Wheww...
It has been 12 months since Eric and I welcomed Enzo earthside and man, what a FREAKING year it has been! If I am blessed to call you a friend, then chances are you know exactly what I'm talking about and you are fully aware of how this story unfolds. If you're new here, I'd like to preface our birth story by letting you know that the words I type do not reflect a positive birthing experience. God has surely shown his grace, kindness, and care for us through it all and I can now share this story in pure confidence of that. Day by day He is teaching me to release things that weigh heavy on me such as expectations, plans, and perfectionism. I'm also reminded that grace and forgiveness are the reason I stand today, and surely I can forgive for the wound that has been inflicted on me. Although it pains me to reflect on the trauma we suffered as a family, I sit with the awareness that every pregnancy is different, every birth is different, and every birth story is deeply important and worth sharing. This is our story.
In her blog post outlining the birth of her 2nd daughter, Clara, my friend Shannon from Kiss In The Kitchen writes,
"I’m a firm believer that you can’t have it all when it comes to growing your family. It’s VERY rare for someone to have a seamless preconception experience, pregnancy, labor and breastfeeding journey. If you can have two of those experiences you’re pleased with, that’s a win. If you can have three, consider yourself even more blessed. If you have all four, then you’re a unicorn and your mom friends are probably secretly jealous."
Shannon clearly has more wisdom and experience in motherhood because I was 100% certain that I was in fact, going to try my darndest to be a unicorn! Conception was seamless (dad's proud to say he got it on the first try) and despite the 1st trimester food aversions, nausea and fatigue, I genuinely LOVED being pregnant. As soon as I saw that faint little blue line the morning of June 13th, 2020 I immediately began planning and prepping for what I wanted the next 9 months to look like. I had a lot of trust in my body and how God designed mommas to birth their babies - I find it so fascinating! I felt that a hospital birth wasn't the right choice for our family, but I also recognized I wasn't very familiar with the birthing community in San Antonio. I knew I wanted to birth my baby either at home or in a birthing center so I began exploring potential midwife candidates in the area.
As I began my search (thanks Instagram), I found Nikki Brown - THE San Antonio Nurse Midwife. What makes Nikki unique is that she is a Certified Nurse Midwife (CNM) who has experience in the hospital as well as home and birth center settings. She is licensed and trained to perform certain medical measures that a general midwife cannot. What's even more special about Nikki is that she owns the San Antonio Nurse Midwife Birth and Wellness Center, 1 of the 15 black-owned birth centers in the United States. Rather than paying hospital bills, our finances would directly help to support a black-owned business that advocates against institutional, systemic racism and strives to drive down the horrible statistics that black birthing people are up against when being cared for in the hospital system. It was an obvious choice for me. After touring the center and an hour-long prenatal visit (yep, hour-long!), I was now fully confident and ready to rock this birth in one of the most beautiful, welcoming, and comfortable birthing centers in Texas.
From July all the way to the end of January, I had a total of 9 prenatal visits, all of which showed positive signs that Enzo and I were healthy and thriving - together! I stuck to my normal weekly routine which included teaching high school students (virtually and in person at the same time), attending CrossFit classes (my absolute favorite thing I did while carrying Enzo), spending quality time with my husband (we discovered HelloFresh during pregnancy and LOVED it), I took lots of warm baths, read every word of the Mama Natural Week-By-Week Pregnancy Guide, studied my birth affirmation cards, and watched all of Miranda Alcaraz's birth vlogs on Youtube! Did I also mention I began consuming raw, salmon roe during the 3rd trimester to increase Enzo's DHA intake for healthy brain development?! I was all in for my baby boy and this pregnancy. In my mind, I believed I was doing "all the right things" to ensure that birth, breastfeeding, and parenting went according to the vision I created in my head and heart.
During the 2nd trimester, I started making additions to my birth team. I began paying bi-weekly visits to Dr. Erica Hernandez of Empowered Chiropractic and man - I can't stress enough what a difference chiropractic care can do for your pregnancy! I felt amazing, truly. Next up, I found one of the best Pelvic Floor Therapists in San Antonio and visited the adorable backyard home office of Dr. Holly Hernandez with Lotus Rehab. I've never left a "doctor's office" feeling more empowered and confident in my body! Holly is a true professional who strives to educate women about their pelvic floor and just how crucial it is to draw awareness and attention to a part of the body that very rarely gets talked about.
