Thursday, September 8, 2011

My Birth Story

This is the story of Leo and Zoe's birth. But it's really my story. I'll tell you more about them some other time.

My water broke at 5:30am on Saturday morning. My first thought: "Noooooo!" It was too early. And I don't mean the hour of the day. I was only 34 weeks and 3 days. They were supposed to stay in there for 3 more weeks! I was in a bit of denial at first. Maybe the leaking would stop. Maybe it was a false alarm. It took me about 10-15 minutes to accept the inevitable. They were coming. Then, I started getting a little bit excited.

I wasn't feeling any contractions, but we knew we still had to get to the hospital asap. My labor with Sam was only 4.5 hours and we dawdled and barely made it to the birth center in time. This time, we would do better! We needed to call the doctor, find someone to take care of Sammy, eat, shower, and pack up a few last items. The eating and showering might seem optional, but I knew I wouldn't get another chance for either for at least the rest of the day, if not longer, so they really were absolutely necessary, and I'm glad I took the time.

My OB, Dr. K.,  wasn't on-call that weekend, which was a huge disappointment. I was told that a Dr. A. would be handling my delivery. Great, some woman I've never met, who has no access to my records. I chose a sole practitioner knowing this might happen, but it still just made me sad.

Our next-door-neighbor ended up being available to take Sammy. This was really the perfect situation - Sam got to spend the day with her best friend, and they had our house key and could come to take care of the animals as well. They even let the contractor in so he could put the finishing touches on that goddamn bathroom. (I'm not convinced that the bathroom project had nothing to do with me going in to labor so early. It was a source of stress for 5 straight weeks.)

We got it all done and got out of the house within an hour without any panic or even a big rush. That was nice. But the most precious moment of the whole morning was when Sammy woke up. She heard me in the shower and came out rubbing her eyes. We told her that the twins were coming. She said, "But mommy, my clock isn't green yet. We can't get up yet." (Her clock turns green at 7:30am each day and that is how she knows it is morning.) We told her that the twins don't know what time it is - that they come whenever they are ready, and they were ready now. It took her a few minutes to process all of this, but at one point I saw her comprehend what was going on. She finally realized, Zoe and Leo are coming TODAY. Her face lit up with joy and excitement, and I wish, oh how I wish, that I had that on video. It was one of my favorite moments with her, ever.

We had no problems getting to the hospital or checking in. I still couldn't feel any contractions. We were brought to the triage room which is just a bunch of beds separated by curtains. They hooked me up to the monitors: one heart rate monitor for each baby plus a monitor for contractions. These are just belts strapped around my waist with sensors in the appropriate places. But none of the nurses could get those sensors positioned properly - I guess Zoe and Leo were moving around too much - and I was continually poked and prodded for the next 4 hours as they tried to get them working consistently. It was frustrating because they could not accept that everything was fine from the readings they did get. They have a rulebook that requires continuous monitoring, and no matter how that interferes with the rest of the process, they have to keep trying. I also got an IV (evil, evil IV) and they took my blood and did a couple of other tests. The monitor told us that I was indeed having contractions. They were mild and irregular. I only felt a few of them for the next 4 hours.

Besides the medical stuff, the staff had to do tons of paperwork while I was in triage. The most extensive form was the one where I acknowledged that "falls happen" and that it is not the hospital's fault if I fall. Ugh, liability bureaucracy. We found out that Labor and Delivery was extremely busy that morning and that they didn't have a room ready for me yet. The plan was to move me to an L&D room for my epidural and the labor process, then to an OR for delivery. But nobody was in any rush because they didn't think I was in active labor yet. After a couple of hours, though, nobody had checked my cervix and I was starting to get nervous. Everything in the hospital was moving so slowly, and I knew that I could go from nothing to pushing in a very short time.

In the middle of all of this, I noticed my nurse's name tag. Her last name was the same as my OB's. Then I remembered that someone had told me that his wife worked in the hospital. Click! I asked her and it was true! She was Mrs. Dr. K.! (For some reason I didn't understand, she didn't want to tell us, but she didn't mind that we figured it out.) I don't know why, but this made me so happy. I didn't feel so alone. My nurse had a special connection to me. Dr. K. would get a firsthand report of at least part of my labor. And I just felt like he was there for me, through his wife. We chatted a lot with her and we liked her as much as we like Dr. K. It was a wonderful surprise.

