How's Your Pain?
By 5pm it was decided. I was going to have a c-section that night. I’d shown up at the hospital in the morning for what was supposed to be a routine NST, and the monitors revealed a steady stream of contractions. When the nurse asked, "How’s your pain?" - the first of hundreds of times I’d be asked - I explained I couldn’t feel any of what we were seeing. Still, sending me home was too risky. I was nervous, the house was a mess, I hadn’t said a proper goodbye to my boy. But in a matter of hours my baby would be resting on my chest. I’d see the face I’d been dreaming of for months, years even. Soon I was lying on the operating table, arms restrained, a blue sheet blocking my field of vision, and the warm tingle of an epidural crawling up my torso. The anesthesiologist did something to my left leg.
“How’s your pain?” he asked. I knew this meant my daughter was minutes away.
My pain was zero. I was pale, nauseous, and dizzy with excitement.
Weeks prior I’d learned that hospital policy dictated immediately following any c-section newborns are held up for their mothers to see, then passed through an OR window to a waiting NICU team to be briefly assessed. 10 minutes tops, I was assured. This was the routine. I knew this going in. I was prepared for 10 minutes. So when the surgery ended, and my husband unflinchingly wiped the last drop of vomit from my lips; when the doctor told me I’d done great and left the room, I started asking for her.
"Is everything okay? Can I see her now? Can someone bring her back?"
The nurse exchanged a glance with the resident. It was quick but it was enough. My pulse quickened. “Dad can go,” they said. My husband looked torn. Stay with me or go to our girl? “Go!” I nearly pushed him out by the force of the word alone. More minutes passed. I fixed my eyes on the clock. Someone put a heavy blanket over me. Someone unstrapped my arms. I saw nothing but 12 black numbers. My husband returned in time for me to be wheeled to recovery. “She’s okay," he started, "She’s having a little trouble breathing, but the doctors said it will resolve itself in an hour or so.”
I knew then there would be no tender moment in the delivery room. I would never know what my baby smelled like fresh from my body. It wouldn’t be my voice that greeted her or my hands that touched her in the first hour of her life outside the womb. The doctors wheeled me past an open door allowing me a peek at my daughter. A nurse held her up. They’d put a cap on her head. “She’s beautiful,” the nurse said. I could only nod as my bed rolled away against my will.
My pain was unimaginable, one thousand, one million, how high is the scale? I was moved further away from her.
Hours passed. My husband stayed with our daughter for as long as he could. He sent photos. “I’m telling her she’s strong,” his text read. “I’m telling her about her mom, how much you love her and want to see her.” She is named for her father and a small part of me knows how special and unique this is for her first moments of life to be shared with her dad. I’ll smile about this at her wedding. Then though, in that moment, I was dying. Doctors and nurses innocently did things that infuriated me. They checked my temperature and my stitches and my blood pressure. They seemed unaware of how little this mattered to me. My heart howled for my baby. Our daughter was being admitted to the NICU for respiratory issues, cause TBD.
A soft-spoken neonatologist stood at the foot of my bed and promised they could make her well. “She is one of our most stable babies,” he whispered. He left with a nod my way. My husband and I prayed from my bed. I could barely speak but I did not cry. The edges of my brain were beginning to register a burning pain in my stomach. My husband slept next to me but I’d never felt more alert in my life. I buzzed my nurse. She came in quietly, didn’t even turn on a light, but held out red jello and cranberry juice. She called me mommy. Mommy was feeling brave at the moment.
“What do I have to do to see my baby?”
She stared at me for a few beats and I knew that she knew. I am too weak still. The epidural had not worn off completely in my legs but it was long gone near my incision. They were yet to break out the good stuff and I was starting to feel all the things I heard happening in the OR. The nurse retrieved a wheel chair and set it four steps from my bed. Four steps. “You have to be able to move your legs,” she told me, “and your pain has to be under control. If you can get in this chair I will take you to your baby.”
Four steps. The world is brought to just four steps. I lied and told her I could both move and not yet feel anything. I sat up and forced myself not to gasp. It never enters my mind that I won’t make it to the chair. Right leg off the bed, no problem. I have to pick my left leg up with my hands but this doesn’t seem to lose me any points. The nurse watched me with the hint of a smile. I took a breath. I stood, mostly with my arms pressed against my bed. I knew the pain was going to swallow me as much as I knew I would get in that chair. I did not experience hours of labor, or intense contractions, or a third degree tear. But I think babies always demand a physical price and I had to pay four steps. I started walking.
My pain was a solid eight, maybe a nine. I was so happy not to collapse. As she wheeled me out of my room the nurse leaned down and whispered, “Good job, mommy.” She knew. We kept moving.