I could NOT WAIT to birth my baby on my terms, with the loving embrace and support of my husband, in the presence of a God who knit this precious baby in my womb. I HAD to have this special moment documented and who better to call on than Vanessa Mendez Photography. Her work is flawless, breathtaking, real, and raw. My birth team was solid but still incomplete. I was definitely overconfident and maybe even naive to think that I wouldn't need the support of a doula while birthing my baby unmedicated. I'm so thankful that Megan, founder of Rooted Birth, reached out and encouraged Eric and me to allow her to offer doula support for the birth of Enzo. All of the pieces of the birth puzzle had finally come together. I was ready. Eric was ready. Everything was planned perfectly to a T.... Notice a theme here?
Now, we wait....
Monday January 25th, 2021
I had reached the point in my pregnancy where I was officially teaching while sitting with my feet propped up. My feet were so swollen that Birkenstocks on their last hole would barely do. I was definitely concerned about the swelling, but every woman whose ever been pregnant reassured me that the swelling was "normal". Lucky for me, I also worked alongside incredible health science teachers who checked my blood pressure daily and took great care of me as I approached the last few weeks of pregnancy.
Later in the evening as I was getting ready for bed, I began to notice a pain in my chest. This wasn't the pregnancy heartburn everyone talked about. This was different, I've never felt this kind of pain before. I decided to lay down and get some rest in hopes the discomfort would dissipate. At 2am when I woke for my nightly bathroom run, I noticed that my chest pain had gone away. I was relieved.
I got out of bed Tuesday morning and went to work feeling a little crummy, but thankful to have a co-worker who stocked up on body armor & life water on their way to school to keep my hydrated. I went about my day feeling tired and depleted, but I was not in pain and was not worried about mine or Enzo's health or safety.
The next day....
Wednesday January 27th, 2021
That Wednesday afternoon I had two appointments after school. The first was an adjustment with Dr. Erica, the second was my 36 week appointment with Nikki, my midwife. Enzo was engaged and in a great position to make his earthly debut - but Dr. Erica was a bit concerned with the swelling going on in my feet. I reassured her I was headed to Nikki's after she adjusted me and that I'd hopefully have answers soon.
Eric and I make our way to the far North Side of San Antonio anticipating a normal prenatal visit. My urine sample was solid as usual and Enzo's heartbeat as fierce as ever, but my blood pressure.... that was a different story. It wasn't crazy high, but definitely higher than it normally has been in the last 8 months. With her index finger, Nikki began poking the flesh on top of my swollen feet. I could hear it in her voice as she looked at me with eyes of concern and said, "hmmm".
Nikki advised that I stay home from work the next two days and come back on Monday to see where my blood pressure was at and if there was anything that came back on my labs from blood that was drawn that day. Being told to go on bed rest definitely had me concerned. I envisioned teaching and working all the way up until I went into labor. All I could think about were my sick days. For those of you who are teachers or are married to teachers, you know the struggle of trying to save your days for unpaid FMLA.
Nikki sent me home with an arm cuff so I could monitor my blood pressure and encouraged me to rest and eat lots of nutritious foods going forward. It was as if Eric didn't even have to ask me, he knew where to take me next. We got back into our vehicle and he drove me to MOD Pizza where I loaded up on the most delicious veggie-covered pizza. Had I known that was going to be my last meal before birthing Enzo, I would have eaten the entire pizza instead of saving some for later.
I immediately drew a bath when we got home and retreated to my safe space. I don't quite remember the details of that bath. Did I lay there with my eyes closed? Did I read a book? Did I watch a birth vlog? I honestly don't remember. Afterwards, I came into the living room to check my blood pressure again in hopes it had gone down after a hearty meal and a relaxing bath. The same chest pain I had on Monday night had now returned. When the numbers popped up on the screen, I took a picture and text Nikki.