Around 11:15am, I started feeling the contractions, and the monitor confirmed that they were becoming stronger and more regular. The first few were no big deal, but then they started getting intense and coming very quickly. I demanded that someone check my cervix, but I was only 2cm. The nurses continued to assume that I had a long wait ahead of me and nobody was making any moves to get me to an L&D room. I still had not seen any doctor, which is pretty normal, but at this point I demanded to see the doctor and for them to get me to a room for the epidural. When the doctor finally came, I think around 11:30, she agreed to get me a room, but her attitude was that I needed the epidural and pitocin, to "speed things along" since my water had broken but I wasn't progressing much. My blood pressure was also high, but since she didn't have my records, she didn't realize that it was actually pretty normal for me. She was concerned about it spiking. I didn't really care about her reasoning, as long as she was willing to get me out of triage for the epidural. I wasn't dying of pain, I just knew that things would move very fast, and I didn't want to get into an emergency situation, or not be able to get the epidural and end up having a C-section under general anesthesia. So I didn't argue about the pitocin, even though I think that trying to induce or speed up labor with drugs is almost always a mistake. Adam got upset because he knew that I didn't want pitocin. But I told him that the doctor's stance was reasonable, given that she didn't know about my blood pressure history. But more importantly, I told him, "Don't worry - by the time they get me the epidural, I'll have made so much progress they won't need the pitocin."

So, they got me a room and I got the epidural pretty quickly. I only had to endure about a dozen strong contractions (mixed with another dozen weaker ones) before I got it. And it was wonderful. I didn't mind laboring with Sam when I could move around and be left alone to deal with my contractions. But in the hospital, when you are forced to lie in bed on your back, and when you have people constantly talking to you and have to tell them to shut up when a contraction comes along, it was really, really painful. The hospital environment simply does not allow you to relax and focus. I recommend that anyone who is giving birth in a hospital should have the epidural. It's insane to try to deal with contractions in that environment. If you want a natural birth, have it outside the hospital, or at least hire a doula to make everyone leave you alone, and don't allow them to limit your movement. Continuous monitoring is the first problem in the chain of interventions leading to C-sections.

After I had been in the L&D room for a bit, Mrs. Dr. K. arrived. She had either ditched her post in the triage room, or had finished her shift and come to me on her own account. She stayed with us through the rest of the delivery. Even though my primary nurse, Ann, was excellent, I was so grateful to have that connection again.

Dr. A.'s orders were to start pitocin at this point, and the nurse could have just put the bag on the IV, but I told her about my fast labor with Sam and how I knew by the strength of the contractions that I was progressing quickly. I asked if she could check me first and she agreed, even though I'd been checked so recently. As she was checking she said, "I'd say...I'd say...[long pause]...I'd say you're complete!" My response: "Ha! I knew it!" Thank god I knew my body and was an advocate for myself. I have no idea what would have happened if they hadn't gotten me that room and the epidural, or if they had given me pitocin when I was already fully dilated. The whole situation reinforced my belief that hospitals do not handle childbirth well at all. I'm grateful for so many aspects of modern medicine: the drugs, the skills of the doctors and nurses, the blood banks, the NICU, and so much more. And I needed that for this situation. But I've done it both ways and I know that hospitals could do much better. Maybe if the "natural birth" advocates weren't so anti-medicine, they would stop promoting birth centers and midwives and try to make changes within the excellent medical system that we already have. I'll have to add that to my long-range to-do list. (Otherwise known as my wishful thinking list.)

