Monday, June 3, 2019

birth story

A few days after Patricia’s delivery, the midwife (one of our seven in the course of this pregnancy and delivery) said it would be a good idea to write down my experience in order to help process what happened. It has only been a week and already many details are blurring together in my mind, so I will start now with as much detail as I can remember. 

Elective trauma. That is what labor is. 

It is trauma on the body and, in some ways, trauma on the mind. But I knew what I was signing up for when we decided to get pregnant. 

Well no, I didn’t know what I was signing up for. And if I had, I may have thought twice about our decision to have our own child. We still would have done it, but I would have thought twice. I hope I never forget the experience of labor and I hope I can forget all of it. I’m sure reality will fall somewhere in the middle. 

Everyone kept telling me, “You’re in great shape. You have a high pain tolerance. You’ll get through labor just fine.” I wanted to believe them, so I believed them. When people asked me if I was nervous for the delivery, I would respond, “Well, if so many other women can do it, I can do it too, right?” It sounds like a way to avoid the question, but that wasn’t it at all. I wasn’t really nervous about delivery. I knew it was going to hurt, but I also knew it was a necessary part of this wonderful process. 

One of my roommates when I was in the burn unit, a middle-aged woman, told me that when she delivered her children she never cried, but that every day when they took her for wound care in the burn unit she couldn’t stop crying. Considering that, I assumed I had done the hard part—wound care—and that labor would be something less than that. 

I will just say from the start, labor was worse than I expected. 

But let me not get ahead of myself. 

I didn’t know until late in pregnancy that “full-term” was a five-week window. Apparently it is safe and healthy to deliver your baby anywhere from week 37 to week 42. That was the window where we could do a home birth in the Netherlands—anything earlier or later, and we had to go to the hospital, even if everything seemed fine. While it is good and fine to make that window known and not focus too much on the due date, it caused some psychological issues for us. We had to stop work and leave Uganda at 35 weeks because after that I was not allowed to fly. Once we reached the Netherlands, we spent a good part of the first two weeks gathering all the supplies we needed for the baby and for a home birth, meeting with the midwife, and celebrating the holidays with Christian’s family. Week 37 for us began on a Tuesday, which was coincidentally January first and the first day insurance would cover the full cost of any delivery. That was the day we started telling Norbert (our baby’s pre-birth name) it could come, and according to medicine and insurance, we were right in doing so. 

The problem with that was that the closer we got to our due date and the further we got from Week 37, the more we felt like our baby was late. We were eager to spend our time outside Uganda getting to know our child on the outside, and we would not have been disappointed to be able to go back home earlier rather than later. Every day we got a bit more impatient. We passed our time by playing tourist and trying to catch up with some of our friends in the Netherlands, but we were impatient nonetheless. We would show up to church and people would look at my ever-growing belly, tilt their head a bit to the side, and say, “Oh, no baby yet?” 

What kind of a question is that? How am I supposed to answer that? “Oh yes, the baby is here, we just decided to leave it at home and in the meantime I swallowed a watermelon whole.” 

I sound a lot more humble in the Netherlands because I don’t know enough Dutch to say most of the things I am thinking. That might not be such a bad thing. 

We spent the evening of January 20th in a normal way. We ate supper, did our devotion, watched a couple episodes of Friends and I stayed up a while to reread the labor portion of one of my pregnancy books. We didn’t even bother saying anything about how this could be the last time we are going to sleep as a family of two because we knew full well that only 5 percent of babies are born on their due date, so there was a 95 percent chance Norbert would not make its appearance the next day. All in all it was a normal evening. 

When my alarm went off at six the next morning, I slid out of bed (which was a short drop because we had to raise the bed three weeks ago for the delivery, just in case) and went straight to the bathroom as usual. Halfway there, I felt warm liquid between my legs. I thought maybe I had wet my pants, but it was more uncontrollable than that. I ran to the toilet just in time to hear a splash as it came out. It felt different than a loss of bladder control, but dare I hope? I sat there for a minute, peed on purpose to confirm that it did feel different, pulled off my soaked underwear and shorts and walked back to the bedroom. I shook Christian awake. 