After sending off a message regarding the pain in my chest, I immediately get a phone call from Nikki. I remember the shock and disappointment I felt when she told me to pack a bag and make my way to a hospital. I did not have a transfer plan and I did not have a hospital in mind. Nikki and I agreed on St. Luke's Baptist Hospital. After hanging up I made my way to the bedroom and began packing. I didn't think I'd leave the hospital with my baby, but I chose to pack a "going home" outfit just in case.
Eric and I load up in the car and make our way to the northwest side of town. I'm not sure if it was fear, pain, or a combination of both, but I did not say a single word on the ride to the hospital. The pain in my chest was increasing and I just wanted answers and help.
10:30 PM
Together Eric and I walk through the doors of the lobby in front of OB Triage. Our temperatures were checked and I was escorted through the triage doors while Eric was told to wait in the lobby. The feeling in my chest had become excruciatingly painful and I could no longer keep the discomfort off of my face. I stood at the reception desk desperately looking around for someone to acknowledge me. A few staff members looked my way, but continued to walk by. In this moment, I felt as if no one cared about me.
Finally, I was addressed by a member of the nursing staff. I say "addressed" because I was not met with any amount of kindness that could justify as a greeting. The nurse told me to begin completing the paperwork on the counter. By this point, the pain began to interfere with my cognitive functioning. Answering basic questions on a piece of paperwork deemed quite challenging, but I managed. Once complete, the nurse asks me a few questions in regards to how I'm feeling. She responded by telling me that I shouldn't be in OB Triage and need to make my way to the Emergency Room.
Eric is able to reunite with me and we make our way down a hall and up a flight of stairs. It was as if the physical activity sent my body into overdrive because I now felt as if my chest was literally going to explode at any minute. We walk up to another receptionist who is busy on the phone. We wait several minutes before being acknowledged. I immediately find myself with both palms pressed against the wall, my body bent over. I knew that I wasn't in labor, but I began to breathe calmly and slowly as if I was. I could not for the life of me understand why I felt like I was dying and that nobody in that hospital seemed to care?
"I could not for the life of me, understand why I felt like I was dying and that nobody in that hospital seemed to care?"
I clearly remember that thought traveling through my head. The receptionist hangs up the phone and hands my husband the same exact paperwork I completed in triage and asks me to fill it out again. I'm mad as hell now. My blood is boiling. My chest feels like it's going to erupt at any second. No sooner did we get our insurance card handed back to us, the door to a small closet of a room opens up and I'm told to lie down on the bed. One by one, each monitor gets placed onto my body. I felt a seriousness of the situation shift once my blood pressure was taken. A staff member helps me off the bed and into a wheelchair where I'm wheeled back down to OB Triage where I first began.
A nurse draws the curtain around Eric and I and asks me to begin removing my clothes and get changed into the hospital gown. Once again, monitors are attached to me one-by-one and my blood is drawn from my arm. Moments later, Dr. D draws back the curtain. The image of him is clear as day in mind still, standing at the foot of the bed I was laying in, arms crossed, his face emotionless. He began asking me a series of questions. I couldn't tell you what the questions were, but I do remember responding "no" to each and every single one of them. With each "no" that I gave, the more worried I became. In my mind I could not formulate an answer for why I was feeling like I was on the verge of death.
The words that are exchanged before I'm transferred to the L&D room are forgotten on me, but here's what I remember happening next. The room was dark and the sound of Enzo's heartbeat on the fetal monitor echoed in my head. He was thriving. By this time, I've been administered medication to stop the pain and magnesium to help with the high blood pressure. I was groggy, things seemed blurry, and I tried my best to sleep while we awaited the lab results.
3:00 AM Thursday January 28th, 2021
With the same stoic look on his face, Dr. D enters the room. He told me that my liver enzymes were in the 600's. I was not given a diagnosis, but instead, told that I was very sick and needed to deliver my baby soon. The nurse proceeds to tell me she's going to check my cervix (this is something I would have declined at the birthing center). I was 2cm dilated but mind you, I was not in labor. Dr. D now mentions the "C" word. Yep... He suggests I have a cesarean because that's the quickest way to make my sickness go away.
