**This post was supposed to be published yesterday, but couldn't finish it in time, so posting it today.**
Born on February 11th, 2020, Avyaan is 2 months old today. Under normal circumstances, 2 months may seem like a long time, but we are not living through normal circumstances. Being pretty much locked at home because of 'Stay at Home' orders in California, days and weeks have started to feel like a homogeneous blob of time rather than discrete periods. Having a newborn at hand also diffuses the boundary between day and night. So it is safe to say that time for us has taken a more abstract form. That said, it does not take away time's effect on one's memory and I want to document as much as possible before the memories start to fade away into oblivion. This post is my attempt to document my experience of witnessing Avyaan come into the world.
Sunday, January 19th, 2020 - Preparing for Childbirth
We had just attended a day long 'Preparing for Childbirth' class at Providence Little Company of Mary hospital. We were the only couple to attend so close to their due date, so were anxious when some of the stuff, like Braxton Hicks Contractions, that was supposed to have been happening for weeks, hadn't been happening for Prajakta. That being said, the class was very useful and gave us a lot of information about what to expect when the mom to be goes into labor, how to manage the pain, when to go to the hospital etc. We had taken an earlier tour of the hospital, so were already aware of what to expect once inside the hospital.
Monday, February 10th, 2020 - The Day Before
First day of Prajakta's planned maternity leave and also our regularly scheduled appointment with Prajakta's OB/GYN where we highlighted our concerns. The doctor, as calm as she always is, told us there was nothing to worry about and scheduled an induction for February 18th, in case Prajakta didn't go into labor naturally. The doctor then proceeded to check if Prajakta was dilated. A quick side note - the procedure to check for cervix dilation is painful to even watch, I can't even imagine what it must feel like! Lo and behold, she informed us that Prajakta was already 3 cms dilated and was in labor! She then asked if Prajakta would be agreeable to stripping the membranes, a procedure meant to initiate/accelerate labor, to which we agreed. Reality started kicking in and some of the stuff we had been putting off for weeks, became a priority. We made our grocery runs, filled up the car's tank, came home and packed our hospital bag.
The Contractions Kick In!
The rest of the day was uneventful till about 8 in the evening. That's when she first started feeling the contractions. The initial contractions were very mild and irregular, coming anywhere from 15 minutes to 30 minutes apart. We mistook these to be the Braxton Hicks contractions that were supposed to have been happening for weeks now, so proceeded accordingly by trying to relax, walk etc. By 11 pm, it was clear that these weren't false contractions, but the real deal. They were coming every 20 minutes like clockwork and lasting for 15-20 seconds each. This is when we debated whether to go to the hospital or continue to stay at home. The contractions weren't very painful yet, and the hospital would have sent us back home anyway, so we continued to stay at home and make her as comfortable as possible. The frequency was now increasing as time passed, as did the intensity.
Tuesday, February 11th, 2020 - Life Would Never be the Same!
At about 2 am, when all attempts to sleep had failed, we decided to try and help Prajakta relax for a few more contractions, and go to the hospital if that didn't help. By now the contractions were 7 minutes apart and painful enough that we had to employ the breathing techniques taught in the birthing class to help with the pain. In the meantime, Prajakta's mom quickly fixed up some खीर and milk to give to her after delivery, and some snacks for me, if we did end up going to the hospital.
Heading to the Hospital
2:45 am is when the contractions hit the 5 minutes apart mark and we decided it was time to go to the hospital. We picked up the packed food and the hospital bag, and drove to the hospital. It was a good thing that we had remembered to check the after hours entrance during the day. I dropped Prajakta at the ER entrance and went to find a place to park. Once inside, we were promptly taken to the Labor and Delivery floor where the on duty nurse checked us in. Pro-tip: Always pre-register with the hospital if you know where you are going to have your baby. The main triage nurse was on her break at the time so, the reception nurse showed us to the triage room, helped Prajakta get changed, took her vitals and *shudder* checked her dilation again. Surprise, surprise! She was still at 3 cms! She didn't want to send us back home, so instead suggested we take a walk on the floor for about an hour and they will re-evaluate after the hour was up. We must have made dozens of loops of the floor, snooped in on the nurses' gossip, slightly judged a couple who waltzed in with a small suitcase and a couple of pillows for their planned C-section, and taken a couple of breaks in between.
Admitted Finally
At 4:30 am, it was time to check again! This time the main triage nurse did it and she declared that Prajakta was at 4.5 cms. While this was progress, they usually admit only after 5 cms, but 4.5 cms wasn't small enough to send us back home either. The nurses checked with the on-call doctor, who thankfully decided to admit Prajakta.
