The Gnome Is Born: Part 1

by Rachael on March 8, 2012

Twice, the Gnome was the baby who came after I had more or less given up. First, I got pregnant just as I was about to give up on having another child. Then, there’s the actual birth….

I posted the prologue to the Gnome’s birth story last week. Part 2 will follow next Thursday soon: I Can’t Believe It’s Over.

Surveillance

In a way, the Gnome’s birth story begins with the January 4 ultrasound in which it was discovered that the fetal hydronephrosis we had been tracking since the 20-week scan had become severe in the left kidney. After that ultrasound, the surveillance began: weekly ultrasounds and biophysical profiles (NST/BPPs).

I first encountered the term fetal surveillance in an Ask Henci post at the Web site of Lamaze International. I thought that Henci Goer had made up the term herself, as a wry jest, but it turns out that it is actually used in medical literature. I joked about the term myself, mostly in an attempt to ward off my anxiety about all the scrutiny. Meanwhile, the weeks of surveillance passed in a blur of opinions, data (not all of it accurate), apprehension, and tears.

On the one hand, there was the perinatologist who told my midwife that the Gnome was going to lose a kidney (which I suppose is within the realm of possibility, but hardly the only possibility). On the other hand, there was the letter from a pediatric urologist that I read every day, once I got my hands on it. The “prognosis is excellent,” it said. “The parenchyma appears to be normal.” I looked up parenchyma. I read many, many Cochrane Summaries. The technicians who did the ultrasounds and NST/BPPs weren’t really supposed to report their findings directly to me, so I figured out (more or less) how to read the ultrasound measurements and NST strip myself.

Once I arrived at 37 weeks, instead of feeling relief, my anxiety increased; what if, in all that data, someone found some reason to proclaim “baby better out than in”? I started drinking red raspberry tea with squaw vine, taking evening primrose oil, going on long walks, and etcetera. The only thing I wanted less than a Pitocin-induced birth was a cesarean birth; as for not wanting a poor outcome, I couldn’t even entertain that possibility. Even in the midst of the surveillance, I could hardly accept all circumstances surrounding the pregnancy, even though I wanted to do so and was trying to do so — sort of.

Then, on the evening of Thursday, February 16 came another phone call from the birthing center with another ugly word: macrosomia. I had known for weeks that the Gnome was big (given all the damn ultrasounds, how could I not?) and, up until then, had been relieved that no one was expressing any doubts that I could actually give birth to my baby. So when I got this phone call, I did what I had learned to do over the past several weeks: I cried my eyes out, and then I got to work. I listed every single thing that Brian and I needed to do in order for me to feel ready to have my baby. Over the long President’s Day weekend, we tidied, cleaned, packed, assembled the cradle, bought tons and tons of groceries, and did I don’t even remember what else so that I would no longer be thinking I can’t have this baby yet, I’m not ready whenever I went to bed at night.

Intervention

Halfway through eating dinner on the evening of Monday, February 20, I suddenly found myself in a state of panic, thinking I can’t have this baby yet, I’m not ready. I still have to critique my students’ exercises! I still have that book review to write! At the same time as I was berating myself for not having accomplished even more than we did over the holiday weekend, some part of me that wasn’t panicked got excited: less than twenty-four hours before I went into labor with the Critter, I had found myself in a similar state of panic. Was this panic that kind of panic, or was I just taking another ride on the roller coaster of the last few weeks of my pregnancy?

The following morning, the Critter and I went to the birthing center for my weekly check-up. The check-up started on a bad note, involving such terms as macrosomia, induction, and scheduled c-section. I said something about being tired of having this pregnancy pathologized in every possible way that the data would support. Then the midwife or I changed the subject, and we reviewed and finalized my birth plan, which was beginning to feel increasingly irrelevant. I asked about stripping the membranes, which had successfully induced labor for my sister. So the midwife stripped my membranes (which was not so bad as I had thought it might be) and did a vaginal check: I was already dilated two or three centimeters.

And then, the midwife checked the Gnome’s heart rate. Bad news: It was abnormally high, enough so that the midwife wanted to send me to the hospital for yet another NST/BPP.

This was when I got a lecture (a well-meaning lecture, but still, a lecture) about this pregnancy being different from the first one. This was when I started murmuring to myself about accepting all circumstances surrounding this pregnancy. This was when I gave up on wanting anything or expecting anything or doing anything other than making my way cautiously, step by step, into the future.

I called Brian, and we both started trying to find someone to take care of the Critter while I was in triage. I called my dad. The Critter and I took a cab to the hospital, where we met Brian. I met another of the birthing center midwives in triage. As it turned out, the NST/BPP was more or less fine, though the AFI was remarkably low (6, though with the deepest pocket at 2.5) — of particular concern with a baby with fetal hydronephrosis. At some point, I don’t remember exactly when, this midwife stripped my membranes, too — a far more intense experience than the first time — and also opened my cervix to four centimeters. Nevertheless, the midwife started talking induction. As in, now. As in, What are you waiting for?

Looking back, I can think of many answers to this question, including everything from, I’d like to have lunch first to Can’t we just wait and see if the stripping of the membranes works? to the very obvious I’m waiting for labor to begin on its own. But I had more or less already given up on my birth plan. The low AFI was haunting me. And by this point, I couldn’t tell if I knew better or didn’t know a damn thing at all.

I did know this much, however: I wanted to get off the roller coaster.

I agreed to the induction — but not just then. Brian and I would meet the midwife at the hospital the following morning. We would try an enema first, and then the dread Pitocin. But first, I had to get my shit together.

{ 6 comments… read them below or add one }

Charise @ I Thought I Knew Mama March 8, 2012 at 5:43 PM

Man… what a roller coaster ride! They really put you through the ringer. I’m so glad I know there is a happy ending to this story but can’t wait to read all the details of your next post! Hugs!

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Natalia March 10, 2012 at 2:18 PM

Congratulations! Happy to hear that everything is fine now and you are all back home. What a journey! Hope to hear more from you soon. Take care, Natalia

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Lauren @ Hobo Mama March 10, 2012 at 4:59 PM

Wow, I’m glad you’ve spilled that the story ends well. I’m on tenterhooks here. 🙂

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Jo March 11, 2012 at 2:21 PM

Is it weird that as I read this, my biggest reaction was, “You should’ve called me! Newborn or not, we would’ve happily taken the Critter!”

I can’t wait to read your final installment.

And, going forward, if you find yourself in a child care pinch at any point for doctor’s appointments for the gnome or otherwise, really, please feel free to call. What’s one more kid in the mix for a couple of hours? 🙂 We’re pretty much always here.

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Rachael March 22, 2012 at 10:10 PM

Thanks, Jo, for the offer (which I keep forgetting to mention in person)! I can bring the Critter along for the pediatric urology appointments, but who knows if/when there will be a return trip to the hospital.

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Rachael March 22, 2012 at 10:07 PM

So it’s been more than a week since “next Thursday” — and still no Part 2. I’m still working on it! Even though it’s the happy part of the story, I nevertheless have a lot to process in writing it. Coming soon!

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