The last month has been FULL. From our daughter entering our lives, to family visiting, to the mountain bike race and Thanksgiving, we feel like we blinked and now it is December. And we want to share about all those things. But, first, on the day our daughter is one month old, I wanted to share her birth story.
Disclaimer: this is long. I tried to ‘cut it down’ for this blog but found myself unable to for a variety of reasons, so this is the full version.
Writing Scout’s birth story was something I had thought about throughout my pregnancy. I knew from the beginning I would want to try to capture and remember as many details as possible. I would want to try to put words to something that in and of itself is a holy and sacred thing. A thing that I believe is the closest I will come to understanding the mothering, nurturing heart of God. A thing that thins the space between Heaven and earth.
I imagined, visualized, and prayed through (as best I could) each part of the labor and delivery. How the contractions would begin slowly, but firmly, and eventually take over. How I would breathe through them, and Landon would be there, rubbing my back to help me. The car ride to the hospital, and how that might be a little uncomfortable on these bumpy Nicaraguan roads. All the walking throughout the hospital to help the labor progress. My friend and doula, Katie, instructing me and coaching me through the laboring. The transition period. The pushing. The hearing and seeing our baby emerge into the world. And into our arms. Kissing his or her little face and hands and feet. The sheer exhaustion and overwhelming joy of our first child finally being in our arms.
I thought through all of that. And prayed over every. last. detail. And I believed so deeply in my ability to birth this baby. I knew I could do it. That my body and mind and heart could do it.
My due date was October 25th. In the days leading up to that week, Landon and I found ourselves naturally ‘hunkering down,’ as Mr. Buzbee put it. Partly because driving anywhere became fairly uncomfortable for me and partly because we were preparing our hearts for the upcoming event, we spent most of our days together, resting. This is our slow season in Nicaragua, so except for a little work on our upcoming mountain bike race at Ruby Ranch, we were able to work from home the little bit we needed to. We worked on small projects around the house, ran last minute errands, walked every evening and watched a lot of Netflix. We talked about how the waiting was so hard, but so good. We didn’t want to rush our baby into the world before he or she was ready, but we also were so excited to meet the little one.
I had my last prenatal appointment with my doctor on Friday, the 27th, two days past my due date. My doctor had a previously planned trip and would be gone from the 28th to the 2nd, so in that appointment we met the back up doctor. He is much younger than my doctor, but seemed nice and willing to accommodate our desires for a drug free, vaginal childbirth. My doctor, Dr. Mendieta, checked the baby’s heart rate, measured my uterus, took my vitals, and said everything was still going well. If anything were to happen while he was gone, we should call the other doctor, otherwise, we would see him a week later when we would need to do a biophysical exam to check on the baby. By that appointment the baby would be nine days overdue, so he would want to make sure that everything was still going well. We left the appointment happy and expectant.
The following Tuesday I scheduled an appointment with the back up doctor to just check in on everything. The appointment was terrible. Though the doctor was cordial and polite, he ended up telling us that because our baby was overdue and big (which he measured from the ultrasound, which can be very unreliable) and because I wasn’t dilated at all, he would need to induce my labor with Pitocin. I was immediately defensive. This was not my understanding of how this doctor was to care for us in the absence of Dr. Mendieta. He was here to manage anything that might come up, not tell me that he needed to induce me that day or the next. There also was no reason to induce, except that the baby was ‘big.’ All the vital signs were great and the baby was still in great health. We left the appointment incredibly pissed off. I actually told Landon in the parking lot, “There is no way this baby is being born before Friday. I can guarantee my body will not go into labor if that guy is the doctor I’m supposed to see.”
That evening, probably due to my stress and ‘excitement,’ the baby in my belly was doing all the acrobatics you can imagine. And for a week overdue mama, that is not a comfortable experience. I tried to breathe. I tried to relax. I ended up resting by leaning on a yoga ball and letting my belly fall forward. Eventually the baby calmed down and I climbed back into bed.
The next two days dragged on in a way. I felt like if I could just get to Thursday evening I would be good. I don’t even remember what we did to pass the time. Probably more of the same. But instead of trying to go on walks to get things going, I found myself very unmotivated to do anything that might kickstart labor. I just wanted to hear my doctor’s voice on the other end of the phone, letting me know he was back in the country, and taking over my care again.
