The Story of the Birth of our Daughter, Louisa

Or: What a Level 1 Emergency C-section Is Like

A year ago tonight, our daughter Louisa was born. She’s a delightful little baby. I love her so much that sometimes I spontaneously start laughing. I’m just as unbearable about it as it sounds. Here she is:

The night she was born was, without question, the most intense moment of our lives, and not entirely in a good way. It goes without saying that the effort and the stakes were a bit higher on the part of my wife Allison, who is the best.

Some wild experiences are enjoyable to share over and over again. This is not one of those. The problem is, when I tell this story, I get emotional, and I prefer not to hucklebuck sob in public. I’m a grown-ass man in America, after all. The thing is, I really do want people to know what happened that night, especially the people I love. So I decided to make like it’s 2004 and I wrote a blog post about it. This is primarily for my close people, but maybe it’s also for anyone else who might end up going through what we did that night.

One of the most unlikely things about the whole experience was that I had my camera with me: a camera that I swore (that we had decided) I wasn’t going to use during the birth. For reasons that I will explain later, I ended up documenting the event in its entirety.

Warning: There is mildly graphic imagery ahead.

We got to the hospital about 11 hours early, as you do when one of you is Allison. Louisa was 10 days late at this point, and so this was a scheduled induction. A few hours into the process, there was hardly any movement at all. Mercifully, Allison was able to get a little bit of sleep at this point.

A quick aside: Pregnancy is, obviously, quite a stressful process no matter the situation, but when you went through as much as we did trying to get pregnant: being told that you’re infertile, having a viable embryo you’ve spent months of agony (and tens of thousands of dollars) on proceed to not make it through the thaw on transfer day... Let’s just say that there was a lot of effort and emotion tied up in this baby. Of course, this is always the case, we’re not special, but yeah, whatever, anyway—we were watching the monitor like a hawk.

The room at Pennsylvania Hospital was spacious and luxurious as hospital rooms go, and we had nested and spread out into all corners of it with our 36 bags of essentials that people tell you to bring for the birth. One of the items I had brought was my gift to myself for the arrival of the baby: A Leica Q fixed-lens digital camera. I’ve been a professional photographer (justification 1) and I’ve done well with my film production business (justification 2) and someone needs to take good pictures of this baby (justification 3), so buying this gift for myself was both righteous and correct.

I have a weird relationship with photography. The aspect of photography that I like is sharing the photos I’ve taken with people for whom the photos have some special value. What may seem odd coming from a professional photographer is that I generally don’t care about photos myself. But when I can take a nice photo that someone else finds meaningful, that makes me happy. I used to take a lot of photos as a wedding and commercial photographer, and a point of pride for me was how many people, most of whom I didn’t know, were using a photo I took as their profile picture on Facebook. At one point it was something like 42 people, not that I was counting. In any event, Allison and I had agreed that I would not be taking any photos until we were safely in the recovery room with a healthy baby. Like many other sentimental people who are vaguely ashamed of modern society, my position was that pulling out a camera taints an experience for the photographer and for everyone else, making them not fully present, and with a moment as important as the birth of a child, breaking out a camera to take a picture would certainly compromise my ability to have the experience with adequate virtue.

This position on photography was one of many positions I had developed to curate the ideal birth experience. Another concerned communication. What could corrupt the magic of this birth more than having my filthy face buried in the lurid glow of my iPhone, tapping and blooping and texting away while the love of my life magically produces the person she made in this once in a lifetime moment? Nothing could be worse than that... If I so much as look at my iPhone or have a stray thought about checking my email or, God forbid, Facebook, strike me down right now. Just end it. I wouldn’t even deserve the senses through which to have this experience. But there’s one problem: We have family and friends who would be interested in how things were going, so I needed to engineer a way to communicate with them and make sure they would feel properly tuned in to the play-by-play without compromising the integrity and immediacy of my presence as a husband and father.

My solution was to send a mass SMS (not iMessage) politely asking that no one text or call us other than immediate family, and then offering an intermediary (Aunt Nancy) who I could deliver important updates to and who would take any questions if people had them. This was a sound design.

