Archives for posts with tag: Family

The Longest Night

The twilight continues with every piece of information you receive.  And you are constantly receiving information.  From the nurses.  From the specialists.  From the residents.  From the pediatricians.  From the financial administrators.  From the smiling, helpful staff.  Always so helpful.  Always smiling.  First, you’ll want to go left.  Then right.  Go down the green hallway.  Green.  You can’t miss it.

Except you do miss it.  You repeat their instructions, muttering them out loud while you try to navigate the labyrinth, but you still manage to walk right past your turn, your landmark. Even backtracking, nothing looks familiar, so you find another smiling staff member.  No, no, the orange hallway.  That will take you to the green hallway.  You can’t miss it.

Eventually, you stop asking directions, preferring aimless wandering to the constant feeling of being lost.

The doctors perform their rounds in the morning.  Six physicians, walking up and down the hallways in a pack, wheeling their laptops on special rolling carts.  They remain in the hallway.   They stand outside your child’s door and discuss her chart, her progress.  If you have found your way back to her room, you get to stand in the doorway with her nurse (one day, having just woken up, I stood in my socks while the well-dressed resident smiled down at me in her polished, sensible shoes) overhearing their updates that are obfuscated by your ignorance.  “Three litres per hour on a ventotherm.” “ Oxygen saturation levels remain normal.”  “Breathing rates still elevated.”  Nasal cannula.  Feeding tubes.  Monitors.  Radiant warmers.  Vents.  Bililights.  And all with their own sound, alert, rhythm, pulse, filling the background with a continuous, deafening chorus.  Something starts to beep persistently, alarmingly.  But nobody moves. Why is nobody moving?  Why do they never seem to respond?  You can barely hear the report the neonatologist gives.   You try to study her observant, patient face.  Try to read her lips as she calmly performs her assessment, gives her update.  Is this good or bad?  Is this progress?  What constitutes progress anyway?  Is the only movement forward a movement out the door?  A movement away from all of this noise?  And where do we go after we walk out of this room?  How do we get home?  Does anyone know the way?

Home.

Home.

That place we want to go.

You can’t miss it.

Sunday, September 1st: The first ten hours after my emergency C-section are a blur to me.  The anesthetic made me nauseous, and I spent most of the night vomiting into the blue bags the nursing staff were bringing me three and four at a time.  Sometime around 3am, I remembered that I had just gone through major abdominal surgery, and I began to hallucinate about splitting open as I wretched, my insides pulling the stitches and glue apart.  I was splitting down the middle.  I looked down at my incision and saw that it was intact.  But what about the inside?  They went through so many layers.  Maybe you just can’t see it.  Where I’m split.  I’m in two.  I’m torn apart.  Groggy, I asked the nurse if there was any danger.  She assured me that I would be fine—“That’s really strong glue they use!”—the anti-nausea medication was on its way, then she wheeled in the large, powerful hospital breast pump and told me that it was time for me to start pumping colostrum.  Maddie was still in the Special Care Nursery.  She had a ventilator taped over her mouth.  She couldn’t nurse.  If I wanted any chance of breastfeeding, I would have to pump every three hours to encourage my milk to come in.  The nurse suggested that I take a picture of Maddie to look at while I pumped.  “Sometimes it helps.  It makes your milk come in.  Reminds you why you’re doing this.”

The Special Care Nursery was at the far end of the maternity ward, at the end of a long hallway.  That first night, my husband pushed me to Maddie in a wheelchair while I held my catheter bag and IV.  Though the nurses encouraged me to remain seated, the bulky wheelchair wouldn’t let me get close enough to touch her.  I stood up and shuffled over to her, wheeling my IV and catheter behind me.  I was bent over, unable to stand up straight, and I couldn’t seem to convince my legs to swing from my hips smoothly.  They moved in halts and jerks.  I looked and felt like a crone, but the desire to hold my daughter for the first time was stronger than my discomfort.  I limped over and looked down at her.