“I feel kind of stupid saying this,” I started. “I think maybe my water just broke… but I’m not sure.” 

That got him awake. He was alert, but skeptical. “You’re not sure?” he asked. I explained what had happened and showed him my soaked underwear, which we both smelled and confirmed it did not smell like pee. (If you think we had lost all sense of modesty at that point, just wait.) We were both still skeptical, so I decided to take a shower and see if anything else developed. As soon as I stepped into the shower, more liquid started dripping down. I called Christian in to show him the small puddles forming between my legs. “Now I am definitely not peeing,” I said with a nervous smile. 

We were incredulous. This was actually happening! After nine months of waiting, and three weeks of really waiting, our baby was coming! 

But the thing is, babies come relatively slowly. At least most of them do. So as excited as we were, we kept doing our normal thing. I took a shower and washed my huge belly for the last time, and then we both got back in bed to try to get as much rest as possible before labor really kicked in. 

While we were lying in bed (I can’t remember if we actually slept at all or if we were already too filled with adrenaline to doze off), I started getting a strange feeling low in my abdomen, like menstrual cramps. It was different than I expected a contraction to be because I had heard those tend to start in the back and wrap themselves around to your abdomen, but mine were concentrated in the front. Being as wise as I am, however (I did get a 4.0 in high school), and knowing my water had already broken, I deduced that it was in fact my first contraction. My first of many. 

Those small contractions came once every ten or fifteen minutes, just enough to be uncomfortable but not enough to wipe the huge smile off my face because our baby was finally on its way. At nine o’clock, we called the midwife’s office to let them know labor had started. They said everything sounded good so far and that we should call back when contractions were three minutes apart and lasted a full minute. We had no frame of reference for how long that would take. We asked if we could still go for a walk and do normal things until then, and the midwife enthusiastically said yes, that I should do whatever I felt like I could do. 

After that, we messaged my mom and called Christian’s parents to let everyone know today was the day. Christian called his dad and said we needed a plumber. “We seem to have water everywhere this morning—on the couch, on the bathroom floor… really anywhere Katie goes.” It took his dad a moment, but the understanding and excitement was clear in his voice when he made the connection. He came over shortly after that to disassemble Christian’s half of the bed so there was more room for the delivery team when they arrived. 

We took a slow morning, getting the last few things in order in the house. I read aloud to Christian the chapter from my pregnancy book about how to breathe during labor. The student in me was ashamed I had not reread and memorized more of it ahead of time, but I figured it was better late than never. I had to keep changing positions to try to get comfortable, but could still read through every contraction, so I considered them minor. After finishing the chapter we decided to go for a walk to the supermarket to get more labor-friendly snacks. 

You know when you go shopping hungry, and your basket fills up faster than a kid’s Halloween candy bag? That is what happened. Everything looked amazing, and Christian wasn’t going to refuse me anything—I was in labor, after all. I found chocolate cookies, strawberries, whole grain bread, salad fixings… I was so happy. 

Christian found an app for his phone to keep track of contractions so we didn’t have to write everything down and carry the paper with us. It measured the length of each contraction and the time in between, exactly the information we needed to know before calling the midwife again. Before we left for the supermarket, my contractions were regularly eight minutes apart and 30 seconds long. As soon as we stepped outside, for whatever reason, they were two- to three minutes apart and lasted nearly a full minute. Our grocery shopping dialogue was basically a repeat of, “Okay, honey, it’s starting…”—grab some food and put it in the basket, walk around breathing deeply for a while with my hands on my hips, trying to act casual—“…it’s over.” We couldn’t even shop in separate aisles because they were coming too quickly to give us time to find each other to time the next one. 

