling was very evident, and in a strange way, it helped me to cope better. I knew that someone else was suffering too. I'm also grateful to the wonderful midwives who cared for me. One in particular (Dmw) showed great concern for Nathaniel and me. She was there for his surgery, dressed his wound and encouraged me to cope. And there were days when this was a real challenge! I owe her so much. We have stayed in contact and I have promised to keep her up-to-date with Nathaniel's development. Nathaniel and I were in hospital for fourteen days. His wound broke down on day three. It had gone from being nice and clean to green and sloughy. It had to be packed twice a day as it was gaping on the right hand side. His skin also developed a rather nasty reaction to any tape that would offer aid in his wound's healing process. As a day three mum, everything seemed to be going from bad to worse. I refused to look at the actual wound for the first week and a half as it was too much to cope with. Dmw patiently and quite determinedly waited for me to pull myself together. I did, but it took time. For as long as Nathaniel was wrapped up and not crying I could forget that I had an injured baby. There were also times when I was frightened of my new babe. How should I carry him? Would he hurt if I held him like I did my other newborns? When he cried was it hunger or pain? Which was the best feeding position? What was comfortable for me may not have been for him. Should he lie on his tummy for so long? What about that as a risk factor for SIDS? There was so much to worry about and so soon after my own surgery. Day nine came and I started bleeding quite heavily. I thank God that I was still in hospital. I had another ultrasound, then went on antibiotics as did Nathaniel, for his infection. Issues regarding his weight loss were pressing as well. He had lost nearly 700gms as all his energy was being poured into healing. Luckily, my abundant supply of milk was the life-line so we were discharged on day fourteen. It was with some angst that I took over his dressings at home. And it wasn't until my mother fell apart at the sight of his wound that I really pulled myself together and got on with the task at hand. Nathaniel needed care and there was no point in everyone around him dissolving into tears. Pob also offered to have his staff dress Nathaniel's wound every other day. This was a relief for me as I didn't want to take sole responsibility for his wound. I felt that I would never forgive myself if something else were to happen to him. It took six weeks for Nathaniel's wound to heal. He is now feeding well and putting on weight. He often smiles and laughs. I think it is only now that my husband is starting to sort out how he feels about the whole situation. I felt so sorry for him at the time. He was dealing with four very lively kids at home, an unstable job situation with all its politics, an elderly mother, an unwell wife and a new babe with an injury. Something or someone had to give, and I understand that. Quite a few people have asked me if I regret having a c.section. With some thought I have to say no. There are no guarantees in life and at the time, it seemed to be the safest option. I now know that the chance of both the bleeding and the laceration happening together was greater then one in a million. I do however sometimes wonder if I had the c.section unnecessarily. I was after all only 38 weeks and I was still carrying high. Given a week or two or three could Nathaniel have turned? Shoulda, woulda, coulda........ hindsight can be torturous. There is also another unfortunate aspect to this whole story that will never go away for me. Because of the inverted T incision made into my uterus and because of the threat of another significant bleed, I have been told now by two doctors that I cannot have any more children. Some people may say "Well, you've already got 5", but to me this is devastating. I love my children; each and everyone of them and I was quite prepared to welcome another should God wish it. I never, never thought that I would have my fertility taken away from me so quickly, so suddenly. I am now savouring each precious moment I have with my baby Nathaniel and in turn I mourn each passing laugh, each midnight feed as I know that these times will soon end. But, after all is said and done, I have my baby boy and he only has a scar as a legacy of his trauma. It could have been so much worse. I know I could have chosen to find fault, but it is somehow easier to forgive and understand. I am grateful to my doctor for his support, to my husband, my wonderful friends and family and to God in whom I will always have unwavering faith. Thank you for sharing my journey. SAS. The Weaver My life is but a weaving Between my Lord and me, I can not choose the colours; He worketh steadily. Oft times He weaveth sorrow, And I in foolish pride Forget He sees the upper, and I, the underside. Not 'til the loom is silent And the shuttles cease to fly Shall God unroll the canvas And explain the reason why. The dark threads are as needful In the Weaver's skilful hand As the threads of gold and silver In the pattern He has planned. Author unknown
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