Maddie_ventilator

She was swollen and red.  She felt hot to the touch.  Feverish.  Her umbilical cord had been cut short in preparation for an umbilical catheter (a direct line placed through her umbilical cord and into her artery.  It’s a painless way to draw blood in infants, and a way to directly pump oxygen into her system.  Maddie wound up not needing it, but her cord had been cut down to a flat scab over her bellybutton just in case).  The nurses had removed her hospital-issued blue and pink knit cap, and I could see her thick, black hair, still matted with afterbirth.  She had an IV in her left arm, which had to be immobilized with a soft cast over her wrist.  Her chest moved up and down rapidly.  Her nostrils and lips flexed with each shallow breath.  She was breathing fast.  Too fast.  They told me to look up at the screen above her head.  They pointed to a number.  It was hovering around 95, jumped to 110, then back to 89.  90.  94.  102.  98.  My husband leaned over to whisper.

“That’s her breathing rate.  They told me it should be between 40 and 60 for a newborn.  They’re trying to get it to slow down.”

107.  91.  96.

“There’s fluid in her lungs.  They started her on an antibiotic.  Just in case.  There’s no sign of infection right now, which is good.  They told me it was good.”

97.  100.  104.  104.  99.

As we left the nursery, we passed a little boy in a warmer.  I glanced up at his screen.  49.  51.  50.  50.  45.

I walked back to my room, dragging my IV behind me.  My husband pushed the wheelchair, ready to catch me in case my shaking legs finally failed me.  I tried to stand up straight as I walked, but I couldn’t.  I’m split.  I’m torn in two.  You just can’t see it yet.

In the morning, Maddie’s pediatrician visited.  “We’re all so surprised by this.  Nobody was expecting this.”  She told me something about oxygen percentages.  About oxygen mixtures.  She said Maddie’s lungs were “sticky.”  They were giving her medicine intravenously to flush the fluid from her lungs.  My usually smiling, warm pediatrician was frowning.  She had always looked so youthful and energetic.  Lines had appeared across her forehead.  I realized I had never seen her in surgical scrubs before.  Her thick hair was pulled back.  She looked paler than I remembered.  Paler than her Hispanic lineage.  “I have to stop at the office this morning for one appointment, then I’m coming right back here.  I won’t leave her.  I’m going to be with Maddie all day, okay?  She is my priority.”

I nodded.  The stitches have failed.  I’m split.  I’m torn.

———-

“This is going to be the best for Maddie.”

I think we were nodding.  I think we were understanding.  I don’t think I was crying.  Not yet.  I know that my husband was standing next to me.  I know that I was sitting on a hospital bed in a well-lit maternity ward, on a bright Sunday in late summer.  But everything was dark.  I was focusing on the pediatrician’s face.  I had to.  Everything else had gone black.  If I stopped looking at her, if I lost focus for an instant, I knew that the blackness would swallow everything.  I knew the dark would take over.  So I stared at her face.  Yes, it was pale.  Paler than usual.

“I have to be able to admit when a patient’s needs are out of my realm of care.  And hers are.  I can’t get her breathing under control.  If we try to take the vent away, she won’t have the energy to breathe on her own.  She needs to be with experts.  With specialists.  This is going to be the best for Maddie.  I promise.”

The pediatrician had called in a team from Riley Children’s Hospital in Indianapolis.  They would be here within the hour.  Maddie was going to be placed in an incubator—boxed up—and sent by helicopter to the NICU.  A pediatric respiratory nurse was coming as well.  She was going to quickly assess Maddie, prepare her to be air-lifted, make sure that she was stable enough for the transport, then take her away.  Away from me.  Away from us.  Maddie would be sent off on a seventeen-minute helicopter ride to a facility that was an hour drive away.

