Sunday, October 31, 2010

Ava and Julia's birth story

If you have been following my preterm labor, it probably came to no surprise that Ava wanted out and she wanted out NOW. I had been taking medicine to try to calm the contractions and everything seemed to be going pretty well in that regard until that Saturday night. It could have also been that I was being stubborn about taking it easy, and decided to join Rick in taking Sophia to her first rodeo. We planned it out that he would drop us off at the entrance, we'd walk immediately to our seats, and then he'd pick us up at the entrance. But because I'm who I am, I wanted to find Sophia a cowgirl hat, wanted to get some food, wanted to let her watch the kids try to rope the fake bull on the hobby horse thing and watch the mechanical bull. So I probably overdid it. I had some pretty intense side pains that night.

On Sunday, I did nothing, until it was time to go over to the in-laws to celebrate my mother in-law and father in-law's 60th wedding anniversary. I wasn't feeling myself, contractions had started up again and I was uncomfortable. I had made a comment to Rick that we needed to find out who was "on call" just in case we needed to have someone come over and watch Sophia if we had to go to the hospital. But instead of my normal night of pacing the house--like the last 2 months of wakeful torture--I had a really good night sleep. This also alarmed me.

On Monday I had my scheduled Peri appointment. I mentioned the contractions, but by that time the NST showed that they were "uterine irritation" or something like that. Still frequent but not intense. Ava's heart rate was looking good on the monitor. I went in to have the ultrasound and we immediately noticed that Ava had started collecting fluid around her other organs. My Peri told me he'd need to discuss things with his associate Peri, which I took as a sign that I'd probably be sent directly to the hospital.

The associate Peri came (she's female and more adept at handling crazed patients--which I didn't need really, until right about then) and told me they wanted to take Ava out before more bad stuff could happen. Do you know my first thoughts? OK, I was terrified of course. But what came flying out of my mouth was "I should have had that cheese danish I'd been craving this morning" and second was "I should have had Mexican food for dinner the night before." If you've ever had a c-section, you know the importance of your last meal, because odds are you are going to be starving and they are only going to offer you ice chips for the first 24 hours following surgery. Mexican food, well also pretty important to have an uneventful bowel movement post major abdominal surgery for reasons I'm sure even people that have never experienced a c-section could appreciate.

At this point, I'm sitting on the exam table in the Peri office with uncontrollable shaking. Ava was only 27 weeks. I knew how important it was to get her to 28 weeks when the chances of survival increase dramatically. I was terrified of losing her. But off I went to the hospital, calling Rick to inform him he needed to handle Sophia's care and get his butt to Labor and Delivery ASAP. By this time it was around 1pm and they had scheduled the c-section for no later than 5:30pm, most likely 3:30pm if they could all coordinate.

My Peri was kind enough to request I have a labor room instead of going into the cold and sterile pre-op room while awaiting the c-section. Labor rooms are large and cheerful, with soft lighting and big screen TVs. The pre-op room makes you want to bug out. I'm grateful that they knew I was on the verge of completely bugging out. The nurse came in and we discussed my needs to hold Julia after I got settled back in from operating room. I knew Ava would be whisked away to the NICU, and felt it would be a good time to have some cuddles with our Julia, and possibly get some pictures of us with her for a keepsake. The nurse set up a photographer from Now I Lay Me Down To Sleep, which I was incredibly grateful for. I had been given a nudge in that direction from a dear friend, researched the local photographers, and stalled. I just couldn't make the contact while trying to keep it together. I am so happy the nurse was able to coordinate.

By then, Rick had showed up and we were getting close to delivery. The c-section was fairly uneventful as far as prep and delivery. We did have a team from the NICU present, including the delivery nurses, a respiratory therapist, and the neonatologist, among others that were observing. They had come in silently after I was curtained, so Rick had pointed it out to me while my Peri and my OB were doing their thing. When the Peri cut through the bag of waters, apparently Ava was anxious to get the hell out of my bad news uterus, because the Peri said she's never seen a baby literally pop her head out without any assistance. Ava come out crying with beautiful color. She was plump and alert, and I was immediately notified of this. I was able to relax a bit after that.

It took what seemed forever for Julia to be delivered. Rick looked at me and curtly shook his head no, all the words were spoken in that brief gesture. I knew she just didn't look good. My heart sank because I wanted her to look "normal" enough to spend some time with. We had been warned of how she may look, and Rick's reaction meant that she was not the way we had wanted to see her.

Ava was taken to the NICU after initial assessment in the OR. She weighed in at 3 pounds, 3 ounces and was continuing to do well. They told us she would be ready for Rick to visit shortly. I still had about 4 hours back in my room for post-op observation. I was rolled in and the photographer was already in the room taking pictures of Julia. I wouldn't have known she was there unless I was looking for her. She was discreet, and when we made eye contact she softly told me her name and asked if we wanted pictures with Julia. I needed this, no matter what Julia looked like. She was my baby girl and I needed to feel her in my arms. I will say that it's doubtful we'll be sharing pictures of this occasion. I have already tried to replace some images of her with images of Ava, because after all they are identical twins and she was meant to look like her sister.

After we said our goodbye to Julia, the chaplain came in at Rick's request. Rick had wanted the girls blessed and I found this to be touching because it showed that he was suffering as well. He's been strong for me and I've been strong for him, and in the process we've tried to let little emotion come between us. I think we both knew it was time to start breaking down that wall. The chaplain called Father Nick, who had baptised Sophia and was also a familiar presence in Rick's life with his time donated to the Boys and Girls Club at Salesians. Father Nick came and blessed Julia, and then followed Rick to the NICU to say a prayer over Ava. After they came back, we discussed options for Julia's remains and decided that we would cremate her and have a tribute for her once things settle down a bit and we can focus wholeheartedly on Julia. This probably won't happen until Ava is home in a few months.

I stayed in antepartum for my recovery. It's a section of the maternity ward that usually cares for women that are hospitalised before they deliver, and so the rooms are bigger than the postpartum rooms and have extra amenities. It's also in close proximity to the NICU. On the way to my room, they were able to take me over in the gurney to see Ava. She was tiny and beautiful and such a miracle to get to see.

4 comments:

Julie said...

Beautiful, as I wipe a tear. Thanks for sharing this special moment.

Lynn said...

Oh, thanks so much for sharing the girls birth story! Ava is beautiful!

Betsy said...

Cara, beautiful story, thanks for sharing with all of us. The pictures of Ava as well. I'm so glad you got some time with Julia, even if it wasn't the way anyone would have wanted it to be. Love you and the girls!

Tish said...

I can tell just by looking at Ava how strong she is, just like her mommy. She looks amazing for such a tiny thing, so beautiful. I am also glad you got to spend time with your precious Julia, and my thoughts will continue to stay with you and her, Ava and Sophia & Rick as well.