Anyway, I was feeling great. I was in no pain and I was ready to be moved to the OR. I still didn't know if I would end up with a C-section or not. Leo was head-down, but Zoe could go either way. The plan was for me to push Leo out and hope that she turned head-down as well. But if she went into a breech position and if the doctor recommended it, I was going to take the surgery and not try to force the issue. They wheeled me into the OR. Adam had to wait outside while they set up the room. I had enough feeling to slide myself onto the table. I felt pretty powerful and in control. But then I spent the next 30 minutes watching as the doctors and nurses fumbled around trying to get things set up. A couple of them had never participated in a vaginal delivery in the OR before, and nobody seemed to know how to get things set up properly. They practically had to pull out the user's manual to get the stirrups hooked up to the OR table. They had machines that were not normally in the room and they couldn't figure out how to plug them in, so there was some crawling around on the floor, stringing wires and cables under my bed to the other side of the room. It was comical!

As this was going on, a steady stream of people were entering the room. There were three or four people for each baby, my anesthesiologist, his assistant, my doctor, my two nurses, another assistant, and probably more that I'm forgetting. My doctors had blue gowns, and the baby doctors had yellow gowns. The yellow gowns were all behind me, so I knew that Leo and Zoe would end up there, where I couldn’t see them. I suppose they do that in case something goes horribly wrong. But I wasn’t too concerned about the babies’ health at this point. I knew that they would go to the NICU for sure, which made me sad, but didn’t freak me out. I was mostly focused on the time elapsing – hoping the staff could get their act together in time. With the epidural, I couldn’t tell where Leo was, and I wanted Adam in the room. I kept reminding everybody, "Don't forget my husband!" Finally, they let him in and the pushing began.

Leo was easy. I pushed a few times and he was out. I'll never forget looking down past my still-huge belly and seeing him being lifted up towards me. I'd been here before - with Sam. I didn't think a second child could be as shocking and awe-inspiring. But he was. I said, "Oh my god. He's real!" There is no other way to describe it. No matter what you experience when they are on the inside, you can't be prepared for the reality of an actual human being coming into this world. They let me hold him for a moment before they whisked him off behind me to check him out. He looked great - pink and full of energy. But his cry started out pretty weak and I worried a bit until it grew stronger. Then I knew he'd be okay. He was four pounds and seven ounces.

Zoe didn't suddenly make a break for it. She just stayed put. That ended up being the best thing, because the doctor was able to guide her to come down head-first as I pushed. I wasn't going to need surgery - hurray! I still had to push her all the way down, so it was a lot more work than it was for Leo, who had been right there at the door. Zoe did end up head-down, but in a posterior position - face up. This means a slightly more difficult birth, but since she was so small, it wasn't a real problem. Still, despite her smaller head, I noticed how much more difficult it was to get her out than it was Leo. I feel for mothers of full-term babies who are born this way! Anyway, after all that pushing (it really wasn't that long - about 10 minutes), it felt like a real accomplishment when I finally got her head out and I cried, "Yes!" like I had just aced a serve at Wimbledon.

Zoe's appearance didn't have quite the impact that Leo's did since I was a bit more prepared for her reality. But still, there was the mindblowing realization that this was a unique human being who had just arrived. She looked different than Leo. She was smaller. Her face was more delicate. She moved differently. Leo and Zoe are not a “set.” They happen to be twins, but that doesn’t mean much more than that they are siblings. I knew all of that in the abstract, but seeing Zoe for the first time made it concretely real.

Despite her smaller size, Zoe’s cry was strong from the moment she let it loose. I knew she would be okay, too. She was three pounds and fourteen ounces.

I didn’t get to see either of my babies much after the first few moments. I didn’t fall in love with them right away. I was stunned from the whole experience, and I ended up having some problems delivering the placentas, which required that I be drugged up even more than I already was. By that time, Adam and Leo and Zoe, along with all the yellow gowns, were gone to the NICU.

Eventually, I was brought back to the L&D room and I dozed off for a while. It seemed that hours had passed before Adam finally came back. He gave me a report on Leo and Zoe which is a complete jumble in my memory now, but which boiled down to “they look good.”  I wanted two things: I wanted food and I wanted to see my babies. I felt like they had been stolen from me. It just seemed so wrong that everyone could see them except me. Still, my hunger was even stronger than my desire to see them. I kept begging for food, but I didn’t get it until many hours later. They made me drink juice and eat a few crackers first (crackers don’t count as food). They are so scared that people might vomit. The whole thing is just so wrong. They should have a feast waiting for you after you give birth and trust you to eat according to your needs!

