I navigate my way through the hospital maze to a small supermarket built into the building and buy some fruit, a bread roll, and a sandwich. When I walk into the suite, the victorious hunter returning with food, I feel like I have accomplished my first useful contribution for the day. It’s fair to say that Alex has been doing all the heavy lifting.
We eat, Alex sitting on a large inflatable ball, bouncing a gentle rhythm, me in a chair, and Christina on the bed, and Alex and Christina talk while I eat my sandwich. There’s grit in my eyes when I blink and a headache at the back of my scalp telling me I haven’t had enough sleep, but I feel wired from adrenaline and relief that Alex is looking better.
I have seen my fair share of suffering during my time as a nurse, but was always able to disconnect myself from it, playing the role of the professional. But having someone I love afflicted with such torment right in front of me fills me with a hollow despair that is hard to swallow.
Christina performs another examination and is happy to report that Alex’s exertions have cracked her cervix open to four centimetres. We all cheer and then Christina leaves to tend to her responsibilities, and we find ourselves, shockingly, bored. The epidural pump chirps with each dose of analgesia it pushes into my wife’s spinal column, announcing that it has everything under control.
I lock eyes with Alex. ‘Wanna watch TV?’
She shrugs. ‘I could go some Friends.’
I set up a laptop on a wheeled table, curl up behind my wife on the bed, and we watch Chandler attempt to keep his relationship with Monica secret from the rest of the gang with hilarious repercussions.
About halfway through the second episode, Alex speaks up.
‘I can feel it again.’
I’m instantly alert. ‘The contractions?’
‘Yep. But weirdly only on the left side.’
‘Yeah. It’s like someone’s drawn a line down the middle of my body that the pain can’t cross. But I can definitely feel it on the left. Through my stomach and back.’
‘Is it bad?’
‘Nothing compared to before, so I’m not complaining.’
‘Can I do anything?’
‘Just watch Friends with me.’
I settle back into the mattress a little less at ease than before.
By the time the third episode is about to start the pain has ratcheted up to the point that I turn off the laptop. All of Alex’s attention is pulled towards her discomfort. She gets out of bed and tries pacing around the room, pulling her IV pole around with her. It isn’t long before she has to sit down again, the pain dragging through her body in ceaseless waves.
Christina returns and Alex updates her on her condition, gritting her teeth throughout sentences as the contractions grip. She is looking pale again. The hollow feeling in my gut is blooming.
Christina administers a bolus dose of the anaesthetic to try and get back on top of the pain and we give it half an hour. By the time we reach the deadline, Alex is moaning through each spasm and hasn’t spoken for the past twenty minutes. I suggest to Christina that we call the anaesthesiologist back to try and reposition the line, fearful that it has slipped, causing the strange hemispherical numbing that Alex is experiencing. Christina pages them and we wait.
After what feels like an eternity of joint deep breathing and pain lines deepening on my wife’s face, the resident returns and I am shooed from the room. I pace again for ten minutes, fatigue forgotten with fear taking the reins, before being allowed to return. Alex looks no better.
The resident gives another bolus before leaving and a cheerful goodbye, having accomplished exactly nothing. Alex is on her side in the bed, sweating despite the moderate temperature of the room.
‘How are you holding up, beautiful?’ I ask.
‘There’s no break,’ she says, out of breath. ‘If I could only get a break. But they’re one after the other.’
She’s cut off as what looks like every muscle in her body constricting to its limit. I encourage her to breathe and tell her she’s doing great.
‘Oh god,’ she pants, ‘my left side. It’s my left side. Why isn’t there a break?’
I rub her shoulder and breathe with her through the next contraction. She looks exhausted. Her body has been working since two in the morning and I have no idea how she’s expected to keep going. She purses her lips and forces her chest to slow, to not hyperventilate despite the adrenaline screaming at her to do just that, and rides the latest crest of pain. I am simultaneously distraught and bursting with pride. She is so strong.
The afternoon ticks away, time measured by the endless cycle of contractions and marked by the next strangled moan that Alex no longer tries to suppress. We cheer her on, applauding when she lets the pain out in an explosion of volume. Christina comes up with various strategies from her bag of tricks to try and speed the process along and provide Alex with some measure of comfort.
She has Alex shift to all fours on the bed and then drapes a folded bed sheet over her hips, with Christina at one end and me at the other. We pull back and forth in time with each other, Alex’s pelvis swaying in between, as if we’re trying to polish her backside to a high sheen. The movement is designed to help shift the baby lower and trigger further dilation of the cervix.
Next, we reconfigure the bed so that a cushioned part of the bed head folds down, allowing Alex to get her elbows onto it and rest her weight, knees tucked under her. She complies, but struggles against the paralysing effect of the all-but-useless epidural. The resident’s latest bolus did nothing to tamp down the pain and only managed a complete lack of sensation in my wife’s lower right body. She giggles and sobs as she tries to draw her right leg up, sliding back down in a puddle of pain and exhaustion.
