Authors Note: This post originally appeared on my personal blog, Sew Thus Is Life, Sept. 28, 2018. It seemed relevant again, given that today, April 17, 2020 is the last day of Black Maternal Health Week 2020. For more information on BMHW, click here. Also check out my Downloadables page for national organizations doing the utterly critical work of centering Black mothers and rallying for birth and reproductive justice.
Today is Sept 27, 2018.
A year ago today I was off from work, attending what was supposed to be a routine 37 wk prenatal visit. A year ago today I thought everything was going pretty well. I was still keeping up at work, I had just done the St. Jude Walk, baby shower had been a huge success, and I has big plans to throw myself in full nesting mode the next week. I felt great, heartburn aside.
A year ago today I got a phone call from one of my attending OB-GYN's to report back to Holy Cross Hospital, and go straight to labor and delivery. I was getting induced in less than 48 hours.
How did this happen?
Let's back up two weeks prior.
At 35 weeks my OB's recommended that I get an ultrasound with the Maternal Fetal Medicine specialist downstairs. At this point, don't get me lying why I had been recommended. Nuggets heart rate was fine, my blood pressure was healthy and low, as it had been my whole pregnancy. Maybe it was because my belly was so small, I'd have to reset my password to my records to remember why. Anywho, I go. At that visit the tech said that baby girl, who had been measuring on target the whole time, was measuring a little behind in her abdominal circumference, but the rest of her looked great. Ok, so nbd, right? The doc comes in, re checks and concurs, so she asks me to come back in 2 weeks as a follow up, nothing big. So I'm still cool. 37 weeks rolls around, I had planned my ultrasound in the morning, lunch with my mama after, then back to the OB/GYN for my routine check. First, the tech had a hard time locating Nugget. She had slid so far down into my pelvis I practically had to take my pants off for the machine to pick up her image.
I heard something about my attending OB would call me with the final outcome.
Then she kept clicking around, trying to make fetch work and get some desirable numbers. Nugget was still measuring behind, in fact her leg and cranial measurements had "stalled" from 2 weeks ago and her belly was measuring even smaller. She goes and gets the specialist, who then studies the slides then asks me how I feel about being induced, because she's gonna call my doctor to recommend so, stating my baby was showing signs of late stage IUGR, (intrauterine growth restriction). I listened, stone faced, trying to hold back my fear and my sadness. I nodded, now immediately regretting working so much, for walking that 5k the weekend beforehand. She said something about my placenta having low blood flow, was I taking the aspirin? I heard something about my attending OB would call me with the final outcome. I left, barely holding it together, in fact I ran into a mutual friend and was so dazed she probably thought I was being rude (sorry Vee). The tears had already started leaking down my face by the time I got to my car and when I got in, my world fell apart. Thoughts of " I failed my daughter" flooded my mind, while tears clouded my eyes. Between sobs, I began Googling what IUGR was, turning to Baby Center birth groups for moral support. I called my mom to say I was on the way and she could tell by my voice something was wrong. Driving the ICC was a blur. On the way I'm trying to call hubby, and tell him what's going on. I had told him to skip this appointment because it was redundant and it would be quick, and I knew he'd rather get home and sleep. Now I'm calling and he won't wake up.
Arriving at my mom's hospital, I try to keep it together while explaining to her the situation. While we talk, my phone rings- it's the attending. She tells me that after speaking with the MFS, they feel it's in the best interest to induce- Friday. So, in my stupor I ask, "so go to the hospital Friday?" She responds no, I need to go home and get ready because I should try to be admitted by 5, TODAY. She explained that they can't induce before 37 weeks, but due to the baby's gestational age, I need to receive steroid injections to help beef up her immature lungs, and receive fluids as my water was borderline low. I hang up, and fall apart all over again.
Thank God for my mom. She decides now's a good time to eat. First she called one of her good friends who is a NICU nurse, to give me some reassurance that everything will turn out fine, and to give me some practical advice in case they deem Nugget needing a NICU stay. At some point she also took off that Friday, so she'd be there if I needed her. While eating hubby and his mom call me back (I had been blowing them up.) Both are a little confused, but hubby wonders if he should call out from work. It's his "Friday", so I tell him to go in. We agree that he'll take me to be admitted.
Exfoliate and wait
Having been talked off my ledge, I tell my mom I have to go prepare, as I hadn't packed my hospital bag completely, and I need gas, lol. I rush back to my side of town, go to Target, and spend way more than I planned to on snacks, comfort devices, a LED candle I never used, a welcome home outfit, and giant maxi pads. We pack the car and head out to sit in rush hour traffic to Silver Spring. I had preregistered for a regular delivery, but since I was going to the Perinatal Care Unit, I had some other forms I had to fill out at check in. We get to my "suite", where I'm told to change into a hospital gown, get blood work drawn, and give preference for interventions if needed. I don't eat again till almost 8 pm. I get my first steroid shot around 10 pm. The first two days were relatively boring, I had to do intermittent Fetal monitoring, which was always normal. I watched TV, colored in my coloring book, and lurked Facebook constantly. I called a few close friends for support, but I kept everything else away from social media and extended family, I was still privately devastated and didn't want to deal with questions or the fake concern.