By the time we got back (with much more food than we intended), it was time to call the midwife again. Contractions and been three minutes apart for about an hour. She said there was still plenty of time, so she was going to finish her lunch and then come over to see how things were going. Considering how quickly my contractions went from eight minutes to three minutes I thought she was being awfully casual about this whole thing, but then again she has delivered I-don’t-know-how-many babies and I had not yet delivered any, and plus I don’t like arguing with people. So I cut up some strawberries, grabbed a chocolate cookie, put on Friends and waited. 

Around two, Christian’s dad sent a message that the midwife had come to their house instead. There had been some confusion about our address since most of our mail is being sent to his parents’ house but we live in a different part of town. We had corrected it at one of our midwife appointments, but apparently it did not make it through the system. Shortly after that a midwife whom we had never met arrived at the door. She introduced herself as Anouk and asked a few questions about the contractions and how things and been going so far. 

“And you are planning on doing a home birth?” she asked. 

Why did people keep asking that? I could understand the midwife asking when we went to our first appointment here, but this was five weeks later and in the middle of labor and there was still confusion about it? 

We went into the bedroom so she could do a vaginal exam to see how dilated I was. I kid you not, that was my first lady parts exam ever. Apparently you are supposed to start getting them when you’re 18, but I skipped it I guess. 

I was three centimeters dilated. I wasn’t sure if I was happy or disappointed about that. When Lisanne (Christian’s cousin) had been in labor a few hours and the midwife came, she was already dilated eight centimeters. Her labor was a total of eight hours, and that was her first child. I had been in labor eight hours already (though it didn’t feel that long yet) and was only at three. I was average. (I have never been average.)

Anouk said things were progressing and that they take time. She was going to send another midwife to come check at five-thirty to see how things were going. Christian and I had the same reaction to that: Five-thirty? There won’t be enough progress in the next three hours to even need anyone else here? The baby is still that far away? 

Anouk left, I sat back down with my strawberries, and we put on a movie to watch. 

Janneke stopped by to see how things were going, but since progress was so slow we asked her to come back the same time as the midwife because maybe by then there would be something to help with. As the movie progressed, so did my contractions. (Actually, the movie never really progressed. It was a Netflix original called IO and it was incredibly boring—a terrible choice for getting my mind off the increasing pain.) I had read that the most important thing was to stay relaxed, so I made that my goal. First I could relax on the couch. When a contraction came, I would lay my head back and start breathing deeply. I focused on different parts of my body—arms, legs, torso—to release tension one limb at a time. Some women cope with contractions by using external distractions, but I found it easier to close my eyes and focus on the pain as I managed it. 

It wasn’t long before I was immobile during every contraction. Once when Christian went to the bathroom and one started, I couldn’t even reach his phone next to me on the couch to time the contraction. Apparently part of my being able to relax included the need to keep still. 

About halfway through the movie, lying back was not working for me anymore. I tried lying on my side and burying my head in a pillow during each contraction, but then I was just oxygen-deficient and uncomfortable. I tried sitting on the birth ball, but that took too much focus not to fall off. I squatted behind the couch, but it did not relieve the pain in whatever magical way I thought it would. I made Christian get me a bucket because I was pretty sure I was going to throw up my strawberries and cookie. I felt terrible. Hands and knees, lying down, walking around—nothing worked. The contractions came every couple of minutes and lasted a minute, meaning I was spending half of my time with my eyes closed, focused on my breathing and hoping I wouldn’t walk into a wall while I was doing that. 

I had read about the psychology of contractions in one of my pregnancy books. It gave two examples of how you could think about a contraction. One was to think of it as pain gripping you all around until you can’t handle it anymore. The other was to think of it as a wave coming over you, bringing you closer and closer to seeing your baby, and that the strength of the contraction was actually your strength. It looked nice on paper, but I tell you, that stuff was pure bull. As much as I tried, I couldn’t see each contraction as a strong wave sweeping me closer to my baby. All I could think of was the pain. It was strong, yes, but it was not my strength. I tried not to fight it, but I wanted to. I did not do too well at the psychology part. 