Before we entered the NICU we had to scrub in. The nurse wheeled me to the sink and squirted anti-microbial soap in my hands. I appreciated further the seriousness of this place. But I was mostly excited. I had glimpsed my daughter only twice and very briefly. Now I would get to really look at her. The NICU is a vast space divided into many open rooms, more like dividers than walls. We went to room five. I hardly breathed she was so close at last. The nurse parked my chair right in front of an open incubator. Three NICU nurses gathered around. “She’s here to see her baby.” The NICU nurses seemed unmoved by this or maybe just a little confused. I can only imagine how I looked.
“I had her tonight,” I stammered, “or last night I guess. I haven’t been able to see her yet. Can I see her?”
This was begging. Her nurse Francisco did me one better. He lifted one set of tubes and put them in the crook of his arm, then another, then at last a tiny bundle of white and without warning he placed my daughter in my arms. Her breathing tubes and vital monitors draped across us both but all I saw was her face. Her eyes moved under her petal colored lids.
I leaned down and whispered to her, “Hi Kajsa. Sorry it took me so long to get here. I’m your mom. I love you.”
I looked up to find four nurses with tears running down their cheeks; I’d spoken louder than intended. Still, their reaction surprised me; they were not too jaded to cry. I put them out of my mind and checked the clock. My daughter was taken from my body at 9:08 p.m. I held her for the first time at 2:38 a.m. The lights were dimmed in the NICU and most of the babies were sleeping peacefully. The nurses went back to charting, faces to their computers, and it felt almost like being alone with my baby. I pulled her close and pressed my face against her head and told her everything. I thought only minutes had passed when a hand touched my shoulder. But it was 4:45 a.m., and the hand belonged to my husband. He’d woken up startled by my absence and ran to the only place he could think I’d gone. The three of us, together for the first time. I held her and he touched me and all that roaring pain in my stomach disappeared.
My pain was forgotten. Together we breathed.
Because I’d delivered via c-section, my stay at the hospital was extended and I made the most of the easy access to my baby girl. I essentially set up camp at her crib side. The nurses were my constant companions. They taught me how to hold her without tugging on any tubes. On day two of her stay, Nurse Matt let me feed her, which then looked like me holding a syringe high and watching 30cc of milk flow through the orange tube going down her throat. That’s called a gavache, they taught me. Because of the nurses’ compassion, I changed 80% of her size preemie diapers and I learned to replace the monitors on her chest: white on the right, smoke over fire. Shoulder to shoulder with them I learned all kinds of things I wished I didn’t need to know: she’s d-satting, he bradyed, he only nippled 20ccs. Irma let me cry and reminded me she’d be out in no time. Jenny helped me give her her first bath in a tub. That was the night of day five. By then she was down to the smallest possible cannula and breathing something almost like room air.
My baby had crawled to recovery, then started to sprint.
I credit Vee for this. When I showed up for the beginning of Vee’s shift at 8 p.m., on day three, I showed up in a wheel chair. She seemed a little impatient. “I know you’re in pain; I had a c-section, but I was walking after 12 hours. You’ve got to start walking.” I’d surrendered to the chair after my four steps. Vee let me hold my girl that night but asked me to leave while she drew labs. This was always the very worst, watching needles pierce my baby’s tiny hands and feet. I rolled away in my hospital gown with tears in my eyes. I had to be stronger. The next night I showed up out of the hospital gown. I’d dressed up in regular pajamas and shuffled the whole way from my room in the postpartum section to my daughter’s crib in the NICU. Vee never asked me to leave during labs again and that night she introduced me to kangaroo care. She pulled over a rocking chair, a privacy screen, and several blankets before instructing me to take off my top.
“You’re going to sit skin to skin. Watch her numbers while you do.”
She was referring to the computer monitor just over our heads. It displayed my daughter’s heart rate, respiratory rate, and blood saturation. Her respiratory rate was the reason we were there. When I first sat in that pine-colored rocking chair, her respiratory rate was much too high, 120s, 130s. A healthy rate is 60 or under. Thirty minutes in, Vee turned to me and smiled. “See?” She pointed up. Kajsa’s breathing had slowed to the 90s, sometimes dipping as low as the 70s.
“She really needed this,” Vee told me. I’m not sure which "she" needed it more, me or her. From that night on, and during many of the days, I sat in that rocking chair with my five pound warrior nestled into my chest. I prayed for her, I sang to her, and with the nurses buzzing all around me, telling me stories and cheering me on, I watched her numbers fall. As much as it was my daughter who needed medical attention, it was me who came to the NICU wounded. And as much as the doctors oversaw her care and created a plan that led to her wellness, it was the nurses who made us both better.
My pain in the NICU mirrored my daughter’s. She blows an IV, has to get a heel stick, cries when I leave, I’m a ten. She has a good night, a good result, smiles when she hears me come around the corner, I’m a zero. But ten or none, the nurses put me in that rocking chair, put my baby in my arms, and in so many ways put us both back together again.