That phone call happened Thursday evening. We spoke briefly about the appointment time the following day for the biophysical exam (because it would involved another doctor) and I hung up the phone incredibly relieved. We got up the following morning and made our way across town to do the biophysical exam. As we drove I felt aches like period cramps, intermittently with the Braxton Hicks contractions. My back was achy, and sitting in the truck was not enjoyable. I mentioned it to Landon, and texted Katie, thinking that at last, labor was beginning.
As we waited at the doctor’s office I couldn’t sit down. It was too uncomfortable. I went outside and leaned against our truck, my head resting on my folded arms. The achy feelings were relieved if I was standing. They finally called us back and I climbed onto the table next to the ultrasound machine, my heart full of hope and excitement that the doctor would tell us the baby was fine and I was showing signs of labor progressing soon.
I don’t remember the order in which things happened after that. I remember the doctor measuring the baby’s head, measuring the abdomen, and listening to the heart rate. As we listened the rate went from 135 to 110, still within normal limits for a moment, but definitely lower than it had been. As we saw the baby’s face (the adorable squishy face) the doctor informed us that the baby was now positioned facing forward, with his/her spine towards mine. The umbilical cord was wrapped around the neck once, and also again around the abdomen. The baby’s head, which measured big, was not engaged in the pelvis at all, which could potentially be explained by the cord keeping the baby from moving down. When the doctor looked at blood flow in the brain, it was within normal limits, but on the low side. As we looked at the amniotic fluid there was a murkiness to it, which the doctor explained could be vernix (not a problem and very applicable to an overdue baby) or meconium (more concerning as it could indicate the baby being under prolonged stress). As the exam finished up the doctor performing the ultrasound said, in Spanish, something about not being able to labor. I looked at my doctor and he was nodding. I clarified that I had heard correctly. They said I had. I looked at Landon and took a deep breath. When the exam was finished I climbed off the table and looked directly at my doctor and asked, “So what does this mean?” His reply was overwhelming: “I cannot let you labor naturally. Your baby is healthy and safe right now. But with all of this, it could be very dangerous for you to go into labor. You need to have a cesarean to deliver this baby. And we need to do it today or tomorrow. You can decide that. I can deliver the baby this evening or tomorrow morning, but you can’t go past the weekend, and you can’t go into labor naturally. Jamie. I’m sorry.” I breathed deep again and asked a few questions about what ifs. The doctors were both patient to answer the questions, but kept coming back to the risk factors. With two or three, and a healthy, normal pregnancy like I had had, they might consider it. Not with as many as I had though. We discussed things a little more so Landon and I could fully understand, and then we walked out together. As my doctor said goodbye he said he would be waiting for my call on what I decided.
On the ride home I called Katie and explained what they had said. It was surreal to be talking through it. Was this really happening? After everything being so good and healthy and normal? Whoa. I held the emotions together until we got home, but then I couldn’t hold back anymore.
It feels like a little bit of an odd thing to say I was disappointed because of all the joy that was about to enter our life. We were about to hold our baby. We were hours away from meeting this little person who we had felt move and tumble and grow inside my uterus for the past 41 weeks and 2 days. We were about to be face to face with a little one that we had prayed about for YEARS. A little one that I told the Lord He would have to change my heart about having, because for most of our marriage I really didn’t care to be a parent. A baby who was waited for, planned for, and already immensely loved.
And yet, I simultaneously felt a deep sadness. I felt robbed of that laboring experience. I felt disappointed in the ending of this crazy, beautiful, fought for story. I also felt incredibly scared. To say that I didn’t think of my own life ending that evening would be a lie. I’ve read the stories. I’ve seen the families grieving. I know very acutely that surgery is dangerous, and unpredictable. And a pulmonary embolism can take a healthy person’s life before anyone can do anything about it.
And so I wept. I laid on our bed, with Landon hugging me, and sobbed. We sobbed. We comforted each other, and kissed each other, and cried. And we prayed. And we just were there. In that indescribable place where great sorrow and great joy coexist, and there is no explanation for it, and no need to ‘make it better.’ In those moments I had a very real prayer utter from the depths of soul. From the part of yourself that doesn’t use the fancy or correct words. And it went something like, “Ok. Lord. If this is the day I die, take care of my baby and Landon. I’ll do this so that this baby can live.”
As we settled into the reality of what was about to happen we realized that we didn’t want to wait any longer to meet our baby. I would have the c-section that evening. I called my doctor and gave him the go ahead to book the OR room and call the other doctor’s. There would be four in the room. Himself, the pediatrician, another surgeon to assist, and the anesthesiologist. I needed to arrive at the hospital at five and the c-section would happen at six.
