Tethered

I was in Wisconsin this past weekend participating in a writing retreat centered on telling our stories as mothers. One of my goals of the last two years has been to make sense of Merritt’s preterm birth, and the NICU stay that followed.

_____________________________

Last week, in response to a post about Merritt’s second birthday, in which I expanded on some of the feelings I still carried for Merritt’s birth and early days, a reader commented:

“I have been following your posts for quite some time now. I guess I don't quite understand why the premature birth and NICU stay are so traumatic for you still. The important thing is that he's healthy, I'm sure you agree . . . but I also feel like you think that statement is trivializing your feelings. Many, many (did I say many?) women don't experience the birth that they dreamed of, for different reasons. I feel like in the long run, it doesn't matter. My relationship with my oldest child isn't changed by the fact that I broke down and got an epidural. Your relationship with Merritt is not changed by the fact that he was in the NICU for a short time.”

I replied directly to her comment and have thought quite a bit about what she said, and what she didn’t say, which has since made me wonder if the bigger question isn't:  Don't we as mothers/women deserve space to feel our experiences for what they are and are we free to be impacted by them in whatever ways that we are affected (whether those feelings are positive or negative); or do we treat birth and the events that may precede or follow as different in our culture in that we use shame to manipulate women into believing that our Truth has no place at the table in the face of a thriving (or even living) child?

The grief I feel for Merritt’s birth affects me when I think about it, and I don’t think about it that often. I think about it most when something in the present recalls me back to his beginning as a measure of his growth or development. Just as Roscoe was born under ideal circumstances, when his birthday comes around I am drawn to recall the memories that I have of his beginning. Both are equally important chapters of our story.

As part of one of my writing exercises at the retreat, I revisited the reflection post I wrote soon after Merritt’s first birthday and tried to identify the under-developed theme, finally settling on the word “tethered.”

Tethered:
1. A rope or chain, or the like, by which an animal is fastened to a fixed object so as to limit its range of movement.
2. The utmost length to which one can go in action; the utmost extent or limit of ability or resources.

I know only one way to mother, and I wanted to mother Merritt in that way despite his prematurity. He was not a baby too sick to be mothered, who needed to rely more on technology for his survival. No. He was a small and hearty baby born early, who deserved to be cared for in all the ways that I was willing and able to meet his need. I was disempowered by the NICU's protocols and routines, an environment in which it was normal and common to assume that I would relinquish his care to staff nurses who did not, from my perspective, understand my needs as his mother, nor our family’s philosophy and parenting priorities.

Trying to be my momma-self in a discordant environment was incredibly unpleasant. My attempts to foster attachment were met with doubt, uncertainty, dismissal, and rejection. I felt alone and vulnerable. It was exhausting to be on guard, vigilant, never taking a mental break, and rarely stepping away from his isolette for fear of Merritt losing his voice. I now know that not all mothers face these issues in the NICU, but we did.

It was a painful struggle to toe that line between accepting the circumstances, working within the spoken and unspoken boundaries, and being true to myself as his mother to advocate for Merritt's right to receive the safest and healthiest birth and newborn care based on the best evidence. In the NICU these issues largely revolved around when I could pick him up and for how long, pain management, and breastfeeding. I suffered from palpable anxiety and stress in those weeks we lived in the NICU. It was traumatic for me as his mother to go through something like that when my frame of reference for what it is to be a mother came from a perspective of having had an easy and ideal birth and postpartum with my first baby. Knowing what could be made it more difficult to accept the inherent limitations of the NICU, a microcosm of separation and detachment. 

I also hold a space for Merritt, and a sense of unfairness that my ability to protect and comfort him within the scope of my role was limited by the outdated routines of the hospital in which he was kept. When choosing between following the rules and betraying my child, I picked my battles carefully, and made decisions in spite of what I believed to be right, in order to conserve my limited resources. 

*

I arrive at the nurse’s station disheveled and in a hurry, excited to see Merritt. It’s 7:20 in the morning, ten minutes before his first feed of the day. I spent the night at home, slept four or five hours and now I’ve returned with another full day ahead.

“Hi.” I smile wearily. “I’m here to see my baby in the NICU. Meritt?” I’m loaded down with a back pack and tote bag. I am very aware of my own appearance in contrast to the nurse's shiny hair, pulled back in a low ponytail, her full face of makeup, and rested eyes. I think they feel sorry for me, trekking back and forth.

“What’s the last name?” she asks, picking up the phone to dial the extension.

“Sears.” I reply.

“Oh sure,” she smiles, seeming to remember me, “Let me just call back and see if it’s a good time.” She pauses, waiting for someone to pick up, “Mrs. Sears is here to see her baby, can Merritt have a visitor?” She looks up at me with raised brows, expectant. Her mouth turned up at the corners.

Of course he can have a visitor, I think. The formality of this is so stupid.

“Oh.” Her voice falls. I study her face, annoyed that we have to go through this ritual every day, now trying to guess as to what the nurse on the other line is still talking about.

“Ok,” her brow furrows, forging a line between them, “how long will it be?” She pulls the phone from her ear and places it to her chest as if to protect the nurses from my response. Her mouth scrunches up to warn me, “They’re getting ready to replace Merritt’s line so it will be about a half hour.” She moves her mouth to reveal only her bottom teeth and sucks in a breath of air. She knows.

I lock eyes with her, my face is stern, “Oh." I swallow hard. "Well...yeah, I want to be there while they place the line. I want to be back there, will you ask them if I can?” Panic rises in my body, I begin to feel hot.

She nods her head then brings the phone back to her ear, “Mom says she wants to be present, is that possible?”

I interrupt, “I want to talk to the charge nurse,” my lips press together in a frown.

I’m gripped with helpless fear. I think back to two days before when I cradled Merritt skin-to-skin after a feeding, only a curtain separating our space from the baby’s next door. Three different nurses tried unsuccessfully to place a line in Merritt’s neighbor. One after the other. That baby’s mother wasn’t around. That baby had no advocate. One after the other, amidst the unbroken and desperate wails of the baby, I could hear the air escaping their lips as they missed. First one, then the next, then the next. It went on for more than 30 minutes before they decided to give that tiny little baby a break.

That will not be Merritt.

The nurse hands me the phone.