In the end, I manhandle the limb into position and she sags against the bed head, spent. After ten minutes, this position only amplifies her discomfort and she slips back down onto the mattress, knees under her, arms at her side, and head on the pillow turned to me. Her face is red, sweat-damp hair stuck in a scribble across her forehead, and her eyes are pleading for a respite. I stroke back her hair and hold a cold wet cloth to her face, the best I can offer and completely insufficient.
A look of panic crosses her features. ‘I’m gonna be sick.’
I bolt upright, looking around, knowing there’s no vomit bags from my perusal of the room earlier in the day. I grab a cardboard kidney dish from a stack by the window and shove it under her chin. Alex vomits, over-strained muscles squeezing again to empty the contents of her stomach. The kidney dish is full to the brim.
‘Just wait, lovely, I need to swap this over.’
I turn away, moving painstakingly slow to avoid spilling the hot liquid over the floor. I feel a rush of elation as I place the dish down without losing a drop. I’m reaching for another when I hear the gag of the next vomit coming up behind me. My shoulders slump.
I turn to find my wife slumped into the pillow, eyes red rimmed and a fan of spew on the sheets from her mouth to down over the edge of the mattress.
‘I’m sorry, love. I was too slow.’
She just closes her eyes, wanting it all to go away.
With the help of soap, warm water, and fresh towels, I clean up Alex and the bed, and get a few mouthfuls of water down Alex’s burned throat.
After another stretch, a doctor comes in, a short skinny man, and announces he needs to do an inspection. Christina has been working hard to report back to the doctor on shift, thereby circumventing any need for him to visit. After five minutes in the room with his arrogant demands and clipped bedside manner, I’m appreciative of Christina’s efforts.
We get Alex onto her back and I notice her eyes are squeezed tightly shut, riding out yet another body-jerking flood of pain. I narrate what’s happening.
‘The doctor’s just doing an inspection to see how dilated you are. You will feel a bit of pressure.’
‘I don’t care,’ she whispers.
Fair enough, I think, and kiss her forehead.
She lets out a grunt as the doctor probes his way inside, far firmer than Christina’s examinations. He takes his time and when he finally straightens, he pulls off his gloves and announces that the baby is face up, the less than ideal position for birth, and one that increases the likelihood of needing a caesarean. Having successfully lowered the mood of the room, he leaves.
‘Fuck that guy,’ I say to Alex, ‘you’re doing great.’
She grunts in acknowledgement of my inspirational speech, or perhaps she is just grunting. She’s in a lot of pain, after all.
The intensity of the contractions continue to climb and a long drawn out moan comes from deep in Alex’s throat. I feel smothered by the pulsing need to help, to take this load from my wife’s shoulders for a spell, and want to scream at my impotence.
‘Can I do anything, babe?’ I beg.
‘My hip,’ she pants. ‘Can you massage it? Oh god, it hurts.’
I feel a gush of gratitude that she has granted me a purpose. I make a fist and gently knead my knuckles into the flesh over her left hip.
‘Harder,’ she says.
I press deeper, rolling my fist back and forth.
I lean forward, letting my weight fall down through my arm until Alex’s skin pillows around my knuckles. I’m genuinely worried I will bruise her. I rock back and forth, watching her face to make sure I’m not adding to her pain.
‘Yesss,’ she breathes, features relaxing a little. ‘Better.’
I raise my brows and nod, and get to work.
At around five-thirty in the afternoon I look at my phone and find I can’t reconcile the time displayed on the screen with my own internal clock. Alex’s ordeal feels to have stretched on for far too long, for days, and yet wasn’t it only a couple of hours ago that we were in our bedroom studying a collection of amniotic fluid pooled on the bed?
Alex divulges to Christina that she needs to use her bowels, but is unsure how to go about it given her right side isn’t giving or receiving signals at the moment while her left side is a cacophony of contracting agony. Christina answers with just one word, ‘Bedpan,’ and makes the call to stop the epidural altogether. At this point, it’s only doing more harm than good. She holds down the power button, suffocating the chirping once and for all, and disconnects the tubing.
Between the three of us, we manage to position Alex on her knees, bedpan cradled between her feet as she squats down on top of it. Utter exhaustion has robbed her of the ability to hold herself erect for long periods, so she lowers her weight onto the bedpan, folds herself forward until her head is on the pillow, and tries to ignore the pain long enough to let nature take its course.
After twenty minutes of no action, Christina suggests that the bedpan be removed. Alex begs her off, stating she is too tired to attempt moving. We cajole her, promising we will help, but she is used up and groans that she simply can’t. It’s when I notice that her calves and feet, still drawn up under her, are turning a shade of purpley-blue more commonly found on drowned victims than healthy pregnant women that our entreaties become demands. Alex turns her head so she is facedown on the mattress, summons resources I’m amazed she still has, and with great effort and discomfort manages to manipulate her numbed leg and get onto her back, allowing blood to flow back into her limbs.
‘I’m just going to do another quick inspection, okay?’ Christina says.
Alex’s lack of protest acts as consent.