We began getting our things ready. The hospital bag I had packed now seemed irrelevant. Would I really need that electrolyte powder I had planned to drink during labor? Who knows. Leave it. What do you even wear or care about after a c-section? Did Landon put enough in for himself if we have to stay longer than we thought?
We eventually got the items together and then we drove over to the Farrington’s house to deliver a birthday present. Bella’s birthday was the day before, but the party was Friday evening and we had planned on attending, but with the change of plans, I told Landon I wanted to deliver it early. Plus I knew it would be good to be hugged by our dear friends. We visited for a while around their kitchen table, explaining what the doctor had said, and then they prayed for us. One of the most beautiful things we get to be a part of here is the prayer ministry at Miss Ruby’s house. But what people may not realize is that it is not just there. We pray with one another and over one another a lot. And so to have such dear friends gather around us and pray for us was incredibly sweet, and a beautiful moment to have on a day that was so full of so much emotion.
We headed to the hospital around four because traffic going across town can be bad. When we arrived and checked in, they let us know that someone would be down to get us. As the orderly went to grab the wheelchair I looked at him and simply stated, “Yo puedo caminar.” He gave me a sheepish grin, mumbled something about protocol, and escorted us up to maternity.
When we arrived in our room my nurse came in and explained that she would need me to change and shower with an antiseptic soap. I anticipated this, and was about to, when my doctor came in and said everyone was getting ready. I had showered at home before we left, so I didn’t push back too much on the extra one at the hospital. I changed into the gown, booties and a hair net, climbed onto an OR stretcher and was wheeled to the elevator. Landon followed until I entered the pre-op area, at which he waited to be escorted to the locker room to change into scrubs.
As I waited in pre-op, I met one of the sweetest nurses I’ve ever known. It kills me that I can’t remember her name now. But her bubbly personality and gentle, kind spirit made me feel instantly better. And then I was able to meet my anesthesiologist, Dr. Padilla. He began explaining to me in Spanish what was going to happen. I listened, but realized I would need to ask him to slow down. I understand a lot, I explained, but maybe just a little slower. He chuckled, and began again, slower. He explained what his job would be during my surgery, and how he would explain each step as it happened. He then began telling me about the spinal block. He laughed and said that mine should be very easy because when people are ‘delicada’ like me, he knows right where to go because he can see the bones. But also how that isn’t the case for most of the world. How they just want to ‘always be eating but never do any exercise.’ Talking with him felt very familiar. It was like talking with the anesthesiologists I used to work with at Sacred Heart, and somehow that put me at ease.
Dr. Padilla started my IV next, and about that time Dr. Mendieta came in. He checked on how I was doing, and translated the only part of Dr. Padilla’s conversation I hadn’t understood: had I ever had any surgery before? I told him only my wisdom teeth, and then we wheeled towards the OR door. As we went by, Landon was standing in the corridor in his scrubs, hat and booties. Something about seeing him in surgical garb was actually comical to me. He looked like he felt very out of place. I said hi as we went by, and we entered the OR suite.
To say that laying on the stretcher looking up at the bright operating room lights was surreal would be an understatement. I can’t even begin to count how many surgeries I have been in on in my career, and yet this was the first time from this perspective. It wasn’t scary or daunting in that moment, but rather just odd. And yet, all the same equipment was present. The flat table. The stainless steel rolling tables with all the packets of sanitized surgical instruments. The anesthesia cart. It was all there. Plus the little warming bed for when the baby was delivered. There was even a circulating nurse and a scrub tech, busily preparing the room and instruments for the surgery to begin.