my cervix was still closed, and physically my body was not in the mood to give birth yet
I got the second steroid shot, and the nurse also informs me since I'm not dilated or effaced (meaning my cervix was still closed, and physically my body was not in the mood to give birth yet) I'd have to be administered a drug called Cervadil to start softening my cervix so the induction can proceed as scheduled Friday afternoon. It's like a tiny tampon they said. Sure, if tiny tampons WERE COVERED IN MICROSCOPIC RAZOR BLADES. They insert an IV and tell me I now need to stay on the monitor so they can see if I start contractions. Joke was on them though, as the Cervadil made me have to pee every 30 minutes to an hour. Around 3 or 4 am I start to experience excruciating pain, the nurse slips a painkiller in my IV, but not before I get a cervical check. It feels like they're trying to rip the baby out (dramatic much). But then the drugs kick in and I can finally somewhat sleep. Four to five hours later the pain is back, but I'm told I can't get any more painkillers without another cervical check. Still scarred by the first, I opt out and suffer through what I now realize are contractions, not just general pain. I was fortunate enough to have my actual OB on duty that day, so when she came on shift she tells me that they'll be taking the Cervadil out in a few hours and at that point she has to see if it worked, so she has to check me, but promised to be as gentile as she can. When she comes back at noon to remove it, she could barely pull it out, let alone do a cervical check because Nugget had descended so far down her head was in the way, and she promptly declares me in active labor, about 4 cm dilated. I immediately call our parents. Its showtime.
The mommas waited no time in getting to the hospital, both were there within a half hour of each other, my mom arriving first. They helped me labor though contractions for almost 4 hours without pain meds or an epidural, as we waited for a birthing suite to open up. (Fridays are busy for babies it seems...). This is the point where I wished I had been able to finish my birthing class, or learned some natural pain management techniques, or even afforded a doula. I went FOUR HOURS with no medication. I may have been able to labor the whole time without interventions, but being a first time mom, not really knowing better, and listening to well intentioned mamas and medical professionals, the minute L& D opened up, I opted for the epidural. I don't regret my decision essentially, but I wish I had tried or educated myself on alternatives. Either way, the pain cart was waiting when I got wheeled down the hall, the anesthesiologist came in less than 15 minutes later. By 4:15 pm I had a flawlessly inserted giant needle in my back, and for the first time in about 16 hours, I got some sleep.
I may have been able to labor the whole time without interventions, but being a first time mom, not really knowing better, and listening to well intentioned mamas and medical professionals, the minute L& D opened up, I opted for the epidural...
Over the next 3 or so hours I progressed fine, making it to 8 cm before they realized I had stalled out. At this point they administer one dose of pitocin to restart and strengthen the contractions. Even with that, due to the epidural, I could barely feel pressure. Another two hours or so pass by and my nurse notices the growing number of juice cups after I sent her on another ice run. She looks for a catheter bag, and not finding one asks when was the last time I went to the bathroom, and my mom if the previous nurse gave me a catheter. I responded before my epidural and my mom, a nurse, realizes I never had one/ hadn't been to the restroom this whole time. THEY FORGOT THE FOLEY CATHETER Y'ALL. So the nurse goes to get one and upon coming back , lifts the blanket to see the baby's head beginning to crown. She tells my mom, "Well this will be in and out", and after finishing runs to page my OB. When they returned, my doctor confirms its time to push and it went extremely quick from there, two good pushes and Nugget emerged, at 9:43 pm.
I firmly believe my birth triggered my postpartum depression and anxiety
Hubby was by my side the whole time, and got to cut the cord and oversee the newborn testing. Most would say, okay, you had an issue, the doctors caught it, problem solved. But it wasn't. I firmly believe my birth triggered my postpartum depression and anxiety. I constantly felt like it was something I did that "caused" her to stop growing. Not once did anyone really ask my birth preferences or if I had a birth plan written out. Black women are more likely to be given drugs like pitocin, epidurals and other interventions leading to "emergency Cesarean sections". Thank God that was not my outcome, and that my labor was just shy of 10 hours. However I fell into the statistic of giving birth to a low birth weight, preterm baby. Did you know that's an issue that transcends all socioeconomic levels?
I was fortunate, but not unscathed. Stories are coming out now of major Black celebrities like Serena and Beyonce having traumatic births and their health nor desires being taken seriously- what do you think is happening to us regular sisters? We, and our babies still die at a higher rate than our White, Hispanic, and Asian counterparts. In my home state and county, Black babies die at a rate of 7.8 per 1,000 births, compared to 5.4 White babies. (I'll cite and clean up these stats later FYI, I didn't make them up.) We deserve better. I love my baby, I'm blessed that she's happy, healthy, and well taken care of. A year ago today, I had no idea what to expect. Today, I spend a good chunk of my time advising moms online looking for community, and I plan to go back to school to become Certified Lactation Consultant, and eventually an International Board Certified Lactation Consultant (IBCLC). Today, I'm the proud mom of a beautiful Black baby girl. Today, I'm better. -xo Postscript: The original statistics quoted were taken from the 2017 Prince George's County Maternal and Infant Health Report. The updated report can be found here, and statistics in this report were from 2017- the year I gave birth to Nugget. In 2017, 1 in 10 Prince Georgians gave birth to preterm and low birth weight babies. In 2017, the infant mortality rate among Black, non-Hispanic infants (12.0 deaths per 1,000 live births) was more than double the rate among Hispanic infants (5.0 per 1,000 live births) in a county that is 62% Black. Cesareans accounted for over 40% of all live Black births. Conversely, they only amounted to 29% of White births. A bright spot is the increased breastfeeding rates- 84% for Black women, but still less than other races/ ethnicities.
I gave birth to another baby girl this past February. This time I was more educated, knew how to advocate, and went into my birth confidently. I had a successful, unmedicated, midwife led delivery that was completely redemptive and healing of my first birth. Thankful for my village who supported me. One day I'll write about it.