Intangibility

Overview: Elliott Marr Wieler arrived on July 1st at 5:54pm - weighing in at 8.1lbs and measuring 21.6in. He is very healthy, happy, and alert. Mom and Dad are proud parents!

Detail: The 36 hours leading to his actual arrival were a mix of excitement, fear, exhaustion, and a small list of intangibles that I am still mulling over. As there are two sides to every story, you can read my wife's blog here. That being said, I felt very locked in with my wife during this process and felt that the decisions that were made (as they were presented to us) were very much a team effort. You hear of the stereotypical scenario with the wife screaming profanities at the husband and moving on without his buy-in. That was not my wife. She was amazingly rational and so tuned to her own body that those around her (and there were many) were simply extraneous noise. She was very responsive to me and I felt honored to be participating with such a strong woman in this process. It became apparent to me that she was at another level altogether when the midwife would ask questions and have to repeat them multiple times to get a response.

The process itself was long and involved - although I must say that the path that was followed was very logical and comfortable when all was said and done...for this I am thankful. For me, the process began at 4:29:50pm - the moment that the contractions warranted me getting a pen and paper to write the times and spacing. I kept the times (duration of contractions and spacing between) on my Casio G-Shock watch while I made my last push to debrief customers on my soon to be disappearing act and turn on my Out of Office Assistant. The process took an amazing "do you believe me now?" at 5:06:10pm when my wife lost about a gallon of amniotic fluid on the hardwood floor while calling the midwife to determine whether we should start to head to the birth center. This was one of the craziest things I have ever seen and my response was to stare in disbelief and laugh with my wife at the event in progress. Laughter in this case was certainly one of those moments where things aren't *funny* in the classic sense - but it acts as a mechanism to assist in coping with intangibles. The intangible feelings had begun. I froze for about 30 seconds and then spent another minute or so looking for the camera in places like the refrigerator, in the chimney, etc. This made it apparent to me that I had officially crossed the sensory overload line.

We loaded up the Montero with the pre-determined items and headed to the UCSD Medical Center. We met up with Marissa (our Doula) just after 6:00pm and began the process in room 207 (Labor & Delivery) - as there were some scheduling issues in the Birthing Center that were preventing us from getting our room. The next four hours were simply a matter of getting used to the fact that *yes - we are at the hospital* and assimilating all the sights, smells, and sounds associated with the room. My wife started working through some positions with Marissa to get comfortable and I put on "Norah Jones - Come Away with Me" and tried to organize the snacks (super helpful!). We met with Jasmine (the midwife on duty) and determined that we could get into our room at the Birthing Center (room 427) by 10:00pm or so.

Room 427 was a night and day difference over the rooms in Labor & Delivery. The intent is to have the space feel organic and much less clinical - and to that end the room was perfect- nice mahogany furniture, paintings on the walls, nice lighting, etc.. We got situated and it became clear that the contractions were really starting to take effect. My wife would drop into these low guttural sounds where she would disappear within herself and get centered. It was pretty amazing to watch. We spent the next 7 hours attempting different positions to maximize the effect of the contractions, while keeping relaxed at the same time. My wife never lost it during the process, but she did have a certain look of "wishing for the next stage" - a mix of patience, pain management, and fear of the unknown. The picture in my mind is captured perfectly here as she waits on the birthing ball at 3:07am for the next contraction to happen...

Just after 4:00am, Jasmine came in to check on the progress of my wife's cervical dilation. We had some reservations on whether this would be beneficial news as a low number would indicate that we still had a ways to go after being at this for over 12 hours. We chose to know the answer which turned up to be a slightly disappointing 6 out of 10. This indicated that we were just over halfway there - good news / bad news depending on your take at 4:00 in the morning. That being said, Elyse pushed on and took to walking the halls with Marissa to get the contractions jump started. I took a 1 hour catnap to regroup and stay positive.

Rebecca took over for Jasmine around 8:00am and checked on my wife's cervical progress again. We were closer to an 8 out of 10 and were definitely making progress. During the exam, Rebecca noticed that Elliott's head was slightly turned and made a note - nothing to be of concern yet, simply another factor in the process. My wife continued to push and drive forward.

We continued to walk the halls together - my wife pausing every few minutes to lean on me and have a contraction. My parents arrived on the scene and were completely understanding when asked to wait in the lobby so that my wife could continue to focus on the task at hand.

By 11:30am, Rebecca noted my wife as "completely dilated" and gave the go ahead to begin pushing. This process was equally intense as she rode the contractions down and locked into pushing the little one out. After 2 hours of pushing, Rebecca noted that Elliott's head was making little progress, and that it was still angled with him looking down and to the left instead of straight forward. To continue in this manner, something was going to have to change. A combination of science, physical ability, and "sheer will" factors all began to converge as Rebecca indicated that Pitocin may be required to keep the contractions going. If we were to continue, we would have to accept the fact that an IV, Epidural, and additional medical intervention would be required. If we were unable to keep pushing and/or additional medical factors came in to play, we would need to consider a Cesarean section. While this wasn't the perfect scenario, we were open to having the path unfold as it should.

