"The Birth" by Papa Smith

The Birth

(As Recorded by Papa Smith)

Quinn Elliana Smith was born into the world on Wednesday July 20^th, 2011 at 8:25 am, weighing in at a staggering 6 pounds, 3 ounces.  As I write this, I am sitting at Research Hospital at 63^rd and Prospect in Kansas City, MO, and the temperature today was a scorching 104 F according to the radio.  I’ve been in the hospital now for several days and it didn’t even occur to me that it was so hot outside.  Hospitals are much like casinos in that you can spend hour after hour inside of one and never be able to tell what time of day it is, much less experience atmospheric conditions.  The nurses working the 12 hour shifts isn’t helping the time warp feeling either.

This all got started on Tuesday when we went to a scheduled appointment with the nurse midwives at Research Hospital.  The scheduled due date had been on July the 9^th, so according to that we were working on week 42.  Since we were overdue, the midwife said that she wanted to determine the fluid levels in the womb and so an ultrasound was scheduled to check it out.  I had the general feeling that she was going to make the call to go ahead and induce Maria, but Maria had plans on waiting until the following Monday.  Either way I had been getting pretty antsy to get this thing done since the longer we waited, the more inevitable it all seemed.  And I don’t mean inevitable in a bad sense, it was more like a feeling of dragging out the labor process for me since it was all the same kind of feeling of anticipation.  In the case of Maria, I don’t think that I could make the same comparison of the act of waiting for labor to the labor itself.

Once we finished the appointment, and learned that the fluid levels were low enough to justify inducing labor, we headed home to pack our bags for the hospital.  I loaded up the books that I knew we wouldn’t be reading, as well as the three pound grab bag of fruit snacks, granola bars, and Poptarts.  Once she told us that she wanted us back at the hospital by 5 pm, I had a split feeling of nervous anxiety and relief.  I had worked the morning, and was still partially in “work-mode”, so after she told us to come in, I had to completely switch gears and get myself ready for what was about to happen.  I think that what made me the most anxious was thinking about how disappointed Maria was that they wanted to induce her, and how I didn’t want her to build up this perfect experience in her mind that would outweigh the other important things that were going on.  She had been so excited about doing the birth naturally and on her own time that I was afraid that the change in birth plan was going to overshadow what else was going on around her.  I decided that I needed to commit myself to getting her to focus on the task at hand, and for her to realize that this was going to be a beautiful and life altering experience no matter how it played it out.

In the hospital, we were placed in one of the delivery rooms which consisted of a TV, a fold-out love seat, a rocking chair, and decent space.  It seemed about as large as our first apartment that we had in Union Hill, minus our ginormous walk-in closet that I still miss.  The bathroom also had a jetted tub in it but it would not end up being used due to the requirement for constant heart monitoring of the baby.  I did have the temptation to slip away at times and take a nice bubble bath to really “get the stress out”, but I decided that doing so would send a bad message to my laboring wife.  Our first nurse was very nice, but after learning of the coming shift change at 7 pm, I began to get nervous that we were going to get stuck with some terrible nurse who had been sequestered to the nightshift for the last 20 years.  The last thing I wanted was for someone who really hated her job and/or life taking care of Maria while she labored.  These fears were not well-founded however when it turned out our night nurse Alexis was really good.  In fact, all of the nurses with the exception of one socially awkward nurse from the NICU were amazing.

The first eyebrow-raising moment of the night occurred nearly right after arrival.  Maria was laid down on the hospital bed and was strapped to a baby monitor.  Immediately after being administered an IV, Quinn’s heart decided to take a little break and clock in at around 70 beats per minutes for a stretch of time.  She had been normalizing at around 130 bpm, so it was a pretty drastic change.  All I could do was to look up at the stupid monitor and feel absolutely helpless.  Several nurses came in to check on the status of the situation, and all I could think about other than what was causing the technical blip was my feeling of helplessness.  I knew that there was nothing that I could do to make a difference in Quinn’s heart rate, and it was a feeling that I slowly began to accept over the course of the night.  A part of me felt like monitoring the heart rate was overkill and that it was just something unnecessary to make everyone nervous.  In reality I think that it just made me nervous, and since I didn’t like it I wanted to blame something else for making things worse for everyone.  It reinforced to me the feeling that this whole event was incredibly fragile and out of my control.

After the drop in heart rate and her recovery, we were told that Maria would have to stay on a heart monitor for the remainder of her delivery.  I expected pushback from Maria since this was a big change to her birth plan, and sure enough I was not disappointed.  At this point I decided that I needed to help Maria realize that it was ok if something changed and it wasn’t going to be exactly as she planned.  It helped that I had mentally prepared for this after learning about the need to induce, so I tried to be a calming and rational force for Maria.  Again, I felt a little like a band aid on a severed limb, but I tried my best to offer a rational voice to her that said there could be multiple paths to the same amazing outcome of a new addition to our family.  I will also note that at this point I was officially entering survival mode for the remainder of the labor.  I had also yet to really dwell on what was going to be happening on the other side of all of this, that I would be holding an incredibly fragile and beautiful person.