My husband and his mother immediately left.  Because Maddie’s delivery was an emergency, he didn’t have any clothes with him.  He ran to our house and quickly packed a bag for himself, then the two of them drove to Indy, fast, in the hopes of meeting Maddie there.  I was still recovering from the anesthetic, still being monitored for any signs of complications or infections.  I had to stay behind.  Alone.  In the maternity ward.  My husband balked at the thought of leaving me, but I wouldn’t let him stay.  I couldn’t endure the thought of her arriving at the NICU without someone, without one of us, without her family.  She had to know, even if she couldn’t open her eyes, that we were with her.

It hadn’t been twenty hours since I had delivered her, and I had never seen her eyes, had never held her.

After they left, I hobbled down to the Special Care Nursery to wait for the team from Riley’s.  I ran my hand through her dark, dark hair, and watched her chest move fast—too fast—up and down as she lay on the warming table.  She was panting with shallow, rapid breaths.  She was still hot to the touch, her body overworked just from the effort of breathing.  Don’t stop breathing.  Don’t stop. Just slow down a little.  Breathe, Maddie.  Breathe.  Breathe.  She was swollen and red, and every now and again her brow would furrow and she would shudder, like a person in a lucid dream trying to wake up, trying to respond to the voices that she could hear but couldn’t answer.  I had to believe that, even in her stupor, even with the ventilator hissing, and the monitors beeping and wailing and alerting, even with my blood pumping so loudly I was certain the whole ward was being deafened by it, that she could hear me.  “I love you.  Mommy loves you.”  I said it over and over again.

When the team from Riley’s showed up, it was as though the Marines had arrived.  Three specialists, all in matching black flight suits, wheeling clean, complicated machinery in front of them.  They were confident, efficient, but gentle.  They sent me back to my room, the respiratory nurse promising that she was going to bring Maddie to me once they got her into the mobile incubator.  While I waited, I filled out some paperwork, and told the nurse my cell number.  She assured me that she was going to call me, personally, the second they landed, and that she was going to stay with Maddie on the ground as well.  “I don’t have any other flights scheduled for tonight.  I’ll be with her.”  The nurse looked at Maddie’s chest x-rays, and quickly assessed her condition. They increased the pressure in her ventilator, forcing more air into her lungs, helping to open them.  The entire hospital staff seemed relieved that they had arrived.  The nurses in the Special Care Nursery looked thankful that someone was given them firm, sure orders, that someone seemed to have a plan.  My pediatrician respectfully stepped into the background, the lines never leaving her face.

They brought Maddie into my room, wedging the large, plexiglass incubator between my bed and the wall, trying to get her as close to me as possible.  One of the men in the flight suits (they never spoke to me.  Only the respiratory nurse ever said a word), opened the small, round porthole on the side, and let me put my hand inside to touch her.  The skin on her fingers and arms was wrinkled and soft, loose.  Her arms and legs were too skinny.  They didn’t have time in the womb to store up the fat needed to fill her out.  Even though she was puffy and swollen, I could feel all of her small, bird-like bones as I reached in and took a hold of her hand.  Her right hand.  Her left was still bandaged in the cast used to hold her IV in place.  The nurse was again assuring me that she’d call immediately.  I think she said that Maddie really did look good, or at least that the nurse had seen far worse.  Every part of me ached to hold Maddie, to climb inside the incubator next to her, to shield her with my body, to warm her with my hands, to breathe for her too.  If they asked me to, I would breathe for her for the rest of her life.  I would give every single breath for her.  Her small, delicate fingers wrapped around mine, and gripped me tight.

Then, they wheeled her away.  It was 4:30pm on Sunday, September 1st.

I began to sob.

I’m split.  I’m torn.