The Painful IV and Wait for Epidural
By 5 am, we were in our delivery room and the triage nurse handed Prajakta over to the labor nurse who started prepping her for the next steps. One of the first things that had to be done was to get an IV line going. She struggled for a few minutes before finding a supposedly good vein, however, when she attempted to insert the needle, the vein slipped out of her hand, leaving Prajakta with a jab, but no IV line. She tried an alternate spot but the same thing happened again. Punctures 2, IV 0. She did not attempt again and called one of the senior nurses, who is supposed to be an IV ninja at the hospital. The senior nurse did find a vein where she could get the line going, however before she could insert the needle, she was paged for an urgent matter in the OT. So, another couple of nurses on duty were called in, who made yet another futile attempt at getting a line started. Punctures 3, IV 0. Finally they decided that they weren't going to get a good vein in the hand-forearm area, so had to use the elbow, not a preferred site for an IV, but we were out of options. So finally, in the 4th attempt, an IV line was successfully set up. We hadn't even gone far enough into labor and Prajakta seemed covered in bandages. The contractions were getting stronger in the meantime. This was going to be a long day!
At about 7am, when the shift changed and Prajakta's primary OB/GYN physician became the on-call doctor, the labor nurse checked for dilation yet again! Still 4.5 cms and the contraction pain was becoming unbearable for Prajakta. To help the labor progress faster, the doctor ordered her to be started on Pitocin, a synthetic version of Oxytocin hormone that is supposed to help with dilation. We remembered from the birthing class that this is called labor augmentation and it makes contractions much stronger, therefore, much more painful. Our original plan was to get an epidural at 6 cms, but if she was to be started on Pitocin, there was no way we were going ahead with that without getting the epidural first! So we requested for the anesthesiologist to administer the epidural. He was in a surgery at the time so would be available only after an hour or so. So we waited, holding hands, and breathing through each contraction as it came, every 3-4 minutes now.
The Epidural and the Epidural
10 am is approximately when the anesthesiologist finally came over to administer the epidural. This was another painful procedure to watch. I'm sure bearing the pain would have been much more intense, but she went through with it without much fuss, partly because of exhaustion and sleeplessness, and partly because she just wanted the contraction pain to go away. Now we waited, the stipulated 20 mins it takes for the epidural to take effect while the nurse started her on Pitocin. Alas! The epidural didn't work, but the Pitocin did. Well, that's not completely accurate. It did work, but only on the left side. She could still feel the full intensity of the enhanced contractions on her right side. By noon-ish, we got the first visit from her doctor, who checked the charts. The baby was doing great, and Prajakta was at 6 cms now. However, learning about only the partial success of the epidural, she asked for the anesthesiologist to come back and readjust the epidural. Neither of us had eaten yet, so we were starting to get hungry, but Prajakta was supposed to be strictly on liquids only now. So we ordered liquid lunch for her while I had some snacks which my MIL, bless her, had packed, and we waited for the epidural to be readjusted.
The anesthesiologist returned after wrapping up a surgery and told us that the catheter would have slipped onto one side, it is not uncommon for this to happen, and a simple readjustment should fix it. He performed the readjustment asking us to call him again if there were any further issues. We, very soon found out that there were still issues. The readjustment did make some difference but she could still feel the pain in her back on the right side. He came back and this time gave us two options - he could either redo the epidural, or she could continue to tolerate the pain. We decided to go for redoing it. This time it worked liked a charm and all the pain went away in a few minutes. Pain free and fed, she could now relax, which meant I could also get some sleep that came well advised by the doctor since both us would need our energies for the actual delivery. Some time later, the nurse propped up a peanut, essentially a peanut shaped inflatable balloon, between her legs as this is supposed to help with the dilation. The next few hours are a blur as both of us drifted in and out of sleep. I only remember the nurse coming in multiple times, to take her vitals, adjust the peanut, change Prajakta's side etc.
Time to Push - We become Parents!
At 4 pm the doctor came in and announced that Prajakta was complete, basically meaning that the cervix had dilated the needed full 10 cms and it was now time to push! A quick primer on what each of us were going to do - the doctor will keep a track of where the baby was and make sure everything is safe, the nurse and I, each, will hold up one of Prajakta's leg, the nurse on the right and I on the left, and provide resistance for her to push against, and Prajakta will do the most important task of pushing as hard as she could up to the count of 10, as many times as possible during a contraction. We were just a few minutes away from meeting our baby!