They moved me to the OR table and then helped me sit up and hunch forward so that Dr. Padilla could administer the spinal block. True to his word, he explained exactly what he was doing before he did it. I felt the cold antiseptic wash. Three different applications, using the same pattern for washing as I had learned in school. Then the pressure of his index finger along my spinous processes in order to locate the correct level. “Take a deep breath for the little pinch of the local.” The slight pinch and burn of the Lidocaine. “Now more pressure. Please hold very still.” Then the pressure of the spinal needle, and the odd sensation of the anesthetic being administered. “Your legs may feel hot and tingly.” Sure enough, they did. The right one a little ahead of the left, but then, slowly, both were warm and numb. Another breath with the needle removal and we were good. The nurse and doctor helped swing my numb legs and big belly back around to be in line with the bed, and laid me back. Oxygen tubing into my nose, a blood pressure cuff on my arm and a pulse oximeter on my finger. The nurse noticed my earrings and Dr. Padilla asked if they could be removed, as they would interfere with the cauterizing tool’s ability to ground. I asked for a small cup to put the earrings in, but at that point we could have thrown them away and I wouldn’t have cared that much. They seemed trivial in light of what was about to happen. After I removed them, the circulating nurse administered the catheter that would drain my bladder for the next 12 or so hours, and the doctors came in to gown up. I remember looking around, watching each person, hoping to not observe something that shouldn’t be done in a sterile environment. But as I watched each person do their job, they did just what I would expect. I also remember watching the doctors waiting for their gowns to be tied up and wanting to help somehow.
Dr. Mendieta explained that Landon was outside and would come in with Dr. Mora when the prep work was done and the curtain could obscure his view of them doing the cut down. I tried to relax and just kept thinking that our baby was about to be born. Within the hour, our kiddo would arrive. I also thought how strange it was to be having a surgery in my second language, a language I am far from fluent in. Again, it felt completely surreal.
Landon came in, as promised, and sat by my head. I asked him to hold my hand. That didn’t last long because it interfered with the IV working, but he was near, and I was grateful for that. Sometime during the cut down I began to feel dizzy and nauseated. I didn’t know the Spanish word for dizzy so I told the doctor I was nauseous, and turned my head to the side to be safe. I could see the monitor from there, and my heart rate did dip down a little, but he re-ran my blood pressure and it came back relatively normal. “You’re ok. It is still ok.” I tried to just relax and focus on breathing at that point.
A minute or so later I realized I was hearing a lot more suctioning than I had. I told Landon, “I think that is the amniotic fluid. Our baby is about to be born. You should watch.” About that time, Dr. Mendieta told Landon he should look over the curtain, and he did (and began recording a video for me) in time to watch our baby be lifted from my abdomen. I couldn’t see but I could feel the doctor press really hard down on the top of my uterus, trying to squeeze the baby out like a contraction would. As the little human emerged the doctor said, “And its a girl! Felicidades!” I couldn’t believe what I had just heard. “Its a girl? Are you serious?!” I began laughing, and Landon was reacting the same. Then I heard him say, with tears in his eyes, “She’s so beautiful. Oh wow. She’s so beautiful.” Dr. Mendieta stated that there was the cord around her neck, and again around her abdomen. As tears began to fill my eyes and run down my cheeks I heard the suctioning of the pediatrician pulling the amniotic fluid from her mouth and her first cry followed. It was the most incredibly relieving sound I had ever heard. I also, simultaneously, felt so spent. Emotionally, physically, mentally. All the prayers we had prayed, all the conversations and discussions about the best course of action, all the tears. It all lifted and released in that moment that my ears heard that hearty cry, and I was left completely drained but in a state of complete peace.
The next thing I heard was Dr. Mora, the pediatrician, state that the cord had been able to pulse for one minute now, and they were going to cut it now. I remember saying, “Ok. Thank you,” and feeling a sense of gratefulness to him. That even despite the drastic change in plans, he still remembered and honored my desire for the delayed cord clamping. Dr. Mendieta told Landon to go with the pediatrician as they examined and wiped our daughter down. After that, I was introduced to our daughter by the pediatrician bringing her to my chest for that first skin to skin contact. I kissed her. Reached my right arm (the one with only the blood pressure cuff) over and held her the best I could. Landon kissed my forehead. She lifted her head and set it back down again, a simple gesture of belonging. Dr. Mora tried to help her latch on to breastfeed but she was very calm and uninterested at that moment. She just laid there, and took big breaths. The doctors asked if we had a name, and Landon replied Scout, but then asked me if the middle name was Caroline. We had discussed a couple middle names, and had decided to wait until we met our child to decide for sure. I couldn’t even respond. I didn’t care to. They could all wait. I was meeting my baby girl for the first time and I needed a minute. I eventually did tell Landon that I thought Caroline was the name, and he agreed. Funny enough, the doctors could not understand the name Scout (there is no Spanish equivalent) so in the OR room they called her Carolina, the Spanish equivalent for Caroline. I didn’t care to correct them.