———-

The nurses tried their best to keep me entertained, or at least busy, that whole, long night.  They brought me a tray of food.  Meatloaf, I think.  I remember there were mashed potatoes.  I hadn’t eaten all day.  This was my first meal since having surgery.  I ate the food, not really tasting it.  I remember thinking it was strange that I didn’t feel hungry, but I ate it all anyway.  The nurses reminded me to “keep pumping!” in voices that sounded far too chipper.  I did.  I even dutifully washed and sanitized my pumping parts between every session, killing the time by running hot water over everything.  They brought me toiletries so I could have a shower.  They removed my IV and catheter, and checked on me every hour.  They told me that I would be discharged early the next morning, smiling, “You’ll have one of the shortest stays ever after a c-section!  That’s so great!”  They asked repeatedly if I wanted anything for the pain.  I didn’t know which pain they meant.  So I just said no.

The nurses had me fill out my discharge paperwork that evening.  They wanted to make sure that all I had to do in the morning was get the doctor’s approval and leave.  While signing the papers, someone from the Special Care Nursery appeared at the door.  She was hesitant.  She had Maddie’s ankle bracelet in her hand.  “I didn’t know if you wanted to keep this.  A lot of moms want to keep it for their scrapbooks and baby books.”  She handed it to me.  She had been able to slip it off Maddie’s too-thin foot without cutting it.  It was complete, but empty.  It froze me.  I held the small bracelet in my hand, trying to keep it warm, trying to keep it feeling alive and still connected to a hot, panting little body.  I rubbed my hands together, willing my nerves to remember the feeling of her soft, soft, loose skin, her bony grip. My hands shook as I held the bracelet.  I don’t remember asking them all to leave—I don’t remember being able to—but soon I was alone in my room, crying, sobbing, panting.  My breath came in fits and starts.  I couldn’t catch it. Couldn’t catch my breath.  I couldn’t fill my lungs.  I stared down at the bracelet. “I love you.  Mommy loves you.”

I said it over and over.

Maddies_bracelet

Eventually, the respiratory nurse called to let me know that Maddie was set up in a private room in the NICU, and that she had tolerated the helicopter ride well.  My husband also called, his voice hopeful.  “She looks so good.  Really.  She looks better already. I’m serious, baby. She looks so good.  They already have her looking better.”  I could tell by his voice that he wasn’t placating me.  And I was happy that he was there, along with his mother, and my parents, who stopped in Indy on their way down to see us.  Three of her grandparents were with her (my father-in-law was watching our older daughter), and her father.  That’s what I wanted for her.  To be overwhelmed with love.  To be full to the point of bursting with care and concern.  I turned on the television in my room, and watched HGTV until regular programming switched over to infomercials sometime around 4am.  By 7, I was showered, packed, wearing my street clothes, and seated in the rocking chair in my room, waiting to be discharged.  I was in the hospital 32 hours total, and when my husband arrived at 7:30, we didn’t even stop to pick up a change of clothes.  By 9am, I was once again running my hands through Maddie’s dark, dark hair, still matted with afterbirth.

“House (Ar)rest”

Having a child in the NICU is like living in perpetual twilight.  The windowless rooms.  The heavy curtain dividers.  The lights in your child’s room—dimmed for optimal “family rest”—that make you blink violently when you walk out into the bright hallway.  The nurses, always looking hurried, yet trained to be silent even as they quickly thud past in their thick-soled black shoes, trained to not disturb the sleeping, the resting, the grieving, the hopeful.  The continuous, 24-hour schedule, skewing any sense of time you may have been able to retain in the artificial environment.  The clocks that dutifully tell you times that mean nothing.  Is it two in the morning?  Or is it afternoon? What does it mean that the clock reads 2?  What does it matter?  Either way, it’s time for another feeding.  Another tube inserted into her.  Another moment, another minute, when you get to fold down the plexiglass divider and touch her.

 

Thursday, August 14th: I was clutching my husband’s arm, my eyes squeezed shut, as the pressure steadily mounted and peaked.  He was lying next to me, calm but alert, one eye on his phone, timing the contraction.

“Don’t forget to breathe, baby.”

His low, still voice reminded me that I was, indeed, holding my breath.  I slowly exhaled and opened my eyes as the pain subsided.  One minute long.  Twenty minutes after the last one.