‘Yeah, so you know how you thought you needed to poop?’ Christina says, head reappearing. ‘I think that was your body letting you know you’re ready to push something else out.’
Adrenaline surges through my tired body like electricity. ‘Did you hear that, babe?’ I say. ‘You’ve done it! We’re in the home stretch.’
She nods, brow furrowed and sweat running down her cheeks.
After the interminal whiling away of the day, the endless cycle of Alex bracing, us breathing together, long deep moans, and all too brief moments when she can slacken before the next round starts again, things are suddenly in motion. Christina is at Alex’s other side, instructing her to bring her knees up. I’m dimly aware of other midwives coming and going, but can’t spare the attention.
‘I can’t lift my legs,’ Alex huffs through the effort of trying. Her body is still unresponsive from the epidural.
We bring her hands and thighs together until she is curled up, face red and eyes still clenched closed.
‘Okay,’ Christina says close to Alex’s left ear, voice calm and reassuring, ‘so, you’ve been clamping down with each contraction, keeping it all in, right? Now I want you to do the opposite. When the contraction hits, I want you to push for as long as it lasts. You understand?’
Alex jerks her head in a nod, lips curled inwards.
‘Are you contracting now? Then push!’
Alex cranes her head forwards and a strangled cry warbles from her strained throat, her face going a deep red.
‘Pushpushpushpushpushpushpush!’ Christina cries.
Not knowing what else to do, I lend my voice to hers.
‘Now breathe!’ Christina orders.
Alex sucks in air, cheeks drawn taunt and mouth trembling. She collapses back into the pillow, fingers losing their grip on her legs. Christina and I take up each limb, raising them to help add more power to Alex’s labours.
‘Excellent! When the next one comes, I want you to do the exact same.’
Alex’s hands make fists in the bedsheets and she bends forward again, every muscle from her neck, shoulders, back, and abdomen locking rigid as she pushes with everything she has.
‘Pushpushpushpushpushpushpush!’ I encourage.
‘Keep going, keep going, keep going,’ Christina calls, bending towards the end of the bed to inspect the progress.
Alex’s face is veering from red to purple, the pressure and lack of oxygen painting her features an alarming mask.
‘Breathe, baby! Breathe,’ I say into her ear, and she must hear me as air explodes from her open mouth and her face returns to a more normal colour.
This is how it goes. Alex strains, silent and unbreathing. We cheer her on. Her face discolours and I beg her to breathe. She draws in air with a cry or a sob or a scream. Repeat.
Christina provides feedback of Alex’s progress, somehow managing to be beside Alex, coaxing her on, and at the end of the bed, coordinating efforts, all at once. I hear mention of a head and peak between Alex’s legs to see a flash of the wet dark features of my child for the first time. It is alien, the colour unsettling, and so very very wonderful.
Alex is dipping into reserves I swear had run dry hours ago, face glossy with sweat, eyes pinched closed, teeth bared, and pushing on like a warrior. I am awed by her. I know that no athletic effort I have done has asked so much from me, that I have never known the physical toll she is enduring. She has run a marathon and is somehow sprinting towards the finish line.
I find myself babbling, words of praise tumbling from my lips, telling her how well she’s doing, how I admire her, love her, and to just hang in there and go a little bit longer. She is so consumed by her exertions that I have no idea if she can hear me, if it’s helping at all. It’s helping me.
‘A big push, now, Alex. The shoulders have to come through,’ Christina calls from the end of the bed.
I repeat the instructions into Alex’s ear, feeling guilty for demanding more. She doesn’t react, but when she next tenses, she gives everything she has left, body coiled with strain, muscles trembling, a wail escaping her whitened lips, and pushes.
There is a small chorus of exclamations from the other end of the bed and movement as midwives reach for blankets.
‘You’ve done it,’ Christina says, and I hear the relief in her voice. ‘Your baby is out.’
A tension unlocks inside me and deflates like a balloon. ‘You did it,’ I whisper to Alex, pressing my forehead to hers. ‘You amazing thing, you did it.’
Her eyes are still closed but she flashes a tired smile. I kiss her cheek and taste the salt of her struggles.
Then Christina is approaching with a bundle of white and red blankets and, nestled within, a perfect new little lifeform. Alex lifts tired arms, opens her eyes for the first time in the past hour, and looks upon the small sticky face of our child.
‘What is it?’ she asks in a dreamy voice. ‘I mean, a boy or a girl?’
Christina bats tears away from her eyes and laughs. ‘You’re the one who wanted to see for herself. You tell me!’
Alex tugs aside the material and smiles. ‘A boy.’ Her eyes lock with mine. ‘We have a boy.’
He lets out a croaky little cry as Alex repositions the blankets and then he calms against his mother’s chest.
I gaze at his features, taking in the minute details of lips and chin and ears and cheeks, all sculptured in ideal and fragile lines. He is so beautiful my chest aches and I want nothing more than to protect and love him.
I lean in, face pressed to Alex’s, and kiss my son for the first time.
Next week’s topic: What goes in must come out