“What’s going on?” I demand.

“Jacqueline, this is Helen, how are you?”

“Fine. What’s going on?”

"Merritt’s line needs to be replaced.” She begins. “Remember how we told you last night that we weren’t sure if the line that we put in yesterday was going to hold up?”

“Yeah,” I remember.

“Well, we weren’t sure then, but it definitely needs to be replaced. So we’ll get that line in and then you can come right back,” she states.

“I’m here, I’m standing right here outside the nursery, why can’t I come back? I want to be there to provide him comfort.” I’m grasping for a way to convince her.

“Well,” she concedes, “let me find out who’s going to do it and see what she says. Sometimes the nurses don’t like to have parents present during procedures.”

I ask who’s been assigned to Merritt, and learn it is Beth, known for getting lines in the first time. My heart settles slightly. I wait.

Her voice returns, “I talked to the nurse and she would rather not have you back here. I’m sorry.”

What the fuck. I knew I couldn't trust that woman.

I say it again, “Well, I want to be there.”

“I’m sorry,” she says, “can you come back in about a half hour? It will take less than 30 minutes.”

I know that I've reached the end of the line. My tone changes realizing that I don’t have say in what happens next. “Well, I’m staying right here at the nurses station.” My words are cold and hard, delivered through my teeth. “I’m waiting here.” I hope my physical presence will compel them to be efficient.

I give her my phone number and ask her to call me as soon as it’s over, then hand the phone back to the desk nurse who smiles meekly and says, “I’m sorry,” without consequence.

I want to kick the wall and fly into a rage, but I don’t. These people are the ones who give me access to my baby, I can only push back so much. 

*

Although getting along was a necessary coping mechanism, I am remorseful for passively giving up Merritt’s right to have me with him. Part of the emotional challenge has been to reconcile these moments in our history, because it will always be what it was, even though I know so much more now.

When I first read Anonymous’s comment, I didn't recognize her words as judgement, unintentional or otherwise, but I see it now. To associate a mother’s dissatisfaction with any aspect of her mothering experience and reflect it directly onto her connection or satisfaction with the relationship that she’s building with her child is an unkindness to all involved. I have to believe that because we can’t know the nuance of emotion that other mothers feel in their own lives, more compassion and empathy is needed mother-to-mother. Are we not collectively our own worst critic? To feel judged causes unnecessary suffering too, as it tethers our ability as mothers to be present in our experience, and limits our capacity to accept our Truth and to bypass the shame, so that we can work through it to become the best versions of ourselves as mothers and women.

Merritt is two years old today

Every year I look forward to these three months between February and May. To say that the boys are just a year apart in age offers a simple explanation for how crazy our days can feel.  Ooh, they're two and three. 

Last year we celebrated Merritt's first birthday with a colorful celebration of hearts and lions. This year, we opted again for a small party with even less fanfare. A simple home cooked meal, a few surprises for the kids, and a short guest list of his two primary caretakers and their partners.

On the menu: chicken adobo (a filipino dish that I grew up on as a kid), coconut rice, a green salad with garlic dressing, and roasted root vegetables. For dessert we shared a mountain of doughnuts served with miniature glass bottles filled with milk, and paper straws.

It snowed most of the day, so by dinnertime the long and blue shadows of winter cast over our meal as we sat down at the table. The kids wanted nothing to do with the food so they played while we indulged in the warmth of good company and candlelight.

While it is Merritt's second birthday, today also marks the anniversary of my second birth. Last year I was melancholic as February came around. This year felt a little less so. I'm not sure what that means as far as progress and healing are concerned, but it appears at first as an improvement. In truth, our beginning still pains me. I try to avoid acknowledging the still tender disappointment when it creeps into an otherwise happy moment. I wish I could pinpoint exactly the thing that is so painful about the birth, or the NICU, but I haven't yet been able. I'm afraid it is all the little things that add up. It makes me heartsick knowing that we can't influence the past. The more time that separates then from now, the less clarity I have. The deeper involved I become in my work supporting women through their own family beginnings, the better I understand how complicated this could be, how unhealed I am, that I may always carry with me a sense of loss and grief. Being made aware of that last little piece was a bummer all on its own.

Though I experience this day with all the bitter sweetness that it brings, Merritt shined his light brightly and enjoyed a very deserving birthday party on Saturday and a worthy encore today with ice cream, a park trip, and many, many, renditions of happy birthday. He is the kind and gentle little brother of our family and we love him so much.

a (birth) love poem

The sun is setting.
The curtains glow floor to ceiling
with the last rays of the day
that came before the night
in which I will become a mother.

Out there the light fades,
and the people call it a good day.
In here the work is just beginning to take shape;
we know we will be changed.

The labor molds us as we move through it.
The effort to not resist
but to open up,

let go.
To embrace this pain as work
and love.

My being,
the baby inside this body,
this man at my side.
We share the work going down tonight
in this homey space.

We're in motion.
This will forever be our beginning.
It is ours.

Moved by a power
so loud and thunderous,
so proud and real,
it calls me back to myself.

Delineating an even stronger version of who I was
before I was Momma.

Reminding me that courage has lived here all along
and challenging me to engage with such intensity I feel I may break.

But instead I bend.
I make more room.
I call for help.

Buoyed by love from the ones I chose
to journey with me,
I'm surrounded by it.
Filled with it
as this miracle moves through me.

Firm, even, pressure
like cool sheets on warm skin,
his hands conform to these fatty hips and thighs.
Rhythmically he smooths out even the most powerful surges
with confident strokes.

It is dark now.
The contraction peaks
then fades away like a shadow in the night.

We labor on.
One contraction at a time.
We can do anything
he and I.

Preventing another preterm birth

I mentioned last week that in preparation to conceive another baby I intend to do everything I can to best prepare my body to carry our next baby to term. Most importantly I want to have a healthy baby.  Also important, I want to avoid a stay in the NICU and I want to have the opportunity to experience another birth at home.

I trust midwives and believe in the midwifery model of care. There is one freestanding birth center in Richmond and I was excited to learn that I could go there for my annual exams and for other women's health issues not in the context of pregnancy or postpartum care. I don't plan to give birth at the birthing center, but I am grateful to have the option to work with women who share my values and beliefs around well-woman care.