“She’s coming.  She’s coming out of me.  I can feel it.  This isn’t normal.  I can feel her head pushing against me.  She’s coming.”

On Saturday I would be 35 weeks pregnant (I believed, though I would later learn that my calculations were off a day).  For the last two nights I had been experiencing contractions that were increasingly regular and painful.  I was being woken up throughout the night from the pain.  I tried to “drink a glass of water and lay down” (the usual advice for stopping preterm contractions), but it didn’t seem to be very effective.  I was told that the contractions were likely “false” labor, Braxton Hicks contractions, that helped to prepare my uterus for the task of childbirth, but didn’t actively advance labor, didn’t affect my cervix.  But these contractions didn’t feel like a general tightening in my midsection.  It felt like a downward push, hard, and insistent, and slowly rhythmic.

The next morning I called my OB, and was told to come to the office right away.  After a quick exam, it was easy to see that I wasn’t having “false” labor, or “unproductive” contractions.  I was in pre-term labor, 2 centimeters dilated, 70% effaced, and contracting every 15 minutes.  My OB put me on Procardia. (A blood pressure medication that some studies have shown helps to slow down contractions, though its efficacy for pre-term labor has really only been recorded for the first 24-72 hours after starting it.  It buys you a couple of days.  But, luckily, I was far enough along that all we really needed was a couple of days.)  Then he told me, “Your job for the weekend is to sit on your couch and time your contractions.”

“Like bed rest?”

He balked.  “I’m not going to tell you you can’t do things.  I’m not going to put you on bed rest.  Let’s call it couch rest.  House rest.  Just, don’t leave your house.  And don’t do much while you’re in it.”

“So, activity-wise…?”

“As close to nothing as you can manage.”

“For how long?”

“For as long as it takes.”

For two weeks, I slowly fused into my couch.  I dropped my daughter off with her grandparents.  I downloaded a contraction timing app to my tablet.  I ate everything out of a microwave.  I obsessed about every twitch, flicker, and tightening in my belly.  I watched my house succumb to the rapid entropy that comes when you have both a husband who works too many hours and a toddler whose idea of “helping” usually includes pulling all of the Kleenexes out of the box while laughing maniacally.  I watched way too many hours of “Criminal Minds” and “Law and Order” (because apparently marathons of violent TV dramas are the only things on in the middle of the day when you have basic cable. Who knew?).  I did nothing, except slowly, slowly, agonizingly slowly went insane.

I took the Procardia for five days.  After two, my “breakthrough” contractions had ramped up enough that the on-call physician told me to double my dose.  After two more days, I developed an allergy to the medication, and had to stop taking it immediately.  Without any medicinal intervention keeping my uterus from contracting, my “house rest” had morphed into house arrest.  I was told to stay hydrated, and keep my feet elevated.  No laundry.  No picking up my daughter.  No walking to the park.  No nesting.  I sat on my couch, thirty feet away from my newborn’s incomplete nursery, and was adamantly forbidden from working on it.

I was miserable.

Even though I kept telling myself that I was lucky (we had made it to 34 weeks with no complications, and if my daughter had been born at this point, the chances of her having long-term problems from being born preterm would be truly miniscule).  Even though I knew that it was temporary (I only had to wait until 37 weeks to be considered truly “full term” and therefore out of danger).  Even though I kept telling myself to be thankful for the outpouring of help I received (My good friends sent me flowers.  My parents drove 500 miles to be with me.  My sister visited from Chicago. My daughter essentially lived with her grandparents, enjoying way too much junk food, way too few rules, and bedtimes that were way too late, for almost the entire time.  I missed her until I ached, but I knew that she was happier being with people who could get down on the floor with her, instead of trapped in the living room with her mother, watching Cars and Up again).  In spite of knowing all of these things, I found myself crumbling every day.  Two o’clock would roll around, and I would sob, knowing that I had already sat like stagnant pond water for the majority of the day, but also knowing that I still had hours—long, long hours—before my husband would come home, before I could move off the couch and into the passenger seat of our minivan and enjoy fifteen minutes of bliss and freedom as he drove us to a local fast food restaurant for dinner.  I watched the clock, timed my contractions, played hundreds of hands of solitaire, and sobbed.