I couldn't believe it. I remember thinking,
"It's happening to me. Doctor's often call for cesareans when they aren't necessary because a 30 minute surgery is much easier than a mom laboring for hours. He'll cut me open, remove my baby, sew me back up, and move onto the next patient till his shift ends."
If you're unsure about this, do your research. Cesarean rates in our country and several other countries are drastically high and often unnecessary.
The magnesium was wearing heavy on me at this point, but I was firm and politely asked if delivering vaginally was an option. To my surprise, he agreed to let me stick to part of my birth plan and stated that we'd start a drip with Pitocin. I wish I could better explain to you the state I was in, but I was so "gone" that I still wasn't comprehending the fact that I'd be going into labor and meeting my son within the next day.
The nurse gets the Pitocin started and ever so calmly tells me,
"In my 13 years of working on the L&D floor, I've never seen someone as sick as you."
WHAT IS WRONG WITH ME? ...... I still haven't formally been given a diagnosis but the word
pre-eclampsia was used a few times, so I just chalked it up to that. You may be wondering about Eric - once again, I was so out of it. Out of my body almost. It's all blurry, but I remember that we both focused on resting as much as possible early that morning.
5:00 AM Thursday January 28th, 2021
Another round of labs came back and my liver enzyme's were now sitting in the 800's. Even with the big jump, Dr. A still allowed me to continue with Pitocin and try to get labor started. The realization that I would be having a baby today must have hit me because I asked Eric for my phone and began typing out an email to my principal and administrator. I told them that I had developed pre-eclampsia and needed to deliver ASAP, therefore my maternity leave was going to begin. I sent a text to my long term sub and let her know what was going on and also asked my co-worker to give me a call when she woke. At 5:26 am I text my midwife and filled her in but also concluded with, "I feel like a cesarean is in the near future."
I set my phone down beside me on silent and slept for the next hour and a half.
Trigger warning - this is where Eric and begin to endure what would later be significant trauma.
At 7:00 AM there's a shift change and Dr. D is no longer my provider. He never came to tell me he was leaving or to introduce me to the next doctor I was being passed off to. The sunlight is now peaking through the windows of the room and I wake as soon as I hear the door open. The memory of this man entering the room, standing at the foot of my bed with his arms crossed, staring me in the eyes is engrained in my head. Eric sits up to listen. Dr. G did not ask me any questions or make any attempt to connect with me and establish a respectful provider-patient relationship. Instead, he stated his name and who he was and demanded I have an emergency cesarean performed immediately.
I was shocked, confused, and in disbelief. One doctor was allowing me to deliver vaginally and at the sudden shift change, another doctor is taking that option off the table and strongly suggesting a major abdominal surgery without providing me with knowledge and explaining why the sudden change.
This is where quality of care begins to decline rapidly.
I politely asked Dr. G to explain why he felt the need for me to have an emergency cesarean. Was there communication that took place between him and Dr. D that wasn't brought to my attention? Has something changed in the status of my health since the 5 am lab draw?
Dr. G arrogantly responded that he had 36 years of experience and knows what he is doing. I could tell he didn’t have the patience for me but I refused to say yes to a cesarean without being fully informed. I continued by asking, “In your experience, what are some potential risks involved when a birthing person has liver enzymes in the 800's?” He explained that I was at high risk for potential seizure and stroke and I was only going to continue to get worse if I did not deliver soon - followed with “I have 5 other patients on this floor that need my assistance as well”. This signaled to me that he did not have time for me and that I was less important. It also reaffirmed to me that a cesarean is far more "convenient" over a vaginal delivery from a doctor's perspective.
Not once was I ever given a diagnosis - nobody told me exactly what was causing my body to become sick so quickly.
Due to Dr. G's inability to establish a respectful provider-patient relationship with me, I had developed a strong distrust towards him. I still hadn’t given consent for the cesarean.