My daughter was born on a Friday. On Tuesday I was discharged, and I had to go home without her. I’d known this would happen, I’d known it for days, and yet the sting of it still surprised me. The hospital has a tradition when a new mom leaves. As they wheel her out, traditionally with a baby sleeping on her lap, they stop at a big black button on the wall. The new mom presses this button and all throughout the hospital Brahm’s lullaby plays. It’s a simple and sweet way to announce a new life. Or, in my case, an excruciating way to be reminded that my baby was in intensive care, not sleeping on my lap. I don’t think the OB nurse in charge of my care on discharge day understood this. I think she was just trying to cheer me up and let me do something all the other moms get to do. She didn’t see me wiping the tears from my face as she wheeled me to black button wall. She didn’t see me shake my head no when she said, “Press the button and announce your new baby.” My husband saw me though. He knew I was crumbling. So he stepped forward and pressed the black button and Brams’s lullaby played and I cried the whole way home.
I’m in the car, my baby is in the NICU and there is an empty car seat screaming at me from the back seat. My pain ripped through me, just like that first night. I can’t come up with a number. It’s too high.
When you spend hours upon hours upon hours in a hospital rocking chair, you can do a lot of thinking. Holding my daughter, I did a lot of thinking. One day, towards the end of her stay, I started thinking about all the medical equipment around me. When was it invented? By whom? How many little lives had it saved? How much did it cost? I got to thinking about those IVs in my daughter’s hand, the ones I hated so much I often cried at just the sight of them. In reality, they were pretty amazing. They were small enough for her delicate hand yet able to deliver powerful medicine to her body. I wondered, were they worthy of hatred? Wouldn’t these same villainous IVs in another tiny hand, say a tiny hand in Sudan, be seen as miracles? Somewhere in that world of babies crying and machines buzzing and doctors consulting all around, I heard the still, small voice of God tell me, “See.”
Vee had been right to send me away during labs. I couldn’t handle it. Since the night of the ten minutes that lasted six hours all I knew was I’d been cheated. My daughter had been taken. This whole thing was a curse. But, See. That was the lie I’d chosen to believe. In reality? I had a beautiful baby girl who survived a pregnancy complicated by an uncooperative placenta and who needed a little extra help when she was born early. And that extra help was right at my fingertips. No fundraising campaigns, no travel, no pleading for care. She was born, she needed medical attention, she had it within seconds. See. The curse was a tremendous blessing. I’d spent a week in the dark because my eyes were closed. That day in the NICU I started to crack them open, slowly, one at a time.
See was not a trite platitude that cast a rosy hue over all my hardship. It did not diminish my pain. It gave me perspective on my pain. It cleared my eyes to see past my expectations and entitlements into the truth: I was in a hard situation, but a hard situation flooded with goodness.
The day my daughter started breastfeeding ended up being her last full day in the NICU. We didn’t give it a shot until the sixth day after her birth, not ideal by any standard. But her nurse Tiffany didn’t act like it was long shot. “That was amazing,” she said after our first try. “This little girl is tenacious, she is going to eat her way out of here.” Kajsa, turns out, is a natural at breastfeeding. I’d just brought the boobs to the party. Twenty-four hours later we were holding discharge papers. Kajsa’s name is Swedish, and her last nurse, Linda, was Norwegian. It was Good Friday. The sun was setting. Poetry all around. We thanked the doctors and packed our bags and put our tiny dancer in her car seat. We should have walked out of the NICU and turned right for the elevators, but my husband took us left. He led us toward the post-partum unit.
“You should push the lullaby button,” he told me.
I giggled nervously and said no. It would be awkward, who would we ask, what would they say? He was determined. Car seat in hand he marched right up the nurse’s station, me trailing sheepishly behind, and he said, “Excuse me. Our daughter was just discharged from the NICU. My wife was discharged Tuesday and she didn’t get to push the button. I was wondering if she could push it now.” The nurses smiled and cooed over our daughter and said of course. I bit back a sob. My husband smiled at me and waited. It wasn’t lost on me the distance from where I stood to the button was about four steps. Right leg, then left, I walked to the button. Tears quietly melted down my face and I pushed. All through the hospital that had been a hell then a haven, Brahm’s lullaby played for our daughter. Lullaby and goodnight, thy mother's delight; Bright angels beside my darling abide.
We drove home under a pink sky, toward Easter and our son. My pain is a memory, a scar on my belly, and reminder to keep my eyes open to the great bounty God has placed right before my bleary eyes.
See, mama, see.
Written by April Hoss. Photo by Sarah Maren Photography.
P.S. If you enjoyed this essay, don’t miss our birth-story podcast episode, Due Dates, Doulas, and Drugs, Oh My!