The nursing team took the blood work required to get the Epidural going and hooked my wife up to an IV to begin a basic fluid drip. We were back Labor & Delivery by 3:30pm- oddly enough, ending up in room 207 - and began the Epidural process. The blood work returned the fact that my wife was beginning to develop a high white blood cell count. The initial thought was that an infection could be in progress based on how long she had been in labor since her water broke. Our decision as to which route we were going to take was needing to be made quickly.

With Linda (the midwife coordinator) leading the charge we assembled all of the medical practitioners that had been involved up to this point to review what should be done. Never before have I had to assimilate so much important information, get a read from my wife, and make a decision based on the well being of all involved. All of the options were complicated by additional factors and uncertainty:

1) Pitocin would kick up the contractions and could have the effect of straightening the baby's head, *but* he may not straighten and the Doctor's were unwilling to manipulate him with forceps based on his size.

2) We could continue to push, but the Doctors would only give my wife 30 minutes of "push time" based on increasing white blood cell count. They were concerned that based on the baby's size that pushing may get him stuck - requiring additional surgical intervention and cervical damage.

3) The "C" word (Cesarean in this case)... lots of potential complications from surgery, extended recovery for my wife, but *hopefully* an unharmed, healthy baby.

Wanting to protect my wife and my unborn child, it made the most sense to move forward with a C-section. The process had run it's course and had lead us to a completely different path, but a logical one nonetheless. My wife and I agreed and we continued down the "spiral of intervention". I am happy to look back at this picture (after almost 24 hours of my wife laboring at the hospital) with our sense of humor intact.

30 minutes later I was in a room filled with other "blue" people (about 15 total) and lots of brights lights and flashing machines. I was asked to sit with the anesthesiologist at the head of the operating table - next to my wife's head, but behind the sheet that separates the patient from the surgery. It was certainly a lot of information to ingest - with my wife hooked up to lots of instruments and many, many people working on her with lots of different objects and tools being passed around, lots of smells, and lots of electronic monitors and metrics being collected in my ears and eyes. I was doing my best to maintain composure and to attempt small talk with my wife when the anesthesiologist dropped one of of the empty drip bags from above the sterile curtain. I watched it slide down, landing somewhere on my wife. A few incredibly long seconds passed (as the anesthesiologist didn't see the mistake) before the primary surgeon simply stating "What's this doing here?!?". The anesthesiologist, realizing he was missing something sheepishly looked over the curtain and fessed up. The primary surgeon clamped the bag, moved it off my wife and dropped it on the ground. Too many variables in this room as my mind raced through "What if" statements...

A few more minutes passed before I was tapped on the shoulder by the nurse. She asked simply enough "Your baby is getting ready to come out. Do you want to take a picture?" I was initially advised by the doula that looking over the curtain can indelibly scar even those who think they have no fear of blood, body parts, and the like. Based on the closeness of the delivery, it seemed like most of the scary work would be completed and I would simply see the fruits of the surgery. I grasped my camera, slid off my stool, looked over the curtain, and was face-to-face with my wife's navel - now running almost perpendicular to where it normally resides. I saw at least two gloved arms almost elbow deep fishing around in my wife's innards for my little one. Again... too much information. Better to sit and wait until the results are complete and without question.

A minute later something resembling a human body was placed on the table beside me where the Pediatric team of 4 awaited his arrival for initial inspection. Without attempting to sound callous or funny in any way shape or form, he simply looked like a mini-cadaver - devoid of color, life, and the normal motion that I had associated in my head with a birth. I was expecting a red little screaming bundle - all curled up and screaming furiously. Instead my first image was this...

Not curled up, eyes open but "checked out", no screaming... something seemed wrong. I felt detached and quickly unsure of what was going on. With the Pediatric team poking, prodding and checking for vitals he began to light up. The vocal cords arrived, arms and legs began moving, and the color of a newborn began to filter through. This was my son! I turned to share a moment with my wife who was visibly shaking from the drugs being administered. Her hands were trembling and she was looking exhausted. The idea of who to comfort and what to do is just something that you can't plan for. It made the most sense at that point to trust that the surgical team is sealing up my wife correctly and get the baby into our possession as soon as possible.

That being said, I fumbled through cutting the cord, got him wrapped up and held him at different angles so that my wife could have some visibility through the tubes and covers. I know that this wasn't what we planned for... so this moment (ultimately missing out on the skin-to-skin contact out of the womb between son and Mommy) was the only thing I wished could be different. I do understand that with a C-section process that this just isn't feasible. We made the best out of the circumstances.

Within 15 minutes, the surgery was completed we were heading to recovery. Elliott was removed from my arms and transferred to my wife to begin the wonderful bond that is the two of them.

From here the true journey begins... for all of these things I am thankful. I love my new little family and look forward to a completely modified existence.