We had considered beforehand that a hot shower might feel nice and relieve some pain during labor. A few times Christian asked if I wanted to shower, and each time I said yes. However, then I would think about how much effort it would take to remove my clothes and then need to get dressed again afterward, and that was enough to make me change my mind. I couldn’t imagine the comfort would be worth the trouble. 

I had been in labor eleven-and-a-half hours by the time the midwives came back. This time it was another one we had never met, plus a student-in-training named Frances who needed more experience to get certified. I was sitting on the couch when they entered, and so focused on my breathing and trying to relax that I couldn’t even open my eyes to acknowledge them. They, of course, were used to that and patiently waited until the contraction was over to greet me and start talking. 

“Perfect,” Frances said as soon as I released a big exhale signaling the end of the contraction. Apparently I am a very good breather. 

We went back to the bedroom for another vaginal exam to see how progress was going. Six centimeters. This time I was unmistakably disappointed. I reminded myself that I had read about that, and how the last few centimeters usually go much faster than the first few, and that offered some consolation. France s asked if I wanted to go back to the living room, but the contractions were so close together and it was so hard to get in and out of that high bed that I opted to stay in bed for a while and labor from there. 

Christian stood faithfully by the side of the bed. I held his hand and consciously tried not to crush it, or even squeeze it at all, when the pain came. He told me it was okay to squeeze as hard as I wanted, and boy did I want to, but in the interest of trying to stay as relaxed as possible (which was not very relaxed at all) I knew focusing my energy on crushing my husband’s hand would be counterproductive. So I closed my eyes and breathed and tried every position I could think of to no avail. 

What surprised me most about that part of labor was not the intensity of the contractions, but the frequency. Yes, they were painful, but I knew they were going to be painful. What I did not know was that they were going to come so often that I didn’t have time to recuperate in between. Wave after wave, one after another, and almost no rest. No relief. No comfort. I felt like I could have handled it if I had a small break to gather myself again before the next one, but that break rarely came, and when it did it was much too short. 

After a couple of hours Frances had me go to the bathroom. I tell you, balancing on a cold toilet through four contractions, waiting for a break long enough to stand up and walk back to the next room, is not an easy task. 

I tried to crawl back in bed, but every time a contraction came I was forced to stay in whatever position I found myself in, sometimes for a minute or two until the pain subsided. 

The midwife told me that if I was hungry this was a good time to eat, but I still felt like vomiting. I didn’t say it out loud, but was pretty sure at some point I was going to throw up on Christian. Nothing against him personally; he was just the closest one to my face. 

When I finally got settled back into bed, Frances checked me again and said I was dilated eight centimeters. To get things moving along more quickly, she had me lie on my left side. I’m still not sure why it made a difference, and why left is better than right, but I listened. It wasn’t long before I wanted to push, but I had not yet been given permission for that. If I started pushing too soon, I could wear myself out before it would be effective, or I could make things move too quickly and increase the likelihood of a tear. 

This was where the breathing patterns from the book came in handy. To keep myself from pushing, I did repetitions of one big inhale, then three puffy exhales. It sounded stupid, but for whatever reason it kept me from following my instincts and pushing. This lasted for I-don’t-know-how-long until Frances told me if I wanted to push, I could push a little during the next contraction. 

Push a little? I thought. If I’m going to push, I’m going to push! Turns out, it is possible to push a little when you’re scared of pushing a lot. 

“During your next contraction, if you feel like pushing,” Frances said, “grab the back of your right thigh with your right hand and bring it up and to your chest, then push.” 

