028

james is here, and he lies on my lap right now like an unreal homunculus.  he is floppy and bright-eyed, bundled up in a pale yellow hospital swaddler that makes him look like a tiny glowworm.  it is now- and not a moment earlier- that i fully appreciate how little i know about babies, how very unfamiliar with infants i have always been.

a steady diet of norco has tamped the pain of my c-section recovery to a perfectly manageable 3, so i've been thinking a lot about how to write this birth story.  i've read a lot of birth stories.  the entirety of my third trimester was spent eating tuna sandwiches while perusing every submission in the history of /r/babybumps.  i lurked an infinite ring of pregnancy journals, bracing myself for the best and the worst.  i watched the fellow pregnant ladies of my birth month club topple into labor & delivery one after the other like a lineup of pre-term and early term dominoes.

and i thought about inductions.

when the night and day shift recovery nurses tag one another in, they swap the cliffsnotes of james' birth through a quiet conference in a corner of my recovery room.  a few times, i overhear induction at 39+5 for chronic hypertension.  my blood pressure has been fairly well-controlled these past nine months, through my valiant efforts to actually stay compliant to a prescription regimen for once in my life.  towards the end of third tri, however, the combination of steadily lower amniotic fluid and a couple of elevated blood pressure readings started building into a general sense of unease.  nervous about possibly going to late term, fretting about dr. cubitt's characteristically blithe description of cord compression under low afi, i approached dr. grisham about induction.

"by 39 weeks, i feel like he's safer out than in," i rationalized my first big episode of nervous mothering to my no-nonsense obstetrician.  all the natural is best mothers in my birth month club balked fiercely at the entire concept of induction, but i did not have to work hard to persuade dr. grisham.  we scheduled for august 1st, two days prior to james' estimated due date.  i felt weird and guilty about eschewing expectant management, but knew i'd feel weirder and guiltier if i went overdue and anything adverse happened to little man inside my wretched body.

but in service of research and with respect to the innate mysticism of childbirth, i asked for ripening and made every effort to gear my cervix to a more favorable state for induction.  by the time sunday the 31st rolls around, i have done the most.  i have shamefully and unscientifically inserted sticky suppositories of evening primrose oil, only to have promptly ruined my sheets.  i have solicited prostaglandins from ian.  i have waddled around my clinic endlessly in the best imitation of physical activity i can muster.  i am 1 cm dilated and 30% effaced.

the dogs are boarded, the bags are packed.  before ian and i enter the hospital doors by the tower a elevators, he stops briefly and kisses me outside in the parking lot.  it is golden hour and he is beautiful in the sunset.

we check into labor & delivery, and are immediately escorted into an immaculately clean birthing suite.   it is already more well-appointed than all the hotels in inner mongolia.

"can you imagine?  this is where james will be born," i tell ian gleefully.

in retrospect, this is a cool literary device called irony, because james was not born in that room.  he took his first icy breath in the operating room down the hall.

but i proceed through the overnight ripening with the optimistic confidence reserved only for fools and drunks- and the cervidil does its job.  by 5 am the next morning, my setup has softened and dilated to the point of initiating contractions on its own.  i confuse these for inexplicable diarrhea pains because all i've known is a dumpster rat's life of eating too much garbage and regretting it immediately.  a pitocin drip starts slowly beside me to augment the labor, and james registers on the fetal monitor clinically happy as a clam.  at some point, dr. grisham comes in and performs a cervical check like an inexperienced high school boyfriend.

a few hours later, i ask for the anesthesiologist.  my wonderment at finally understanding what labor pain feels like has quickly dwindled, and i appreciate very little about the contractions- but they are still tolerable.  they roll in like small storms, the sharpening sensation of gastric distress modulated with the spasming qualities of a charley horse.  i think back through a lifetime of painful experiences.  this is worse than being dragged down the stairs by momo, but much easier than the first few hours after waking up from abdominoplasty. 

dr. holder comes into my room and questions about me the marcaine? noted by my night nurse under drug allergies.  i relish this opportunity to plague yet another innocent bystander with the story about my pain pump and close call with marcaine toxicity.  we decide that i am not allergic to the drug, but that my plastic surgeon was certifiably wild as fuck for instructing me to refill a 0.25% pump with the wrong concentration.  he starts the epidural.  it feels like nothing, then it feels like sliding into a warm, anesthetizing, toffee pudding.  i can still move my lower body, but the motions come with a comfortably detached ease.  

active labor progresses over the next several hours with textbook pacing and mvus- the epidural stalls nothing.  james' heartbeat tracks happily with no signs of fetal distress, my contractions are pitched perfectly for cervical change.  my nurses and dr. grisham check on me every hour and seem pleased with the results.  i progress to 80% effacement and james drops lower in station, ready to take off on a cool slip 'n slide adventure.  i take some time to beat my face with all the palettes i dragged along, cringing a little at my own inanity as dr. grisham walks in on my careful arrangement of foundation brushes.  

and then things fall rapidly out of alignment, my labor and delivery become a little less perfect.  