At this point, Dr. G approached me at bedside for the first time and at the end of my bed. While slipping a rubber glove over his hand he announces, “I’m going to check you.” He did not ask permission and I did not give permission for him to forcefully insert his fingers into my cervix. The cervical check was very aggressive and extremely painful compared to the first one I'd received by a nurse earlier in the morning. It was so aggressive it made everyone in the room extremely uncomfortable including my husband and the nurse on shift. The aggression behind the cervical check felt intentional, I felt like he was trying to punish me for simply asking him to help me be informed.
I don't remember much at this point, but I do know that Eric and I still weren't consenting to a cesarean just yet. It seemed as if the Doctor did it to please me, but he went ahead and put in another order for labs to be drawn once more. I cannot for the life of me remember the details of the phone call, but I do know that I spoke to my midwife between 8 and 9AM.
9:00 AM Thursday January 28th, 2021
The results from the labs returned and to mine and Eric's devastation, things had become much worse in that short amount of time. My liver enzymes were in the 1000's and my platelets were now sitting at a terrifying 49. There is only one option on the table left that keeps me alive. It's an emergency c-section under general anesthesia. Several blood transfusions and more magnesium. I do not get to be awake to witness my child being born, I do not get my golden hour, and Eric cannot be in the operating room to witness either. Receiving the news sent me into a shock state, my mind and my emotions went numb. I felt my body and mind give up as I released myself over to the medical staff.
The anesthesiologist entered the room. I could tell he was different. He was kind and compassionate. As he was preparing his things to prep me for anesthesia, he said, "We are going to do everything to keep you safe, but you are very very sick". The awareness of knowing that I may not survive krept in, but I was too numb and mentally paralyzed to feel any emotion towards what was happening at this point. I still have not been given a true diagnosis.
The two nurses on each side of my bed abruptly begin to wheel me out of the L&D room. Eric told me he loved me as he watched me leave the room. It isn't lost on me how terrifying this moment had to have been for him. He feared my loss and the thought of raising Enzo without me. I've encouraged him to write out Enzo's birth story from his perspective so that I can understand what he experienced through his own lense.
I entered a brightly lit operating room. The radio was playing upbeat rock and roll music. It felt like there were at least 10 other people in the room with me, but I had never felt more alone. Not a single staff member said a word to me as I lay there, cold, scared, and exposed. I could hear everyone chattering amongst each other, the sound of medial equipment clanging as they prepared to knock me out, cut me open, and retrieve my son.
The shock of it all may have numbed me emotionally, but I remember saying to myself, "If nobody is going to talk to me or comfort me, then I'm just going to talk to God." I stared up at the bright lights above me while a nurse rubbed ice-cold iodine all over my belly.
I prayed hopelessly yet boldly,
"God, please allow me to wake up from this and be given the opportunity to be Enzo's momma".
A mask of sorts was placed over my face as I was told to take one big deep breath in.
Lights out...
9:38 AM Thursday January 28th, 2021
Six layers of muscle, tissue and organ cut open and abs separated later....
At 9:38 AM Dr. G pulled Enzo from my womb.
A nurse went back to the L&D room and asked Eric for his phone. She said, "I'm going to take pictures of your baby, he's here!" Eric replied, "And what about my wife?!" The nurse said, "Things are pretty calm and quiet in there, I think she's ok."
The nurse returned to Eric with a few images and said, "Congratulations! Here's your son!"
I would not open my eyes for another 8 hours and I would not hold Enzo in my arms or set my eyes upon him for another 27.
6:15 PM Thursday, January 28th, 2021
I am just now starting to open my eyes for the first time post-surgery. My throat is throbbing and I'm so incredibly thirsty. I ask for water and am given ice chips. I desperately need to cough, but God the pain. There are so many IV's in my arms and I didn't have a pumping bra so pumping without assistance was impossible. Luckily, the lactation consultant stopped by earlier and taught Eric how to use the Medela hospital pump. I praise God daily for that man. He held the flanges up to my breasts every 2-3 hours for the next 24 hours to make sure I was removing milk. He knew breastfeeding was so important to me.