Sunday, August 25th-Monday, August 26th: I was 36 weeks pregnant.  I was 4 centimeters dilated.  Once again, I grabbed my husband’s arm in bed as he timed my contractions. Every 10 minutes.  I was certain that I was going to be having my baby.  “It’s happening.  It’s really happening.”  We dropped our sleeping daughter off with my mother-in-law, and drove to the hospital, getting there around eleven at night.

The nurses hooked me up to the monitors.  We all watched the needle swing wildly and regularly, showing my contractions.  I was effaced.  My baby had dropped.  One of the nurses, after checking me, exclaimed, “Your cervix is READY for birth!”  I was uncomfortable, but smiling.  It was over.  I was done.  I would no longer have to sit in misery.  I was going to have my baby.  She was a little early, but it’s okay.  She’d be fine.  She was measuring big, her heart rate looked great, and, being a girl, the odds of her having problems would be low.  The nursery wasn’t finished.  The laundry wasn’t done.  Nothing was ready.  But it didn’t matter.  She would be here.  Finally.  I breathed more easily, knowing that it was all over.

Then, the OB made the decision to stop my labor.  It was her medical opinion that we wait.  I was just 36 weeks.  It was cutting it too close.  She confessed to being overly cautious on such matters, but told me that being conservative would be a good thing for my baby.  Really.  I was given two doses of terbutaline to stop my contractions, spent 9 hours at the hospital, slept 20 minutes, and was sent back home early enough for my husband to go back to work after just a few hours’ nap.  I was left alone, pregnant, and in labor.  Again.

I couldn’t believe it.  I was told that after 36 weeks my labor would be allowed to progress.  That it was standard procedure to allow a woman that far along to give birth.  But I was still pregnant.  Still sitting on the couch.  Still crying at 2pm after realizing that I may have to deal with an entire month more of labor.  Still guilty for wanting my baby to arrive, not for her sake, but for mine.  I was being a horrible mother.  Selfish and whiny, I just wanted my discomfort to end, even though the possibility that my unborn child would have complications was very real.  I didn’t care.  I wanted my baby.  For me.  I wanted to feel better.  I wanted it to end.  I was angry at the OB.  I was angry at my body, which didn’t seem capable of holding on to her any longer.  I was even angry at my child, not because it was her fault, but because I knew that I couldn’t blame her.  I was angry at her, and I hated myself for being angry at her.  Because I knew that I had to sacrifice my comfort for her safety.  Because I knew that I’d always have to sacrifice my comfort for her safety.  Because it wasn’t fair.

So I cried.

Saturday, August 31st: I believed that I had made it.  According to my calculations, I was 37 weeks.  Full term.  Out of danger.  If my preterm labor ramped up again, my OB would not try to stop it.  I was freed from house arrest.

To celebrate, my husband and I decided to wander around the Fourth Street Festival, an art fair held every Labor Day Weekend in our hometown.  I was going to look at the handmade art, enjoy some people watching, maybe even have an ice cream cone.  I wasn’t going to be alone anymore.  After two weeks on my couch, it would be Heaven.

It was brutally hot.  We stopped and looked at the booths set up by local artisans and craftsmen, chatted with a few of them whose work caught our eye, and tried to turn our faces to the hot breeze that worked its way lazily down the street in between the crowds of people.  We spent most of the afternoon sitting under a tent, listening to Americana, sipping lemonade sold by the high school orchestra.  I began to really notice my labor. Whenever I had another painful contraction, I would grip my husband’s arm.  I seemed to be clutching him every song.

As we walked back to the car, I had to stop frequently and wait through another minute-long contraction.

“These are getting closer together.”  Once again, his voice was calm, but he was watching me intensely.