During the next contraction, I gave in to the urge. It was a strange mixture of pressure and relief at the same time. It felt good to finally be doing something, instead of trying my level best not to do anything. Some liquid came out, but I don’t know if it was urine or more amniotic fluid. It didn’t matter. I was in the middle of labor and had been pantless for hours and there is no room for modesty or embarrassment in that. 

I didn’t expect the baby to come flying out right away or anything, but I was a little discouraged when Frances explained between contractions that right now the baby’s head was still high in my pelvis and my pushing was getting it closer and closer to the exit, but it would still take awhile. On average, a first-time mother pushes for one hour. Oh joy. 

We did a few contractions on my side, and then Frances let me roll onto my back and try the more traditional semi-laid-back pushing position. I found this a little easier because I was more even, not lopsided like when I could only lift one leg. Each contraction, I grabbed behind my knees and pulled them up while Frances, the midwife, and one more delivery-help-person (who also happened to be Christian’s aunt, Joke) assessed how things were going down there. Christian made some photos, but spent most of his time standing by the head of the bed, encouraging me through each contraction. 

When I first lay back, Frances coached me through how to most effectively push. “Grab the backs of your knees and pull your legs toward you. Keep your knees out, even between contractions. One is coming? Okay—chin on your chest!” I put my chin down and bore down with as much effort as I could muster. I bore my teeth and grunted. “Don’t make any sound!” Frances said. I pursed my lips and shut up. I guess if I made sound then some of my effort would be wasted on my grunt and not on my push. The next million (or dozen) pushes were silent. 

I didn’t have much clue about the progress of the delivery. When I started pushing, the baby was still far from coming out, but after some time I started wondering if we were close to being done. Or were we even halfway? At one point, the midwives started talking about being able to see the head, and I thought it must be almost over. I hoped it was almost over. But apparently between contractions the head slips back in again. It felt like two steps forward, one step back every time. 

And then I got tired. So, so tired. People talk about the pain of labor, but they don’t talk about the effort. I would have been happy to lie there and be in pain and have contractions wash over me again if it meant I could stop pushing so hard. Every contraction consisted of three pushes. The first was always my best with all the energy I could muster. When I couldn’t hold my breath any longer, I exhaled, took another big inhale, and bore down again. By the time I repeated it for the third push, sometimes I wondered if it was even worth trying, because I had so little strength left to give it a good push. 

I had no sense of time. Frances said for first deliveries the mother usually pushes for an hour. I had no idea if I had been pushing for 20 minutes or two hours. The pain was so intense and the effort took so much out of me that sometimes I would go three or four contractions without even opening my eyes. I just wanted it to be over. 

“Christian,” I said, “I know when our baby comes I should be so excited that we have a baby, but I feel like I am mostly going to be excited that this whole thing is over.” I was losing perspective. But I think that’s normal. 

A bit later: “Christian,” I said again, “the rest of our children are going to be Ugandan. And adopted.” I meant it. 

Christian faithfully stayed by my side the entire time, bless his sweet little heart. It was not an easy task (well, easier than mine) because he had to stand by the bed for hours and hunch over to get close to me. He did his best to comfort me in the small ways he could, and depending on the moment it helped or it didn’t. Sometimes rubbing my back felt nice; sometimes it was just one more stimulus when my body was going through too much and I would bat his hand away. People said before the delivery that at one point I would scream at him that it was his fault or he needed to get out of the room. They said I would not mean it and that he should stay there and remember I didn’t mean it personally. The closest I got to doing that was one time in the middle of a contraction when he had leaned in to encourage me. He was counting my breaths during the contraction, but he was so close I felt smothered. I quickly said, “I need you to get your face out of my face!” And he did. What a sweetheart. 

I started getting to the point where I didn’t know how much longer I could keep this up, but I wasn’t about to say that out loud. That would be like admitting I couldn’t do it, and besides, what was my other option? We weren’t in a hospital with pain medication, and even if we had been, I knew it would have been too late for it anyway. I briefly wondered what I wanted to prove by not getting an epidural like so many other people I know, but again, it was too late to reconsider that, and I had already committed to adopting any future children. 