The hospital was still busy. The next step was for me to be moved to a “Family Centered Care” room, and there was a room available, but there were 13 women ahead of me in line just waiting for someone to physically move them. Apparently, the move process requires more paperwork and specially skilled “transfer personnel” in order to accomplish the daunting feat of wheeling the bed into an elevator, pushing the right button, and then wheeling the bed into a room. But my nurse, Anna, decided I was special and she wheeled me there herself. I know this is something she normally doesn’t do because when we arrived in the FCC area, she said hello to a lot of the staff saying things like, “It’s nice to finally meet you in person.” “We’ve spoken on the phone so many times but I’ve never seen you before.” I’m not sure why we got such excellent treatment, but I was so grateful for it because it meant that I’d get a meal that much sooner.

Zoe was born at 3pm. I arrived in the FCC room somewhere around 5pm. We quickly found out that the NICU doesn’t allow visitors between 6:30pm and 7:30pm because that is when they do their shift-change. I didn’t want to wait until 7:30 to see Leo and Zoe. I told everyone that I was going to make the trip (four floors down and maybe 40 yards of walking), so they should help me get ready. I had to use the bathroom and they had to give me some lectures about this and that. I ordered food from the cafeteria so it would be there when I got back. Suddenly, it was 6pm. I told them I was going now. They tried to get me to go in a wheelchair, but they were so slow about everything I was afraid that I’d lose my chance if I waited. So Adam and I walked, wheeling my IV cart along.

I don’t even remember much of my first visit to the NICU. It was overwhelming. I just wanted to see their faces, and once I did, I felt better. First I saw Leo, and noted what a big nose he had. Then I saw Zoe, and noted how tiny she really was – more tiny than I had realized in the delivery room. As I was finishing up with Zoe, I felt something dripping down my back. My epidural injection site was leaking. Someone found me a wheelchair and we went back to the FCC room. It turned out to be nothing. Then I ate.

That’s the end of the story. But there’s a postscript. About two weeks later, while I was visiting Zoe (Leo was home by that point), one of the NICU nurses came up to me and said, “I just had to come over and say hello. You probably don’t remember me, but I was there when you came to visit Zoe that first time. I’ll never forget how determined you were to see your babies. I couldn’t believe you had just delivered them three hours ago. You were amazing.”

Yes, I was.




  1. There's a Hebrew expression, kol ha kavode, which means literally "all the honor". It's said when someone has accomplished a great feat. So, Kol ha kavode for all you and Adam have gone through to have these children join your family! :)

  2. Hooray for Amy and the whole Mossoff family! I love a story with a happy ending.

    Both of my full term babies were posterior and one weighed 8 -12.5. Thankfully our memory clouds these things. Otherwise I think it might be a far less populated world. LOL

    Congratulations and {{hugs}} from all of us at Quent Cordair Fine Art in Napa!

  3. You rock. Thanks for this story.

  4. What a story, Amy, thanks for sharing! We are all so happy for you & send hugs and kisses.

    On the hospital birth: I think it really depends on which hospital. I had a VBAC with #2, and they also required constant monitoring and IV, because of the added risk. But our L&D room had dimmed lights with a comfy sofa and chairs, I had a wireless monitor, a nice deep whirlpool tub which I could use with the monitor, music from an iPod, and really not that much fussing by medical personnel for the first 10 hours or so of labor. But then, of course, we're in Berkeley, and they are all about natural birth here...

  5. Good point, Heike. Your hospital sounds perfect! That's exactly what I'm talking about when I say that these elements should be incorporated by hospitals. Those things might sound hokey to anyone who has not given birth, but they are so important. Wireless monitoring - that alone makes a huge difference. They wouldn't even let me stand up for contractions, let alone get in a tub (which they didn't have anyway).

  6. Wonderful birth story Amy - way to go on being your own advocate. You are right - it's ridiculous that you have to be. Can't wait till we get to meet the new Mossoffs!

  7. i have tears pouring down my face - so beautiful - i am pregnant with my 6th child due in about 4 weeks and cannot wait to meet him, it's easy to forget how precious and tiny and perfect they are when they are just born.