in any other context, this would be a midwife's scaremongering tale about the slippery slope of hospital births or the dreaded cascade of interventions.  this could be a blog entry about how it all went wrong and how traumatized i am.  but i went into this pregnancy and labor with a very distinct, unwavering goal and knew that i would never be married to the process- only the outcome.  my only birth plan was to give birth.  i wanted james and myself to both come out of this statistically dangerous day alive and healthy.  and also ian too, but he was really only in danger of having a vending machine fall on him or something.

i know that this acceptance of deviation doesn't come across as a particularly cool plot device or anything, but i can't stress enough how irrelevant the process of birth actually felt to the importance of the event itself.

so little man gets stuck.  and my labor stalls for the next three and half hours.  dr. grisham describes the situation to me with a calm, clinical detachment that silently places the burden of choice upon my shoulders.  i understand the words he is saying, but in the context of my mental imagery, caput succedaneum sounds like an unforgivable curse that voldemort is placing on my baby's fragile head.  i imagine james trapped up in my pelvis, with the force of my contractions bearing down upon the finite space.  my endlessly patient day nurse amanda and i try for a last valiant effort, placing me in increasingly humiliating positions.  but a little after 6 pm, we give up the ghost and sidestep the trappings of natural birth in favor of getting my son here safely.  we go for the c-section.

ian scrubs into his operating room getup, and we both jam on cool hairnets.  we look like we're ready for our first day of work at luby's.  my parents flit around my bed anxiously, realizing that i am taking a massive detour from their limited experience with childbirth (unmedicated, vaginal, directly into a hole dug into the earth of the gobi desert).  my sister, always too cool to be overly sentimental, begins to tear up a little.  i am only being taken a short distance down the maternity ward hallways, but i feel like i'm being shipped off to die in a remote country.  i am very tired, but also very nervous.

the exhaustion really settles in once we are firmly ensconced in the cold clutches of the operating room.  ian sits in a chair next to my head.  he kisses my hair and reassures me that everything will be fine- and i want so badly to look into his eyes and stay connected to him through the surgery, but i can't keep my eyes open.  i am shaking so hard i make myself nauseous.

by this time, i am probably notorious for being the patient who asks every nurse within earshot for some zofran.  i ask for it so often and eagerly i feel like an addict- but it is my secret goal to get through this hospital stay without vomiting.  the crna in the OR obliges me with another hit of my gogo juice, and i spend the next hour on the operating table shivering and sleepy-eyed behind the drape.  ian holds my hand.  i try to not think about the tugging and pressure churning somewhere vaguely south of my neck.

i wish, very hard, to be anywhere else but here.

the pressure then changes, mounts in intensity, and dr. grisham's idle chatter with his nurses and scrub techs shifts into a focused exchanged.  from somewhere distant, i hear a voice ask are you ready? and i don't know if they are talking to me, ian, or james- but the tugging sensation increases by tenfold, and every synapse in my brain is firing wildly panicked, fearful signals while something like adrenaline surges through me into a fever pitch.

ian rises from his chair, and i can't see his face but he is saying oh my god in a voice i have never heard him use, a voice i've never heard anyone use- it is choked with emotion and excitement and i barely have time to register the swell of love and pride before i hear a tiny, powerful cry and dr. grisham appears in my field of vision, holding up a squalling baby brightly outlined in the operating room light and crystal clear through the plastic window at the top of my surgical drape.  he is almost alien in his casing, covered in vernix and blood, and his face is squished into classic newborn bawling- but he is my son and all of a sudden i am choking back sobs, trying to take in the enormity of this tiny little vision, this extraordinary creature who has been, for so long, an invisible little sidekick trundling away happily inside my belly but is finally here in person now and he has so much glorious, thick, dark hair it is still visible through all his gore and all my tears.  i hear dr. grisham say congratulations, he is really cute and a nurse beckons ian to help clean up his son.  i close my eyes, hearing his little squawks of confusion as he is rinsed and evaluated. each time he cries out, i sob in unison.  out of relief, pride, love, incredulity, or sheer animal instinct- i don't know.  one sentence loops in my head over and over again.  i can't believe he's here, i can't believe this is him.

ian lays this clean, swaddled little bundle next to my head and then i am only inches away from the upside-down face of my child.  he is wide-awake, wearing a little white cap, and stares up around him in wonderment.  his big, dark-blue eyes are familiarly almond-shaped and they are brighter still than even these sterile, fluorescent lights above him.  and cognitively i know that all newborns look like puffy, nondescript little meatloafs, but ian and i still point out identifiable features to one another, absolutely mesmerized by his alert and curious face.

he weighs in at 7 lbs, 2 ounces and scores an apgar of 9/9.  i make it through labor and delivery without vomiting.  i am proud of these accomplishments, but prouder still when they heave me back into my transport bed and place this heartbreakingly tiny bundle on my chest for skin-to-skin.  

my body is drained and my brain is reeling, i feel like an exhausted shell of a human body and every sensory input feels oddly pitched to be fuzzier than usual- but somewhere in this haze of befuddlement i remember a lofty thought i had years ago.  if i ever have a baby, my 19 year-old self once hypothesized confidently, i'd want the first words they hear from me to be in mongolian.

so i ask this tiny, brand-new creature "sain bainuu, minii khüü?" and he blinks back at me in response.  my birth plan is completed.

welcome home, temujin james hoshut.