After a few minutes of Scout there on my chest, the doctor picked her back up to take her to the nursery to do her exams and get her vitals. I said goodbye to Landon, as he went with her, and relaxed into the finishing of the surgery. Very sweetly, all of the people in the room congratulated me. They delivered the placenta, and told me it had weighed a pound and a half, and looked very healthy. Dr. Mendieta also said that the murkiness we had seen on the ultrasound was in fact vernix, not meconium, which made me relieved. It meant Scout wouldn’t need antibiotics. As they sutured and then stapled my incision site closed, they began peeling back the sterile field. At this point I still felt drained and tired, but luckily I didn’t feel dizzy or lightheaded anymore. After everything was closed and bandaged, they slid me back over to my stretcher to go to recovery for the next couple of hours.
The recovery room was a bit of a haze. I had been so cold in the surgery, that the first thing I asked for was more warm blankets. They gave them to me, and then the nurse even gave me an electric blanket for my two hour wait. I tried to close my eyes and just rest, but the adrenaline of what had just happened kept me from actually sleeping. The anesthesiologist came and spoke with me, as did Dr. Mendieta. They said everything went very well from their perspective, and they would be checking in on me later that evening. For now I was supposed to rest. I ended up seeing Dr. Padilla sooner than he had thought, though, because about an hour into my time in post-op I began itching. From about where my abdomen was numb, up and across my chest. I told my nurse about it, and she came to look. She said it was red, but there wasn’t a rash. She called Dr. Padilla anyway. He came and evaluated me, and prescribed some sort of allergy medicine. I was probably just reacting to something they had given me, though not severely. The medicine helped, and I rested more.
I asked my nurse at some point when I would be allowed to go back to my room. “The doctor would like you here until nine.” I looked at the clock on the wall and said ok. Every time the machine took my vitals I checked to see where I was. It was always within the normal limits for my age and situation. When it was finally nine o’clock, I asked if I could go to my room. She said yes, she was just finishing the charting. About ten minutes later the phone rang. It was the floor, asking where I was and when I would return. I found out later that Katie and Landon had been told the 9 pm mark as well, and were making sure that there wasn’t a relaxed attitude being taken when it came to reuniting Scout and myself. It took just a little while longer and the orderly came to transport me back to my room. My recovery nurse came with me, and they once again transferred me to a bed, this time the hospital bed I would spend the next couple of days recovering in.
When I got to my room I was greeted by Katie. I had told her to tell the hospital when she arrived that she was family, which gained her immediate access to our room. She had actually recorded a sweet video message and sent it to Landon, which he played for me when he got into the operating room. Just knowing she was there, waiting and praying for us all, was a comfort. She had actually been able to meet Scout by then because of saying she was family. I was glad.
A few minutes later they wheeled Scout into our room in her bassinet. Landon picked her up and handed her to me, and I don’t remember very much about the next few minutes except that I couldn’t stop staring at her, and really, seriously, couldn’t believe she was a girl. The nurse that brought her in tried to help me to get her to latch on for breastfeeding, but it ended up being a little more frustrating than helpful. I told her I was ok, and would keep trying. She left, and then Katie helped me figure it out.
The rest of the night was a haze of nurses checking on us, doctors popping in to see how we were doing, visiting with Katie and assuring Landon it was ok that he slept. He had a terrible migraine and felt nauseated for most of our time at the hospital. I felt horrible that he had had the headache. On the day of his daughter’s birth, no less. He eventually fell asleep, Katie said her goodbyes and I laid in my bed next to my sleeping daughter, unable to sleep but so exhausted. It definitely wins as being the most exhausted and joyful I have ever felt, next to the day Landon and I got married.
I found out the next day that when Landon followed Scout and Dr. Mora into the nursery he asked about skin to skin contact. The nurses said that, yes, sometimes the mothers come in to do that with their babies. He told them he would like to do that. They looked bewildered, but Dr. Mora said of course, so they let him. He sat and held Scout on his chest for an hour and half. He only got up because he had to use the bathroom, and the headache was worsening. He also advocated for Scout not needing the medicine on her eyes, as she had not exited the birth canal. So she only received her Vitamin K shot, to which she gave one small protesting cry, and then calmed back down after she was left alone.
Scout Caroline Baron is the little girl we were both scared to have, but both definitely needed. She was born at 6:20pm on November 3rd, 2017, at Vivian Pellas Metropolitano Hospital in Managua, Nicaragua. She was delivered by Dr. Walter Mendieta, via cesarean section. She weighed 8 pounds, 8 ounces, and measured 20 inches long.