“No, no,” I gasped.  “It’s just the heat.”  Suddenly, I was aware that my newly acquired freedom was at risk.  It was my first day out of the house in weeks.  It might turn out to be my last.

We went back to my mother-in-law’s house to pick up our daughter.  There, in the cool of the air conditioning, my husband quietly timed my contractions while we sat around and chatted, trying to ignore the elephant of my impending delivery.  Every five minutes.  I somehow convinced him to take me home.  Somehow decided that my labor would stop if I was in my own bed, resting and watching cartoons with my daughter.  An hour later, they were four minutes apart.  I called my OB.

“Rachel, are you in labor?”

Gasping, “Yeah.  Yes.  I’m pretty sure I am.”

“Then get here.  Now.”

At 7:23 my OB checked my cervix.  “You’re 6 centimeters dilated.  Your baby is coming whether we do anything or not.  Within the half-hour, you will be having a c-section.  Okay?”

Joy, nerves, excitement, fear.  I had no time to truly feel any of them.  I called my family.  Everyone was at a barbeque at my aunt’s house.  They immediately started laughing and making guesses about the baby’s weight and the time of birth.  They started a friendly bet around the table.  I heard their overlapping conversations, their joy, as chaos and noise.  I was smiling and laughing.  I was still smiling and laughing, even when I was being wheeled, alone, into the OR.  I was still smiling and laughing, even when I started to tremble, shaking uncontrollably.  Am I cold?  I must be cold.  Maybe I should ask for a blanket. The nurses joked and smiled at me as they wrapped me in warmed blankets and tested my belly for numbness.  My husband came in, then, wearing blue scrubs.  I was still trembling.  Still smiling and laughing.  It was 8pm.

Maddie_birth

Ultimately the c-section was a wonderful experience.  It was fast, efficient, and without any complications.  I felt nothing but a slight tugging sensation, then I heard the roar of congratulations as the nursing staff and my OB welcomed my little girl into the world.  My husband, smiling behind his mask, was holding her in a tiny bundle.  It was 8:33pm.  She was born at 36 weeks, 6 days.  I had been one day off in my calculations.  She was the oldest a “premature” baby can be, though her size belied her early delivery.  6 pounds, 15 ounces.  We all laughed.  The OB joked, “If she waited three more weeks, she would’ve been HUGE!”  My husband placed her face next to mine, and I began to cry as I kissed her, the tears rolling back into my ears.  She was red and swollen, puffy from the strain of the birth, but I could see how she looked like her sister, her father.  Her eyes were closed, and her lips were pursed.  A frown was working its way across her forehead.

And she was quiet.

She wasn’t crying.  It wasn’t a cry.  More of a grunt.  A gasp.  One of the nurses appeared, hovering over my head and haloed in the bright spotlights above me.  “Rachel, she seems to be having a little trouble breathing.  We’re just going to send her to the special care nursery.  Just to get her some help.  She just needs a little help.”

I couldn’t look away from her, from my daughter.  I couldn’t stop kissing her.  My husband was looking up at the nurse.  Quiet and calm as always, but alert.  I didn’t notice him tensing up.  I was looking at my daughter’s chipmunk cheeks. Just a little help?  Just a little? I nodded.  “Okay.  Yeah, I understand.”

The nurse looked kind, but she wasn’t smiling and laughing anymore.  “What’s her name?”

“Madeline.  Madeline Louise.  Maddie.”

“You’ll be able to see Maddie soon, okay?  Daddy’s going to take Maddie the whole way.  He’ll be with her the whole time, okay?”  She looked down, “Maddie, give Mommy a kiss.”  The nurse put her hand on my husband’s arm, and he stood up, pulling Maddie away from me.

I twisted my head around, trying to watch her from where I was strapped to the operating table.  The last thing that I remember was my husband’s shoulder, in blue scrubs, hunched over our new daughter, as he turned away from me and walked out the door.