Between contractions, I started praying. Every single time I had a few-second break, the prayer went as follows: “Thank you, God, for this child. Please give me strength. And please let this next contraction be the last one.” It sounds calm when I write it, but in my head I was practically sobbing the words. I kept telling myself if I gave it my all on the next push, maybe our baby would come and it would be over. 

I told myself that for a lot of pushes. 

It’s a good thing I didn’t know how long it was going to take, or I would have been thoroughly discouraged throughout most of labor. During every push, Frances was by my side yelling, “C’mon c’mon c’mon c’mon c’mon!” and “One more! One more! One more!” It wasn’t specific or articulate, but somehow it helped. 

After a lot of pushing, my contractions started getting further apart again. To be honest, I may have missed a couple. The pain was so constant that a couple of times I thought, Is this another one? and since it wasn’t totally clear to me, I gave myself a rest and didn’t push. But that only happened once or twice. Frances had me lie on my left side again to try to speed things up. After a few pushes I could go back to my back. It still felt like we were close, yet so far away. The midwives talked forever about seeing the head. They tried to show me in a mirror, but so little was visible I again found it discouraging. I pushed. And I pushed. And I pushed. 

I had read that when the baby is crowning, you are supposed to stop pushing for a short time to give the vagina time to stretch out and not tear while the baby comes out. I think Frances  explained that to me during labor, but I can’t remember for sure. Every push, I kept waiting for her to tell me to stop because then I would know we were almost finished and I could muster up the rest of my strength for the final push. 

She did not tell me to stop. 

At one point I think Frances said she was going to cut me, but I wasn’t aware of much at that point. I just needed it to be over. I couldn’t be quiet anymore. I could do the pushes, but at the end of every one I gave a loud grunt/shout/intense exhale before gathering myself for the next one. I was loud. And despite my previous fears, I didn't care one bit what the neighbors heard or thought. 

After one particularly hard push, I couldn’t help but scream. The midwives were busy, but I still wasn’t sure what was happening or how far we were… until all of a sudden they placed something big and grey and slimy on my chest. Our baby had come. 

I cried, partly out of relief and (more than I expected) out of joy at seeing our child for the first time. I was so happy to stop pushing and instead look into my baby’s eyes and see this tiny human being we had made. It was making a mess on my shirt, but I didn’t think about that. I held it in place and looked incredulously from its little face to Christian and back again. This was what all of that was for. 

What a stark contrast from the agony of labor to the combined relief and joy in seeing our baby face to face for the first time. I think there are very few times in life when two such intense emotions coincide in an instant. 

After a couple of minutes, I came to my senses a little bit and asked, “What is it? A boy or girl?” I will never forget the moment after that. All four people in the room—the midwives and Christian—all looked at each other in silence as if they were waiting for someone else to give the answer. Finally Frances said, laughing, “We haven’t checked.” 

Christian picked up our baby from my chest to announce whether we had a boy or a girl, but it was harder to see than we expected. For one, newborns that fresh are lumpy and strange-colored and have slime and gunk all over them. And then there was the umbilical cord hanging down between its legs, obstructing an easy view of the area we needed to see. After moving the cord and inspecting the area, Christian announced, “It’s a girl!” 

I cried again. I had hoped for a girl so badly, but was always scared it would be a boy and I would start out motherhood by being disappointed. I knew I would love a boy to the moon and back, but we had both longed for a girl. Now we had one! 

Someone asked what her name was, and we immediately replied, “Patricia.” We had decided to name her after my Grandma Pat, a woman whom I fully respect, admire, and love, and someone I hope Patricia takes after (apart from her stubbornness). We had our little Patricia Mirembe after all. 

The midwives did the Apgar tests, of which I was only partially aware, but Patricia scored well. 