I brought in a list of questions I had been gathering related to preventing premature rupture of membranes (PROM) and preterm birth and we chatted at length about what exists in the literature and their experience and observations around these topics.  For much of the conversation there were two midwives in the room and we had a little pow-wow reviewing my birth histories, and discussing a plan of action moving forward.

My midwives are collaborating with me, not dictating, and I'm driving my care. There's no telling the course of my next pregnancy, but I do feel like I can use the evidence that exists as a guide to facilitate a better outcome.

There are many known risk factors for preterm birth and I only detail here the ones that are personally relevant, but you can read a comprehensive list at the March of Dimes website.  Having had one preterm birth puts me in the greatest risk category for having another preterm birth, so I'm taking this seriously.

My research is still evolving, but there are definitely some things that we know:
Child Spacing: pregnancy spacing of less than or equal to 12 months is associated with higher incidence of PROM and premature birth. 
Testing Positive for GBS: women who are GBS+ are more likely to experience PROM
Circulating autoantibodies: women who have circulating antibodies in their bloodstream (thyroid related) are less likely to carry to term and more likely to miscarry.
Bacterial Vaginosis and other infections: highly correlated with PROM

Nutrition also plays an important role in healthy pregnancies and healthy babies.

Possible nutritional preventive measures include: fish oil, iron, magnesium, and zinc, as well as folic acid, bioflavonoids (orange pith!), selenium, vitamin C, and higher protein intake. Some of these vitamins and minerals are associated with strengthening the amniotic sac, which is protective against infection and PROM, while others boost the immune system. I doubt that the exact mechanism for each of these is clear, but the greater body of literature shows significant positive associations, even if small.

With Roscoe, my first sign of labor was when my water broke around 1:00 in the afternoon at 38 weeks and 2 days. Still considered term, but on the early side, especially for a first baby.  My labor was very fast at 5 hours and 23 minutes. Similarly, my water broke around 1:00 pm with Merritt, although much earlier in the pregnancy. A midwife adage that mine relayed is: A water that breaks at night is labor. A water that breaks in the day is something else (infection, a malpositioned baby, etc.). That is not to say that labor won't proceed as a result of the PROM but that labor wasn't the primary cause of the water breaking.  Eight to ten percent of women experience PROM as the first sign of labor, so while common it is not normal.

Here is my plan:
1. I am giving my body more rest time between pregnancies. The spacing will probably be around 24 months.
2. I will wean Merritt before I conceive again. I know that many momma's nurse older siblings through pregnancy with no problem. I nursed Roscoe through my pregnancy with Merritt, and I will never know what affect it may have had, but since my amniotic sacs may be weaker, and nipple stimulation can induce uterine contractions, it's something that I am choosing not to do this time.
3. My practitioners will be aggressive from the start to screen for potential vaginal infections
4. I will follow the Brewer Diet advocated by Dr. Bradley. My midwife did note that she doesn't typically suggest 100 grams of protein for her momma's but that given my risk factors she definitely would.
5. As we always have I will be working closely with my endocrinologist to ensure that my tsh levels are in the normal range.  This is the best protection against high levels of circulating autoantibodies.
6. I'm going to be more diligent about flossing my teeth, and gum health in general, including visiting the dentist more regularly. Periodontal disease is highly linked to preterm birth.

In addition to a prenatal vitamin, I will take supplements for vitamin c, fish oil, iron, and folic acid. I want to investigate further selenium, magnesium, zinc, and maybe bioflavonoids (an herbal supplement), especially optimal dosing. My preference is to take in the necessary vitamins and minerals through food rather than supplements, and bioflavonoids aren't regulated.

I will continue to exercise through this next pregnancy, as I did with the other two. I will also do my best to reduce unnecessary emotional stresses (no plan yet for how to accomplish this!).

Are you aware of any other evidence-based steps that I can take?  If you experienced PROM or premature birth with one of your babies did you have a similar experience in subsequent pregnancies?  Did you do anything differently?

March for Babies, the walk

We woke up on Sunday morning to a downpour of rain.  We knew that March for Babies is a rain or shine event so we dressed for the conditions as best we could, and tried to maintain our enthusiasm for  walking five wet miles in 53 degree temperatures.

In truth, it felt like a silly hardship to complain about compared to our NICU journey, and to what many babies face every day, just to live.

One corner of Monroe park was bustling with walkers and sponsors, music blaring.  We turned in our funds raised: $625.00!  and took our place in line--we were one of the last groups to join the pack.  The kids were snuggled in the BOB, protected by a rain cover and packed-in with plenty of books and snacks for the road. We found Roscoe's mini rainbow umbrella in the trunk of the car and it was good enough.

It appeared that many walkers had decided to stay home and that, certainly, the babies and smaller children had been left to be warm and dry. Still, those who had shown up were in high spirits and never let on that the weather left something to be desired or that their shoes were already soaked through. In the crowd I caught glimpse of a banner held In Memory of some mother's baby.

Within the first block Merritt was screeching to be released out of the stroller and so we stopped. Emergency vehicles charged with following up the rear were less than half a block behind us, so I lifted Merritt up and plopped him into the Ergo as we scrambled not to be caught in the very last position.

The rain was steady and we tried to keep a decent pace to minimize exposing the kids to the elements. Our hope was that they would fall asleep en route, around 10:00, which is their nap time.

The city was smoky with fog and drizzle. We walked quietly across the Manchester Bridge and I felt very small so high above the James river with its rushing water and ruins of industrial city landscapes. I held on tighter to Merritt.

We turned down Semmes Avenue where traffic flow was reduced down to a wide sidewalk.  I listened to two mothers exchange stories of their premature twins, and focused intently on the back of one mother who had pinned to her shirt a laminated collage of her babies Then, and Now as toddlers.

We started across the Lee bridge and rain hit from new angles as the winds whipped everything up. I fondly remembered these winds from running the Richmond marathon in 2005. A newlywed in graduate school with "nothing to do" I had signed up with the training team the week we returned from our honeymoon, begging the coaches to let me run even though training had commenced a month earlier. My favorite training run incorporated this river, and this bridge.  Our coach had warned us that on race day the winds would be tremendous and that our mental focus would need to be acute. I think it was around mile 16 or 17. I remember running the Lee bridge and gathering up in my mind all the longing and hope (and expectation) that I carried for one day becoming a mother. Fueled by joy and felicity I persevered through that wind to the other side and around the corner to pound through the miles that lay ahead of the finish line. I was 23 then, unaware of life's disappointments and struggles. That was before Grave's Disease.  Before the depression. Before the separation.  Before I felt a mother's love, and before Merritt's premature birth.