Seemingly nothing happened during the first few pushes. The actual pushing part was stressful for everyone, but the time between contractions was surprisingly normal. We were all chatting about stuff, cracking jokes etc. We may very well have been friends out for a coffee if the setting was changed. After about 20 minutes, the doctor invited me over to her side and asked me if I wanted to look at the head. Nervously, but excited, I hopped over. The baby had started to crown and I could see just a tiny wad of hair sticking out which went back in after the pushing was over, but was sure to make a bigger appearance during every subsequent push. I may have exclaimed that the head seemed too small, comparable to a small orange. The doctor, having heard this comment from numerous dads to be before me, calmly explained that most dads think that, but the head is big, has to pass through a narrow opening so takes a conical shape. But eventually the mom's muscles can't hold up and the whole head just pops out. Another 20 minutes or so later, the head did pop out. One shoulder, another shoulder and the rest of the body quickly followed suit, and at 4:53 pm, we met our baby! He came out all guns blazing, crying at the top of his lungs and we couldn't be happier. The adage that your birth is the only time when your parents are happy to see you cry, rang true. After the doctor had suctioned out amniotic fluid from his nose and throat, he was quickly wiped up and put on Prajakta while I got the honor of cutting the umbilical cord after the iron rich cord blood had made its way into the baby's body. The baby was immediately given a Vitamin K shot, Hepatitis B Vaccine and Erythromycin ointment in the eye. In the meantime, the doctor went back to work, extracting the Placenta and patching up the torn tissues during the delivery.
It is a philosophical revelation watching the placenta. A piece of tissue that was responsible for keeping the baby safe and alive inside the womb ll this time has lost its utility once the baby is born, and promptly gets tossed in trash. I did get to look at it though, before it was disposed.
Wednesday, February 12th - Thursday, February 13th, 2020 - Recovery and Discharge
After a couple of hours of recovery and bonding time, we were moved to a different wing of the hospital where we stayed for 2 days. These days were spent in getting to know our baby, putting in practice what we had learnt in the 'Baby Care Basics' class, fumbling and asking for the nurses' help whenever we felt stuck. The nurses also took Prajakta's and the baby's vitals every couple of hours or so, while the doctor came in once a day to check in on her recovery. There were also a battery of tests performed on the baby, namely Billy Rubin Count, Hearing Test, Heart Function Test and blood samples for California mandated New Born Screening tests, all of which came back normal. He was also given a head to toe exam by the hospital pediatrician and given the all clear.
Lack of a successful latch and low milk production meant that ours was going to be a primarily formula fed baby. We had numerous sessions with the on call lactation consultant, tried breast pump, hand expression etc. When nothing seemed to satiate the baby, we had to request the nurse to get some formula. This was the only time of our 2.5 day stay in the hospital where we felt judged. On requesting formula, the nurse quipped back, "Already? You're giving up so soon?". She may have meant it as a joke, but to us sleep deprived new parents, it felt like an insult. Now we had to learn to feed the baby with a syringe and finger in his mouth. This was a weird experience to say the least, but a first among many firsts that happened in the hospital - first diaper change, first bath, first photo shoot and several other things that I may not be able to recall.
On Thursday, the doctor gave us the all clear and we were left with some last loose ends - one of which was to file the paperwork for the baby's birth certificate and SSN, i.e. the name, to tie before we headed home. We named him Avyaan.
I paid the bills, picked up the prescriptions and waited in the car while the hospital staff wheeled my wife, and my son in her arms, out to the parking. It was time to go home! :)
Parting Thoughts:
- As if pregnancy wasn't a cumbersome enough process, the delivery is even more complicated and painful one. No wonder mothers are put on a pedestal in almost all cultures! You get an acute sense of this when you witness your wife bearing your child.
- Nothing will make you feel more useless in life than seeing the love of your life in unbearable pain and you being able to do absolutely nothing to help her other than not come in the way of the doctors and nurses taking care of her.
- A child is the greatest gift a woman can give you. There's nothing you can do to reciprocate that will ever come closer. Try to gift her something to show your gratitude. More importantly, strive to be a person worth going through all the pain for.
- Every person should witness childbirth at least once. It is a life changing experience and makes you appreciate mother nature and women, as well as modern science, doctors and nurses, even more than before.
- Becoming a parent rearranges your life's priorities. The transition is fast for some, akin to a switch being flipped and more gradual for others, but it does happen and if you are observant, you will notice small changes in your behavior as if being tugged on by invisible strings.
- There is no shame in feeding formula to a baby. This was my only complaint against the hospital. While breastfeeding is obviously preferred, not being able to breastfeed your baby is not a reflection of how good or bad of a parent you are.
- As a new parent, you learn everything from scratch. Take all the classes you reasonably can, read everything you can get your hands on, plan all you can, but be aware that nature works on its own schedule an plans. Trust your doctors and nurses, they have done this hundreds of times, but do not be afraid to ask questions.