I don't remember much about that evening, but Eric explained to me that the anesthesia used on me caused Ezno to have difficulty breathing when he was born and he is currently in the NICU hooked up to a CPAP machine with oxygen. I asked if he'd met him yet and if he had any pictures. This was the first thing he showed me:
I couldn't believe that was him. Quite literally. I was happy, but not overjoyed like I thought I should be. In full transparency, bonding did not happen through the screen. Not witnessing him be born, not seeing him, or holding him. My womb was empty but I didn't have a baby in my arms. I felt like my mind was playing tricks on me.
I'm very much delusional but somehow manage to FaceTime my parents and respond to missed text messages from Nikki, my midwife. It was through this conversation that I finally learned that I had a very rare condition affecting 1-2 women per 1000 pregnancies called HELLP syndrome. The cause of HELLP syndrome is unknown by the medical community to this day.
8:00 AM Friday, January 28th, 2021
We are approaching the 24 hour mark since Enzo was born and I am desperately longing to meet my son. Early that morning Nikki sent Jenna, a CNM at St. Luke's to come a visit me. Jenna strives to improve birthing outcomes and create positive birthing experiences, even when things don't go to plan. She understands the importance of informed consent and positive provider-patient relationships. It was so comforting to have Jenna listen and sit in the grief and pain with me. I was so grateful for her visit.
God knew this momma needed tender love and compassion because the nurse that would be caring for me all morning was an absolute blessing. She overheard me relive the past 24 hours and wanted to help me make sense of it all. After Jenna left, the nurse on staff brought me an article about HELLP Syndrome. Had I been informed of my condition and what exactly was happening to my body, there is no doubt in my mind that I would have agreed to the cesarean much sooner.
10:00 AM Friday, January 28th, 2021
My platelets were still sitting at 49 so another round of blood transfusions was in the works. The game plan was to wean off of magnesium around noon, get me on my feet, and take me to go meet my son!
3:00 PM Friday, January 28th, 2021
All of a sudden things are moving abruptly. My nurse begins to prepare me for getting out of bed for the first time since I entered the hospital. She removed my catheter, got me all cleaned up... and HOLY SH..... there is nothing in the world that could have mentally prepared me for excruciating pain of trying to get out of that bed. The slightest movement sent a near unbearable surge through my body. I notice that someone else has entered the room, but I don't pay them any mind. I was on a mission. As I'm working up the courage to do the impossible, the lactation consultant begins to give me advice on breastfeeding and latching. REALLY?! Can't this wait? Bless her - she really had the best intentions, but the rambling and the advice she offered was overridden by the pain. I finally stand, only to be bombarded by someone on the phone who is upset with me because I haven't completed Enzo's paperwork yet for his Social Security & Birth Certificate. The lactation consultant is still imparting her wisdom on me while I'm on the phone... fresh on my feet after a major abdominal surgery, making my way to a wheelchair so that I can go meet my son. If it weren't for the magnesium, your girl would have lost it on somebody...
Ahh... at last. I'm in the wheelchair. My nurse is pushing me with Eric by my side and I'm on my way to the NICU to meet Enzo for the first time.
3:39 PM Friday, January 28th, 2021
I'm wheeled up to cart where Enzo is laying, brace myself for the pain, stand up, and gaze my eyes upon the tiny, perfect human that God knit ever so beautifully in my womb for the past 8 months. He was so perfect. That was my son. That was my baby boy. He was mine and I was his.
In that moment, the trauma, the grief, the pain... it had all disappeared. God heard my prayer and he graciously responded. The honor of being given the opportunity to be Enzo's mom for the past year is not something I take lightly or for granted.
After much reflection, I am aware of just how grateful I am for medical intervention because it was very necessary and saved my life. However, at minimum, birthing mothers deserve to be treated with dignity, compassion and respect. They should also be empowered to make informed decisions with the help and knowledge of the provider. Even during scary and traumatic events when the birthing person or baby is at risk, positive interactions remain essential and I believe providers are responsible for setting the tone and creating that safe, respectful environment for mom, dad, and baby. My first birthing experience was the complete opposite of the minimum. It’s a story Eric and I will live with and share for the rest of our lives. It’s the trauma, grief, and lamenting that we continue to work through and heal with God's grace, peace, forgiveness, and mercy.
For that, I will continue to share our story and of God's goodness. By Grace, we are surely blessed.