The nurse put in the Cervadil at 9:15 pm on Tuesday, and consistent contractions promptly followed at 9:30 pm.  Our hope was that the Cervadil, which is meant to soften the cervix in preparation for delivery, would get the labor jumpstarted and Pitocin would not be required.  We were told by the nurses that this was a possibility, but not to get our hopes up.  The Pitocin was what Maria really wanted to avoid.  This was the drug that usually started the intervention process that was hard to alter once it starts.  The story goes that Pitocin causes more powerful contractions, which causes more pain, which usually creates a demand for an epidural, which in turn requires more Pitocin to incite the necessary contractions for birth.  From what we knew, this cycle usually ended up with a dramatic increase in stress on the baby and mom, and also leads more easily to a C-section.  This is what Maria had built up in her head as a symbol of failure for herself, and it was an outcome that I was prepared to help her accept if it was necessary.  Luckily however, the Cervadil did the job and the remainder of the birth would be without interventions.

The first two hours after the Cervadil was administered was actually pretty tough for Maria, but it wasn’t due to strong contractions.  To get a proper baseline on Quinn’s heart rate (I think), Maria had to lie still for two hours, without even going to the bathroom.  I immediately felt like this would be impossible for her since I knew she was unable to go one minute without either applying lotion to her hands, going to the bathroom and peeing for two or three seconds, or layering her lips with chapstick.  Movement is a part of her DNA, so I knew this would tough.  While I said that I was already in “survival-mode” at this point, I was briefly lulled into a false sense of comfort during this time since she was laying still and the contractions were not intense.  I allowed myself to watch half an episode of Conan O’Brien, which unfortunately only served to take my mind off of the task at hand, which forced me to refocus later on.  I also had the idea that I was going to be able to get some sleep that night too, which looking back now is pretty laughable.

After the two-hours of stillness came and passed, things started to progress pretty quickly.  I began to feel like this thing was really going to happen, and I decided that I was going to treat it like a project.  I just needed to get Maria through each contraction and avoid passing out myself, and then at the end we would be given a baby.  The baby at that point was still a drastically different idea to me than it is now as I write this.  The “baby” idea still felt more like something that was just going to be happening, and that I had accepted up to that time as a thing not to be understood, but simply accepted.  As I found out later, the understanding did not come for me until sometime after the birth, when I was alone in the hospital room holding a swaddled child and watching her stick out her tongue at me over and over again. 

By 2:30 am, Alexis has checked Maria’s cervix and she was dilated 2 cm.  This was progress since at the appointment earlier on Tuesday she was dilated only a fingertip.  Again, I felt like this was a project.  I was able to report progress to my superiors, and perhaps I could put this on a nice progress curve, showing hours of labor spent versus total projected labor hours.  At the end of the hours spent, we would be able to have a nice little payout to show for all of our time spent.  It was the only way I could apportion my thinking to avoid thinking about the things that I couldn’t control.  After the 2:30 check, the labor kicked it up a notch.  Active labor had begun and by 6 am, Maria was 4 cm dilated.

This was an important time for us since 6 am was when Maria was to be put on Pitocin.  Her progress to that time would be key in order to show that the Pitocin was unnecessary.  I was tempted to pull out some progress curves that would show to the nurse that more labor was achieved in less hours spent!  This would prove we were ahead of schedule and no interventions would be needed.  Luckily I didn’t have to look like an idiot in front of all the normal people in the room since the nurses agreed that the Pitocin was not necessary.  By this time I was beginning to look at Maria in a different light.  The uncomfortable contractions from earlier in the night had given way to intense and debilitating labor pains.  It was hard.  The look on her face was painful to see, and part of me resented this thing was happening.  It’s not that I resented Quinn, but it was more of a Biblical resentment.  As in, “Man will be forced to work the land, and women are cursed with the pains of childbirth”.  In a small way, it was the same feeling that you might get when you go to work in the morning to that job that you really hate.  A feeling that we have left the Garden of Eden, and something in this world is not right now that we have chosen to abandon God’s original plan for our existence.

The time from 6 am until around 7:30 was very hard to witness, and I shudder to think about the pain that I watched the woman that I loved experiencing.  I was incredibly relieved to hear that when the nurse checked her at 7:30, Maria was 9 cm dilated, and nearly ready to start pushing.  It was good to know that all of the work she had done had gotten her to this point, and selfishly I was relieved that I wouldn’t have to watch any more.  Our Doula, Ashleigh Smith, had arrived at around 5 in the morning, and did an excellent job calming us both down.  I had been trying to encourage Maria to vocalize her pain, while Ashleigh brought her back to an expression of breathing.  This turned out to be fortuitous since I am sure the vocalization approach would have rendered her voice-less by the end of the ordeal.