Crossing the bridge on Sunday, Merritt was cold, his little eyes squinty and tired, his hair damp.  Roscoe had fallen asleep. Andy and I were drenched and continued to walk in formation, only speaking to commiserate. As we reached the ramp off the bridge, we could hear pulsing beats from speakers at the finish line.  We were close. 

As we re-entered the park I was approached by a woman who recognized us as having donated small toys and art supplies to the children's hospital for little ones with extended stays. I walked over to her tent and another volunteer gave me a hug and shared how much each donation means to the families who receive them. I broke down in tears. I had feared these tears but it felt good to let them out.

She asked me to tell her my story. She had one too and turned to show a photo of her daughter who had been born at 28 weeks gestation and had suffered a brain hemorrhage that resulted in severe brain damage, handicaps, and learning disabilities.  Her daughter died when she was seven years old.

I told her how Merritt had been born at 33 weeks, and paraphrased the events because hearing her story made mine feel less traumatic. We hugged each other.

I expressed my growing fear of having another premature baby, and of having to negotiate that experience again as a family.  She shared that she went on to have two healthy pregnancies and two full term babies.  I felt some relief for her and a little hope for us.  

Thank you so very much to everyone who generously donated to March for Babies on behalf of our little lion Merritt. You are awesome!

April Airhart
Alicia Blakey
Heidi, Griff, and Lillian Bone
Katy Carkuff
George Fields
Kelly Johnson
Madeleine Ly
Olga Meyerson
Jessa Diaz Poppenhager
Robert Ragos
Vanessa Ragos
Kate Reilly
Al Salas
Carmen Gragnani
Courtney Sears
Ernie Sears
Valerie Sears
Jack St. Clair
Amber Sterling
Danielle Temple
Nicole Tully
David Williams

An heirloom quilt fit for a baby

The inch worms have descended on Richmond over the last few weeks, rappelling from the tree tops on thin silk threads and landing on just about everything in sight. We find them inching their way around in our grass and hair, on our clothing, furniture, and windshields. They are devouring tree leaves and getting fat before they burrow into the ground to emerge as moths after Summer has ended. The whole phenomenon reminded me that I've been meaning to share Merritt's quilt for almost an entire year.

Roscoe and Merritt's Aunt Coco quilted it for him and I think her love note and the pictures speak for themselves. It is a gorgeous and heartfelt gift.

Merritt, 3 months

Dear Merritt,

This is the first baby quilt I haven't delivered on time.  I'm going to let both of us take the blame for that one. You'll find that being early is generally a good thing but that, truth be told, being late usually isn't a problem either. The most important thing is that you show up.

The orange and brown fabrics in this quilt are from a fabric line called chrysalis.  A chrysalis is where a caterpillar makes its home as it grows and changes into a butterfly. A fitting theme for a baby quilt for a baby who has just been welcomed by his new family, don't you think?

I wish you all the love in the world as you grow and change.

                                                                                    Love, Aunt Coco

The one and only

For you quilters: The pattern for the squares is called, "Sunkissed Squares" from Moda Bake Shop. Courtney used one fourth of the pattern for a baby sized quilt but added the borders to make it bigger. The back was improvisationally pieced and follows no pattern. The straight-line quilting was done with a walking foot in a chevron pattern with the lines placed two inches a part. (She used painters tape to mark them off and then sewed along side the tape.) 

Then and Now

All along, we've thought that baby Roscoe looked nothing like big boy Roscoe, whether the comparison was made at six months or a year, or two. When he was born I remember the weight of his little body feeling so familiar, but for days and days I just couldn't place his features. He was our little ET.

A recent photo from our latest shoot made me do a double take. It's a rare expression and I recognized that face immediately. After digging through his birth photos I found it. Less than an hour old, in his Poppa's arms for the first time.

Back then, as I quietly took him in, obsessing over every newly born detail, I had no idea who he would be or what he would look like three years into the future. It is hard to believe that there ever existed a point in time when that knowing little face of his felt like a stranger.

As sophisticated and independent as Roscoe is at 2, it's sweet to catch a glimpse of my baby as I remember him in the first hours of his life.

Marching for Merritt

I've been looking for a way to give back through an organization or community opportunity related to prematurity. You may have noticed the  March of Dimes button in my side bar. It's a small start but we are walking as a family this year!  I'm looking forward to meeting other families who share the NICU experience and to learn more about how I can get involved here at the local level.

We had hoped to raise at least $100 to celebrate Merritt, and to support the March of Dimes in their mission to improve the health of babies by preventing birth defects, premature birth, and infant mortality. 

Through some very generous donations we met and then surpassed our goal in the first 24 hours! 

I cried with every donation that came in.  It means that much to me.

There are 39 days until the walk and we have a new goal of $500. The funds raised will support research and programs that help moms have full-term pregnancies through health education and legislative initiatives, as well as bring comfort and education to families with a baby in newborn intensive care. 

If you would like to donate any amount of money to our fundraising effort, please visit our March of Dimes web page or donate directly through the button in the side bar.

Every single dollar is so helpful and very much appreciated!

For those who followed our NICU journey through this blog or who lived it with us in person, thank you for supporting our family. We are grateful to each of you. 

Edit: Whoa, look what you guys did!!  We reached our second goal.  You are awesome! Thank you so very much.

Reflecting on Merritt's Birth-Day

Merritt turned one year old on Saturday. We celebrated with a sweet and colorful afternoon party that fit perfectly with Merritt's low-key personality and my need for a quiet anniversary.

I recall the ache of my sinking heart when, at 32 weeks 6 days, my water broke and I understood that Merritt was on his way. The juxtaposition of the onset of labor for each of my two boys is stark. What I welcomed with warm confidence and joy with Roscoe, I summoned will to push away with Merritt. Whether or not I was ready to give birth to him, and for reasons that we'll never know, our little Merritt boy needed to be born early and by the time I had realized it, the process was in full motion.