Doctor Paige came in to check on how the labor was progressing, and it wasn’t. It became clear that we were in for a very long night. I called the families to let them know it wasn’t happening tonight and I teed up another text message to let everyone know it would be a while:

Just wanted to send another text update. The induction process is taking a lot longer than we anticipated, but it’s nothing abnormal. Everything is going well, Allison is relatively comfortable and has even been able to get some sleep. Stay tuned. Updates hopefully tomorrow.

Ten minutes later, Louisa was born.

Here’s what went down in that ten minutes.

As anyone who has been hooked up to one of these monitors knows, there are two graph lines that thump along, one tracking the intensity of contractions while the other tracks the baby’s heartbeat, and these two lines mirror one another. Basically, what’s happening is that, at a regular interval, the momma squeezes the baby really hard and the baby’s like “woaaah you’re squeezin’ me hard” and her heartrate slows down while the contraction is at full intensity, then the momma eases up again and the baby’s like “phew, that was pretty intense squeezin’, thanks for chilling out, i need to stretch out a little bit here” and her little heartbeat speeds up to make up for lost time. This is totally normal and the way it’s supposed to happen. This is just another one of God’s well-designed mindfucks, you know, just to keep things exciting.

We watched and listened to the monitor for a while, doctors and nurses stopping in periodically so we could play the game of reading their faces and everything looks normal, I mean perfect, totally perfect, right? What a perfect little baby she is…

Then the next contraction hit... This time, the heartrate drop was, shall we say, more pronounced… Meaning it went to zero. Now, the machine isn’t perfect, and sensors get misaligned sometimes, and little dropouts had happened over the hours previous, so the “What the fuck is happening?!” voice in my head was accompanied by a quieter “Everything’s okay guys” voice. I think the combination of those two voices shorted out my heart for a minute or so.

The contraction subsided and Louisa’s heartbeat came back. But this time it was really, really strong and fast, like a kickdrum roll at a death metal concert. Exhilarating, but also reassuring, the sound of Louisa’s little babyheart returned to normal. Allison was pretty out of it at this point, exhausted by the pain and fatigue. I left the room to go get my seventeenth cup of ginger ale.

From the Ginger Ale & Saltine Station you can see into the staff area, and it looks just like Grey’s Anatomy in there. A couple dozen handsome and diverse people in scrubs flirting with and probably filing their nails or whatever, just sort of hanging out, surrounded by life and death. Seriously, no sarcasm: It looked great in there.

I got back to the room just in time for the next contraction to hit. For the second time in a row, the heart monitor flatlined...

For some reason, I walked over to the monitor screen with my phone and took a picture of it. This was the first picture I had taken since we entered the the labor and delivery unit.

Doctor Paige came in with the nurse to watch the monitor. She had the same great demeanor/bedside manner she always has, but she watched a little bit longer than normal this time. Again, Louisa’s heartrate came back furiously, and then on the next contraction, again, it disappeared. Then Doctor Paige said “she is not happy…”

Then there was a look, not a panicked look persay, but a look that definitely contained “uh oh…” somewhere in it. She reached down to inspect Allison with her hand. A look of disappointed confirmation came across her face. She nodded to the nurse who quickly left the room. She then turned to Allison, who was oddly calm, completely confident that her beloved Doctor Paige was with her. “Allison, don’t worry, but people are about to start moving really fast, okay?”

Instantly, the entire cast of Grey’s Anatomy were in our room, and Allison was being moved from her bed to a rolling bed. My heart was now definitely beating faster than Louisa’s. My eyes darted around rapidly, scanning the faces of probably a hundred and thirty or so people in the room. They were all business. I couldn’t get a read on any of them. Their poker faces were so strong, all of them.

All, but one.

It was the young resident who had climbed up on the gurney with Allison and had her hand in Allison. “Is it a cord?” she asked Doctor Paige. Then she smiled. But this was not a good smile. this was a practiced smile that she saved for when things were not good.

Every muscle and neuron and blood vessel in my body were now activated, on high alert, and my life flashed before my eyes. I don’t know if it’s technically possible to have a near-death experience when you yourself are safe, but that is the only way I can think to describe what I was feeling at that moment.