It was also during this period of transitional labor that I kept sneaking a peak at the relentless pulsing of Quinn’s heart across the monitor.  There had been a few more drops in heart rate, and although I didn’t quite know exactly what it all meant, I was growing more alarmed by the increasing amount people who were making appearances in the birthing room.  Initially I was annoyed because I thought they were all nursing students who wanted to see some action.  I would learn afterwards that the head nurse from that morning had made the call to have the NICU team at the birth to assist if required.  The drops in heart rate that we were seeing on the monitor were being caused by a compression of the umbilical cord as Quinn sloshed around in the primordial ooze of the womb.  Specifically, the cord was short and it connected to the bottom of the placenta instead of to the middle of the organ.  The connection point was also stratified with multiple blood vessel connections branching out more like Spiderman’s webbing instead of a tube, which increased the risk of compression.  An additional and extremely rare complication was that umbilical cord was interwoven through the water bag that held the baby, amniotic fluid, and the placenta.  Most of this we would not find out until after Quinn was born.

As the 8 o’clock hour approached, Maria was talking about the urge to push.  While this was somewhat of a relief that the end was in sight, it was disheartening that the midwife that would be delivering the baby was stranded on Bruce R. Watkins freeway instead of standing in the delivery room.  Maria had labored so quickly towards the end that the midwife was caught off guard, and Maria had to resist the urge to push throughout several contractions. 

When the midwife finally walked in (and I managed to avoid dropping an F-bomb in relief), things immediately transitioned to an urgent scene, one in which getting the baby out was the utmost priority.  The heart monitor for Quinn was all over the board, and I spent all of my efforts getting in Maria’s face and repeating the midwife’s call for pushing.  I think Maria must have pushed with all of her might and then reloaded with a series of breaths at least 8 or so times.  This was painful to watch (probably not as painful as it was to pass a six pound object out of one’s private parts) and I was praying that it happen quickly.  This was also the first time that I was concerned about the baby’s health more than Maria’s.  It had dawned on me that this was serious for Quinn, but that I felt like even in the midst of Maria’s pain, she could do this. 

My feelings of fear proved legitimate when the head finally emerged and Quinn’s umbilical cord was wrapped firmly around her neck, restricting both oxygen flow and the final passage out of the birth canal.  I did not look down to see this.  Besides knowing that I would most likely get sick or faint, I did not want to think about what was happening down there.  I did not want to think about the idea of Maria giving birth to a baby and then watching as it dies in a crowded delivery room.  I think that I went back to the idea of working on things I could control and help.  I could keep looking Maria in the eye and keep her focused, telling her she was doing an amazing job and that she had given birth naturally, just how she had intended.  What I could not control or help was the breathing of a little baby who had been rushed immediately to a warming table and swarmed by staff from the NICU.  I did not know all of the details at the time, but I knew it was bad since I did not hear any crying.

After a painful five minutes, I was taken over to the warming table that was still in the delivery room where I watched a man squeezing a breathing apparatus into Quinn, helping her to receive Oxygen.  The team was working frantically around her to make sure that all of the vital signs were positive before they took her off to the NICU.  As I remained there in the delivery room, Maria had to painfully deliver the placenta and had it pulled from her since it was stuck.  All of this added insult to injury since Maria and I were still clueless as to the status of little Quinn.  The only thing that we had going for us was that Maria was still in a state of delirium from all of her efforts, and that provided a much needed distraction from the other much worse pain that we could have been embracing.  It wasn’t until our midwife returned to the delivery room and gave me two thumbs up that I breathed a sigh of relief.  She told me that once in the NICU, Quinn had start crying so hard she spit out the breathing tube they had inserted down her throat.  In another hour, we would be holding Quinn in the delivery room and Maria would be giving Quinn her first breastfeeding.

Now, as I am finishing this narrative four days later, I am sitting in my living room at home with a healthy baby Quinn and a healthy Maria, as well as two hairy and healthy dogs.  It is amazing to me how life seemed so incredibly fragile in those moments and how now I can already feel the miracle starting to fade in my mind.  New miracles are taking its place on a daily basis, but the miracle of Quinn’s birth seems somewhat distant already.  It almost seems symptomatic of the human condition towards all of God’s gifts.  Just like a politician, we have a “what have you done for me lately” mentality that is hard to break.  We are all wandering in the desert.  We spend a moment to praise Him for all that He has given us, then there are periods where we intermittently believe the truth that we once knew so well, and then we make room for distractions, which finally leads to a permanently foggy image of the once beautiful miracle.

As I reflect back on my emotions from that night, and my feelings up till this point, I can say with all honesty that I have felt alive.  I have felt like a part of the spiritual and natural world like I never have before and I feel lucky to have been a participant up to this point.  I look forward to the coming days to see what other new levels of participation I will get to experience.

 My first time meeting little Quinn.