When I first shared Merritt's birth story there was more that I wanted to write.  At the time, I wasn't sure how my sadness and anger, and feelings of powerlessness fit in with the story of how I met my second, and perfect, little boy. There wasn't room for the raw grief that I felt. But, there has always been more to say, and the feelings I felt then have only intensified with time.

Probably because life has been so very full and a little crazy since Merritt arrived, it's been hard to find time to process any of it. I've needed to grieve for what was lost, on both our accounts, and yet I haven't made time for it. And so, as the new year came and then February arrived, a sad disappointment lingered, which speaks nothing of the pride and sweet joy that Merritt brings to our family, or to the growing love that I feel for him.

We were very lucky that after a swift and uncomplicated labor, I gave birth to a small but utterly healthy baby. I know now that if any of the variables of Merritt's birth had been different--if labor hadn't progressed as quickly, if there had been earlier signs of the placental abruption, if Merritt’s heart tones had recovered even just a little bit slower--he would have been sectioned out. We were very close, in fact.

I’m so grateful that Merritt breathed well on his own, that he was a good size for his gestational age, and that his little system had the opportunity to experience the stress of labor and a vaginal birth.

The smug pride that I felt for beating the odds by giving birth to Merritt in a way that was as close to what I had hoped for us as I could have grasped at the time, was overshadowed shortly after by a quiet and serious panic that set in when first I was made to wait over two hours to see my baby and then, later, when I learned what a NICU stay of any length really implies.

That low-level heightened awareness stayed with me for the full 28 days, and I remained very guarded and vigilant. I held close to my determined heart the confidence I knew as a woman who had done most of this before--birth, breastfeeding, mothering. I clung tightly to the good and powerful feelings I kept from Merritt's birthday, and found enough strength to carry both of us in the foreign world of isolettes, feeding schedules, and separation. My role in there, as Merritt's Momma, made me feel for the first time in my life that I was a grown up. Truly. Merritt's tiny person needed me more than any other single thing and knowing that I was wholly responsible to him was humbling and intensely exhausting. (Posts about our adventures in the NICU begin here.)

I feel more deeply now, though I had always believed it to be true, that the way in which our children are born, our experience of birth, and the way that we process and retell our stories, is so vitally important to our health as women and to our role as mothers, with much, much, greater far-reaching importance and consequence than our society gives credit. I find it miserably inadequate when I hear of these powerful experiences of life and birth and loss whittled down to the healthy baby, healthy mother mantra.  Many will find it hard to understand, but while I am thankful that my baby was healthy and I am also thankful that I was left intact, some things (many things) were lost for me in that experience. I grieve for those things.  And I know many mothers who feel this way and who share the same sense of longing for what could have been.

Of course, I feel so sorry that Merritt was born into a circumstance where separation of mothers from their babies is not only normal but expected. Where painful procedures are frequent and, in our case, where I conceded (more than once) to stand at the nurses station while my baby had IV lines placed, a routine for which the nursing staff wouldn't allow me to be present.  I feel a lot of guilt for leaving Merritt so vulnerable and if ever our family has to endure another stay in the NICU, I will fight against any policy that elevates a protection for nursing staff above my right and responsibility to advocate for and emotionally support my own child.

While Merritt won't remember all that he went through before we brought him home from the hospital, he certainly experienced it, and I will never forget it.  I'll always wish that he had a more peaceful and deserving entry into the world.

A funny story

Merritt was supposed to be an Aries, due April 8. To complement the space theme we stenciled the Aries zodiac on his nursery wall, among other constellations.

Two of his Grandmothers, Tippy and Nan, each cross stitched a zodiac for the room as well--a Taurus for Roscoe and an Aries for Merritt.

The zodiac was such an integral aspect of his nursery design that it dawned on me a few hours after Merritt was born, the details with which we had personalized his space in the house were now inaccurate. As it turns out Merritt was born a Pisces.

So his Tippy cross stitched a Pisces replacement and I planned to get the three constellations framed as part of Merritt's story.

A few months went by and while we were at the beach this Summer, Nan pointed out that she wasn't so sure that Merritt was a Pisces, after all. She was confident that he was an Aries, which I disputed, but conceded that I may have been wrong considering my state of mind at the time that I did my initial research.

I double checked a few days ago and, to my dismay, Merritt is neither an Aries nor a Pisces.

Born on February 18th he is an Aquarius. Sigh.

Nonetheless, we have two very lovingly cross stitched signs adorning Merritt's wall.

Merritt's Nursery

He's five months old and his nursery is finally finished! At times I wasn't certain where this room's design was headed but, now that it's complete, I'm captivated by the way all the details have come together.

We started with an inspiration piece and worked our way from there. Other posts related to the design process can be found here (drapes), here (zodiac signs), and here (constellation wall art).

It's dark and dreamy, but also full of cheer. I can't help but smile every time we're in it.

Wall paint: Olympic, color matched to Serena and Lily's Steel

Ceiling paint: Valspar's Denim Blue

Chair and star paint: Valspar's Mac and Cheese

Star stencils for wall art: Kosmic Kreations

This little light of mine print: etsy seller hopskipjumppaper

0-9 numbers print: etsy seller hopskipjumppaper

Matting and frames: Michael's

Wall clock: etsy seller mbartstudios

Station pendant lighting: Restoration Hardware Baby

Dresser and crib: Pottery Barn Kids, handed down from Roscoe's nursery

Chair: an existing piece that we repainted

Spot light lamp: Pottery Barn, discontinued

Rollie pollie: pattern from www.dana-made-it.com and fabric from Spoonflower

Wire baskets: Restoration Hardware, discontinued

Distressed shelf: Restoration Hardware Baby

Wire wall cubby: Hudson Goods

Curtains: Anthropologie, discontinued

Garland: A spectacular gift from a friend who plans to open her etsy store soon!