The fragments of words and sentences spoken in that thirty seconds had magnetically bonded to form my following understanding: This was an Emergency, a Level One Emergency (does this scale count up or down? seems like it counts down…), having something to do with the umbilical cord, and we were going to have a C-section. Right now.

The crowd screamed out of the room and I went to follow them, when a tiny little person stopped me at the door.

“Okay, we need to pack up the room,” she said.

“What?”

She had begun to gather up some of the trash around the now completely silent room and was deftly putting all of our spread-out belongings into our bags.

My brain short-circuited at this point, and all that came out of my mouth was “Is everything okay?”

“Oh, everything’s going to be okay, they’re prepping her now and then they’ll have a seat for you in the operating room.” The tiny person dumped my ginger ale in the sink. “Let’s pack up the room.”

So here I was. Packing bags. Here is an approximation of my emotional/endochrine state: I’ve been thrown off the top of a skyscraper and now I just need to make sure to clean out my email inbox before I hit the ground.

“Don’t forget your camera,” she pointed at my camera, which was sitting on the windowsill. I grabbed it and slung it over my shoulder. It didn’t make it into a bag.

This whole process probably took 90 seconds. I put on a hairnet and booties, walked into the OR, and sat down in the seat they had for me, next to Allison, under the bright lights. The doctors, nurses, and technicians were still all business, shouting things, call-and-response jargon, reminding me a lot of a film crew. They still weren’t letting on. Allison was so oddly calm. She turned to me “Is everything okay?”

“Yeah,” I said. “Everything‘s okay.”

A moment later, the doctors were cracking jokes. Someone actually said: “Your insides are just as beautiful as your outsides.” Then, the doctors starting cooing and giggling.

“Congratulations, you just gave birth to a three-month-old!” That was Doctor Paige’s voice.

Then, we heard her. That little squeaky growl of Louisa’s first cry. And then, someone said “Hey dad, get a picture.”

That’s when I realized that I had the camera slung over my shoulder. Taking a picture was really not something I would have considered doing. I had just had all of my blood vessels, nerves, bones, and organs pulled from my body and laid out on the floor in the form of a rally course for gremlins on dirt bikes and then two minutes later everything had magnetically snapped back into my body. But I had a very loud and obvious camera hanging on my shoulder. “Hey dad, get a photo.”

So I did. I got a lot of photos.

I documented our entire meeting with our little girl. I documented her first opening her eyes and looking at me (I know they can’t see, shut up), Louisa meeting her amazing mother, the first time we held her. And it was all because this crew of professionals, just doing the work they do every day, had spotted the camera slung over my shoulder and said “Hey dad, take a picture.”

The truth is, there’s absolutely nothing that could have taken me out of that experience, and I have to admit that I’m really glad we have these photos of this most intense and alive and electric moment of our lives. These photos are meaningful to me.

I called Allison’s parents: “You know that conversation we had a few minutes ago? Yeah, I was wrong about that. You have granddaughter and she’s perfect.”

Fast-forward. Louisa is pretty much the coolest, sweetest, cutest, and most fun baby ever, of course, and were it not for the trained professionals at Pennsylvania Hospital with the experience of seeing a prolapsed umbilical cord a hundred times before, we woudn’t have her.

There are a lot of jobs in the world that I think, if I worked hard at them, I could do okay. Lawyer, carpenter, professor, therapist... Hell, filmmaking is really challenging and for some reason I think I can figure that out. But healthcare, especially the high stakes world this Penn Medicine crew performs in every day... I could never do that. I just couldn’t. Thank God there are people who can. What a privilege it is (especially in this backwards-ass country) to have access to medical professionals like these. There’s no way to adequately express the gratitude.

There. That’s the story. I love my alymak (pro-nounced allie-mac) and my baby bee (long story). Some lessons:

  1. A prolapsed umbilical cord ain’t nothing to fuck with.
  2. Some people are really good at their jobs (especially at Penn Medicine).
  3. Sometimes you just need to pause and pick up your shit, no matter what time it is, and...
  4. It’s okay to take photos, even good sometimes.
  5. My wife is the best ever.