Rocket growth chart: Eboo

Changing table caddy: Everything Bin from Serena and Lily, pattern and style discontinued, handed down from Roscoe's nursery

Changing table cover: Serena and Lily, pattern discontinued, handed down from Roscoe's nursery

Woven Basket: Williams Sonoma Home, discontinued

Stained glass brother stars: etsy seller KurtKnudsen

Coat Rack: etsy seller Andrewsreclaimed

Crib quilt: a one of a kind, hand-made gift from Merritt's Aunt Coco

Summer sewing projects

The extent of my sewing experience can be summed up in the fabric Christmas ornaments that I stitched and stuffed as an 8 year old. In one word: primitive.

Inspired by my mom and other women who know how to sew for function and maintenance (like hems, and buttons) but who also know the craft and how to create, I’ve been wanting to find time to learn how too.

This leads me to reveal that poor baby Merritt’s nursery never did get its final treatment and, at the moment, remains unfinished. I made up my mind last week on a few simple pieces of art, and then decided that it was high time I figure out how to sew the rollie pollie that I have been eyeing as the finishing touch.

I ordered the fabric from spoonflower, which is a rabbit hole for fabric enthusiasts—the patterns are made to order and you can even create your own design with uploaded images. It’s pricey--I bought 2 yards of upholstery cotton twill for 64.00—but worth it if you have something really unique in mind. I bought a bunting pattern that already existed. I thought it worked nicely to subtly incorporate into the nursery the popular garland trend, plus I like how the pattern repeats to give the illusion of sunrays, which complements the existing "space" theme and cheers it up a little bit.

My sister in law handed down to me her sewing machine last year when she upgraded, and we're hauling them to the beach next week to set up sewing camp. I’ll have good help as I make my way through the rollie pollie pattern with its zipper and double layers.

Merritt's Birth Announcement

Front

Back

I love the mix of textures, and color photos with black and white. It seems that I can never go wrong with Tiny Prints. Do you have a favorite online stationary store?

Merritt's birth story

It's Mother's Day weekend and a good time to finally share the events that led up to meeting my second son.

His birth is emotionally complicated for me since we had planned to give birth at home. When my water broke at 32 weeks 6 days we headed to the nearest hospital for a preterm delivery.

Part 1 of our story can be found here.

Part 2:

Earlier that day

By morning, the regularity of the middle of the night contractions had dissipated but because I was uncertain of when true labor might begin, I requested to meet with the Neonatalogist and also the on-call OB/GYN. I had every intention to take a nap that afternoon and catch up from lack of sleep from the previous day and night but, both physicians decided to stop by before I had the chance.

1:10 pm

Mid conversation with the obstetrician, as we discussed my "ideal" birth and reframed some of my expectations to reflect the current circumstances, the contractions returned and this time they were uncomfortable. I had five contractions over 45 minutes, and at the end of our talk I knew that this was the official start of my labor.

Still on the antepartum/postpartum floor, assuming that I wouldn't be allowed any food during labor, I ordered the lunch that I hadn't eaten earlier in the day. Then I called Andy and my doula to let them know that it was a good time for them to make their way to the hospital.

2:10 pm

Nursing staff came in to hook me up to the external fetal monitor (EFM) and within a few minutes I was wheeled off the floor to Labor and Delivery. The power of the contractions was familiar and continued to increase. I was in labor, but the nurses insisted that I remain in bed on my back while they monitored the contractions so that they could confirm it.

One nurse turned on the tv and handed me the remote before she left. (ha!)

2:30 pm

Andy arrived shortly after I was settled in L&D, and because I had left my room before lunch arrived, and because I was so hungry already, we plotted how to get food and water (I had been told not to eat or drink anything). He bought some chapstick, and retrieved some water bottles and GUs from my room on postpartum.

The intensity of the contractions required my total concentration, and because I was confined to the bed, I couldn't rely on position changes. Instead, I dug deep into my arsenal of Bradley techniques--stuff that I had never used or needed for Roscoe's labor.

Centered at my cervix, each contraction radiated tight and hot to my hips and lower back. Andy applied counterpressure on my lower back for a few contractions, but lying on my side required that I "push back" to avoid being pushed over, and it became less helpful and more irritating so we stopped.

What worked best for the duration of my labor was total relaxation--I never really understood how this technique could work during labor, but it is the cornerstone of the Bradley method and given the constraints of the situation, I was willing to give it a try. Nestled in a bed of pillows and fully supported, I invested my energy in relaxing every part of my body, and then used visualizations to help me focus in on the work of my cervix. I visualized my body making way for my baby.

My Ipod was incredibly helpful--while I hadn't had time to load a birthing playlist (or even make one, for that matter!), for the duration of each contraction I turned on my music and went to other places. I think I listened to the same three or four songs on repeat: Roscoe by Midlake, Dog Days Are Over by Florence and the Machine, Clocks by Coldplay, and I Like It by Enrique Iglesias (don't ask! It was on there, and it worked.).

Music always gives me energy to physically push myself, but in this birth, it also served to drown out the myriad distractions in my room: nurses coming in and out to check the monitors, lights flipping on and off, NICU team staff preparing and organizing in their corner for Merritt's arrival.

4:30 pm

My doctor stopped by for an update and after we talked for a few minutes she checked me and confirmed that I was 4 cm dilated, and 100% effaced. Active Labor! Honestly, I would rather have not known of this "progress" because the contractions were already so powerful. I didn't want to be discouraged, but knowing that I had 6 cm to go was discouraging. I gave myself a moment, and with the pain of the next contraction I forgot all about numbers and welcomed a return to work.

I asked for water and freedom to move and labor as I felt most comfortable. One point not up for negotiation was the EFM--because this was a preterm birth I had to have continuous monitoring, which was ok because the leads were plenty long and gave me enough space next to my bed to move around. The nurse gave me a hard time about wanting to labor out of the bed, but conceded "as long as the monitors could be read." I was given permission to eat ice chips, which I was so grateful for.

5:00 pm

I was relieved by the thought alone of maybe finding a more comfortable position. As you might expect, the external monitors were so sensitive that they lost signal anytime I wasn't lying still and, like clockwork, an exasperated nurse would run in to check the leads.

5:30 pm

My doula arrived, which emotionally relieved a lot of my stress. I really wanted her to be there to help us through the later stages of labor, and I felt much safer once she was with us. We tried some new positions (squatting with the head of the bed raised at a 90 angle, squatting on the floor, sitting on a ball, leaning over the side of the raised bed) and with minimal luck Lori manually kept the monitors in place.

My nurse stormed in to announce that I could have ten more minutes, but then it was "back to bed." The different positions were not very helpful at that point anyway, so I took what I could get and we kept at it. Ten minutes later we had found a squatting position that was more helpful than others and when we asked for more time the nurse said, "well I have the solution, I'll just put in an internal fetal monitor!" (The kind that screw into the baby's head). I had heard enough and jumped back into my pillows.

With the monitors registering properly, Merritt's heart rate was decelling with each contraction. Although this is normal, and he was recovering ok as far as we could tell, the nurse continued to come in and out of our room every few contractions, drowning us in fluorescent overhead lights upon her every arrival. Andy and Lori encouraged me with each contraction to take big deep breaths in order to get the most oxygen to the baby. Lori's mantra was "breathe for your baby". I felt lightheaded and the pain was making me feel nauseated. The nurse warned that if I was going to throw up, that I couldn't have any more ice chips. My doula said it was a response to the pain and I confirmed that I wasn't actually going to get sick. Lori gave me some physical support with counterpressure, and both Andy and Lori cheered me on and continued to work with me through each contraction.

5:45 pm

I silently talked myself through each contraction. I can do anything for 90 seconds. I focused on each contraction independent from the rest, and took full advantage of those quiet moments in between where comfort still reigned. Labor is such a beautiful and mysterious process, and those breaks are built in for a reason. Releasing long, relaxed, exhalations also helped me to manage my pain.

I remember being so thirsty during this labor, probably because I wasn't allowed to drink anything, and I couldn't get enough of those ice chips. At some point I snuck two GUs, which were just the thing at the time. (I highly recommend them for running, and other marathons, like birth!)

6:00 pm

By the nature of the contractions, I knew I was close to the end and began searching hard for that feeling to bear down and push, because then I knew relief would come. When Lori and Andy pulled the covers back to help reposition my pillows they found blood and Lori said, "uh, I think she's complete" and went to alert the nurses. In no more than a minute or two, my doctor had arrived, along with several nurses, and an entire NICU team. The room was suddenly bright again and filled with people.

I still had no urge to push, although I could feel him moving down. My doctor checked me one last time, noted that I was 10cm dilated and declared it was time to push. I also remember mention of a suspected cord around the neck and placental abruption.

I wanted to push on my own terms, but I still didn't feel the urge and while I had been told that I would be allowed to give birth in whichever position felt most comfortable, my doctor insisted then that she wanted me on my back in the traditional birthing position. She insisted too, on directive pushing which is totally unnecessary in a natural birth especially, and another common practice not at all supported by the literature.

After a few minutes I could feel the transition from labor contractions to pushing contractions, but my urge to push was still ramping up. My doctor relied on the monitor to estimate when a contraction was about to happen and then she would begin to count to ten, but by her third count my urge to push was over, and I wasn't going to push any more. She began talking about the baby's safety, and how I needed to get him out, like, NOW. Pushing was forced and more painful than necessary. I will always remember the sterile drapes and her stern and serious face.

By the third or fourth contraction I finally felt a real urge to push, and when Andy leaned into me to share his concern that we'd be headed for a c-section if the baby wasn't born soon, I followed her instructions to push, with way more force than I would have chosen if left on my own. As Merritt was crowning, I started to resist and told my doctor that I wanted to breathe through a contraction or two to ease him out, but everyone in the room was insisting that he was right there, and so close to being born. My doctor maintained that I should continue to push, push, push.

One of my most vivid memories of this birth is the feeling of shooting a baby out like cannon ball.

6:20 pm

Merritt was born with the cord wrapped around his neck (she just unwrapped it, no biggie) and a robust cry. His cord was cut after 30 seconds, (not the full sixty that is recommended for delayed cord cutting, but we were thankful for any delay). They let me give him a kiss, and then he was handed over to the NICU staff. He weighed 4 pounds 1.6 ounces, and was 17 inches long. His Apgar scores were 7 and 8.

6:30 pm

I delivered the placenta uneventfully and without the use of pitocin. A partial placental abruption was later confirmed.

6:35 pm

Andy was invited to join the NICU staff to observe and take pictures. I remember looking over to the blur of people revolving around Merritt. Andy was tearfully trying to capture the moments that I couldn't be a part of.

6:40 pm

Merritt was shown to me one last time, and then taken to the NICU. Andy followed to know the location, but wasn't allowed to stay.

6:50 pm

The doctor came in with a dinner menu, but we quickly realized that the cafeteria was closed. Andy was instructed by staff to leave the hospital to find food (so horrible!), but a girlfriend of mine arrived shortly after with homemade enchiladas and strawberry shortcake.

We had to spend over an hour on the L&D floor, with promises to see Merritt on the way to Postpartum. Instead, we were taken directly to Postpartum where we were made to wait more.

Around 9:00 pm

Two and a half hours after his birth, we finally got to see Met and hold him for the first time.

Merritt is Two Months Old

Its been a while

Let's seeeee, what's been happening around here over the last two weeks?

Roscoe has weaned

Short story: I was nursing Roscoe once a day at nap time for 3-5 minutes, but our routine was interrupted abruptly when I was admitted to labor and delivery back in February. Andy took over everything in my absence, including naps. I continued to offer to nurse Roscoe whenever we did see each other, and I made a point not to refuse when he asked. In a context outside of nap, nursing lasted only a half minute or so and seemed to serve as a familiar way to touch base with each other. The beginning of the end came when when my milk arrived. Roscoe retracted back with a troubled look on his face, made an exaggerated guttural gagging sound and uttered..."milk." Then he said "done" and was done. Well, mostly. He continued to like the idea of nursing, and continued to request it only to repeat his initial reaction, which then became a sort of game. Since we've come home from the hospital Roscoe has been adamant that milk is for Met.

Brothers

Roscoe reigns as Merritt's big brother. For a 22 month old we've learned that this role largely consists of doling out well intentioned affection with reckless abandon--a gesture challenged greatly by an effort to learn to practice restraint of his wildly excited limbs and appendages (also known as the art of being gentle). While two kids are harder than one, we've quickly learned that it's not the newborn we have to worry about. It's the toddler. Looking back to Roscoe's first few months, I'm a little bewildered as to why we felt so challenged (although to be fair, I understand now that the first time around for us was not so much about the baby as it was the life change). So far, Merritt and Roscoe are a sweet little pair, and I'm already looking ahead a few months when there will be a little more give and take interaction between the two. For now, Roscoe just vies for Merritt's attention--he frequently demands, "look at me! look at me!!"

Merritt is a mellow fellow

He's a quiet little guy who sleeps most of the time (and doesn't necessarily demand to be in arms, which is a strict departure from kiddo numero uno). He wakes to eat, and stays alert for a half hour or so to quietly soak up our rowdy household antics. He nurses on a pretty predictable schedule, so I've found a few opportunities to get out and about without him. Merritt also travels well in the car (such a nice surprise, given infant Roscoe's fear and loathe of the confines of the car seat) so he and I have gone out together a time or two as well--roaming the grocery aisles for the first time in almost two months felt like a real treat.

Nap time is the hardest time, and nursing too

Without fail, as Roscoe's nap time approaches Merritt begins to stir for milk. It has become the most stressful time of the day for me as I ricochet down the hall between the two boys in a sometimes successful attempt to tend to both of them simultaneously.

For a Momma handicapped by limited resources (only two arms and two legs!), nursing requires another balancing act, plus a whole lot of patience. While Merritt eats, Roscoe dances around us, picking, poking, prodding, and testing his limits. He's intent to be in contact with one or both of us at all times, bouncing erratically yet unassumingly on whatever surface we happen to be sitting. It drives me crazy and I'm still experimenting to find the most effective approach to curtail the behavior when I have little ability to immediately redirect or remove him from the scene.

I joined weight watchers

I have literally lost 3 pounds since Merritt was born. THREE. I do believe that four weeks of hospital food and near round the clock sitting gave me the worst head start on postpartum weight loss ever. While it could be argued that getting back in shape should sit lower on my list of priorities, it does not! I joined weight watchers and lost a pound last week. Weight watchers accommodates nursing mothers and is designed to facilitate a loss of one pound a week. Even though I didn't feel hungry and had enough points to indulge my sweet tooth, a one pound loss still feels a little disappointing. At this rate, my postpartum weight loss journey will be very s-l-o-w going.

We're over this monitor

Early last week we met with Merritt's pediatric pulmonary specialist. The data that was downloaded from his monitor revealed only one true spell over a two week period. I was hoping to get a reduced prescription, perhaps nights only or during feeds only. Instead, we were ordered another two weeks on the monitor 24 hours a day. ugh. I have a strong dislike for that little machine and I'm not at all convinced that it is necessary. I'll admit that Merritt hasn't been hooked up for the last four days...I keep telling myself tomorrow. We go back in two weeks and there needs to be data on that hard drive, so TOMORROW!

What's next?

I've been a little overwhelmed and a lot tired since we came home two weeks ago. Merritt is 6 1/2 weeks old, and was officially due this Friday. I've been quietly mourning the fact that I didn't get a "honeymoon" postpartum period, even if only for a day or two. Andy returns to work tomorrow, but my mom will be here to help out this week so I'm hoping to reclaim a tiny piece of what I might have missed.

At the end of the day

For the first two weeks of Merritt's NICU stay, dinnertime remained the only constant for us. I made sure to be home for that hour in an attempt to preserve a sense of normalcy, and family togetherness.

What's for dinner was the last thing on my mind after those long, long days inside the hospital walls. Lucky for us, beginning soon after Merritt was born, meals began to arrive at our doorstep. Dinner. Menu decided, ingredients purchased, prepared, packed, and delivered.

We were spoiled every other day (for two full weeks!) by a meal made with love by our best friends and family. Truth be told, good food warms my heart any time, but there's nothing better than looking forward to sitting 'round a dining room table of familiar faces and savoring the minutes while devouring the fruits of someone else's labor. Especially in hard times.

My friend Emily used Food Tidings to organize our meal tree. The site greatly simplifies the task of bringing nutritious food to the belly of someone in need, and it makes the effort easily accessible to those who are interested in helping. Check it out!

We're Home

Merritt is one month old today (37 week gestation equivalent)! Roscoe will be 22 months old tomorrow. He's been so content examining all of Merritt's details. Here he's taking a close look at toes.

saying goodbye and giving thanks

For the past ten days I've been living with Merritt in the nicu. Our room is small, but it has a makeshift bed and sliding glass doors with privacy screens. Having a place to sleep when Merritt sleeps has saved me. We also have a lot more control over our environment; no more bright overhead lights, beeping monitors, or late night staff chatter.

My totes and duffels are piled high in the only available corner, muslin blankets, a boppy, onesies and tiny socks, and other new baby essentials are strewn about--in addition to my computer, agenda, snacks, and reading materials. It's weird, but just as the place was beginning to feel kinda like home I got word at rounds this morning that Merritt will be discharged tomorrow.

That's right. By mid morning tomorrow we will be set free.

After 26 days, the news doesn't feel quite as thrilling as I imagined it would. In fact, nostalgia for this experience has set in before I've even stepped foot away from it. This room, our nurses, these monitors, they're imprinted into the story of Merritt's early arrival--a series of events that have further shaped my identity as a mother. I've never had to fight so hard for the role.

The first month of our life together, me and Merritt, was more agonizing, tender, and emotionally complicated than I can put to words. Our family's shared investment to take care of each other in a crisis has made me overwhelmingly proud, and while I know that Roscoe wasn't left behind in the larger sense of the word, I hope that he will eventually understand that if the roles were reversed his Momma would feel the same fire to fight for him.

The hospital environment and nicu way of life, which at times made me feel powerless, eventually gave way to necessary partnerships. The impact that this experience has had on the four of us is tremendous, yet Merritt is just one of hundreds of babies admitted to this nicu every year. I imagine that for most of the nurses, caring for us during our stay was just part of the job (although many went above and beyond), but for us our stay in the nicu was our life. Now the thought of leaving this familiar place and these familiar people suddenly seems very strange and a little unsettling.

Will they know how much we've been changed, and how their dedication and investment in our success has really translated for me and Merritt? I will have to tell them.

I'm thinking a good old fashioned hand written note may be the way to go. And a sweet treat never hurts.