Joke placed Patricia near one of my breasts and got her started suckling right away. Then Francis told me I had torn during delivery (they never got to the episiotomy as planned) and needed to be stitched up, so I handed Patricia to Christian and scooted to the end of the bed and didn’t bother about the mild pain they were causing because I was so enraptured by the sight of my husband holding our little daughter. I was so relieved, and so happy, and so in love with both of them. 

Janneke came in to see her granddaughter, and we started calling family members to tell them the good news. Once I was all stitched up, everyone else left the room so Christian, Patricia and I could have some alone time—our first alone time ever. We couldn’t stop smiling. Christian stood next to the bed and we thanked God for a successful delivery, then prayed for Patricia, her future, and our family. What a beautiful start to life with the three of us. 

After about an hour I was allowed to get out of bed and shower. There was a lot of blood everywhere I went, but no one seemed concerned about it, so I figured it was normal. I felt weak. My legs shook. My head spun a bit when I stood up. My stomach still looked six months pregnant, but instead of the tight, round belly of pregnancy it was squishy and flopsy and full of organs that had yet to remember their rightful places. I walked like a cowboy. I felt strange. But I also felt wonderful, because after getting out of the shower and getting dressed, I saw Christian carrying our baby. Our daughter. Our Patricia. And that was the most beautiful thing I could have imagined. 

Patricia Mirembe Berkman came into the world on her due date: January 21st, 2019. An average first-time labor is 15 hours; ours was 16, from 6:00 a.m. to 9:57 p.m. when she was born. She weighed 3.7 kilograms—8 pounds, 4 ounces. (She was bigger than we had hoped!) It felt like she had a head the size of a basketball. It looked like she had a conehead the size of a normal baby head. She was 50 centimeters (20 inches) long. For the first twenty minutes or so, her lands and feet were blue. That has since changed. She had ten finger and ten toes, which Christian counted twice just to be sure. 

I found out the following day that Patricia came out with her hand by her head and the umbilical cord wrapped around her neck and wrist, pinning her arm up in an awkward position. That is a big reason why the delivery took so long. It was an easy fix by the midwives—two fingers under the cord and they were able to pull it over her head and rectify it—but it jostled Patricia’s shoulder a bit on the way out, which is why after birth it took a long time before she cried. She was in shock. (I’m sure the rest of delivery was no picnic for her either.) I was happy to have been aloof to that situation during the delivery because I probably would have worried and possibly panicked. I was so pleased with the midwives and help that we had and how (relatively) easy they made the whole process. Frances, still a student, was so confident I would have assumed she had been doing it for a long time. 

The midwives left around midnight, and Christian’s family went home shortly thereafter. It was only the three of us left in the apartment. I was a little scared, being held so responsible for keeping another human alive and at the same time so incapacitated from giving birth that I could hardly get out of bed by myself. Christian brought the rest of the chocolate cookies to bed and we had a snack, having skipped dinner in the midst of everything. Then he climbed into bed next to me and we fell asleep around 3:00 a.m., listening to Patricia make sucking sounds and coos from her bed next to ours. It was crazy, not feeling her kick me in the ribs while I fell asleep, but instead listening to her breathe. It had been a long, long day, yet it felt like all of a sudden everything was different. 

The next week was filled with uncomfortable sitting, almost fainting on the way back from the bathroom, blood clots the size of a grapefruit, engorgement when my milk came in (which felt like carrying wrecking balls on my chest for two days), pain during nursing, pain during sitting, pain during standing, having to literally pick up my floppy stomach and carry it with me when I rolled over in bed… but every day things got a little bit better. For the first two days or so after delivery, I didn’t want to think about that day. Like I said, it was trauma. But they say in time you forget, and I can already see how that is true. I have written this so that I might not forget, but at the same time I am happy to forget most of it. The only reminder I really need is this sweet baby sleeping in my lap as I write, and I know that for her I would elect to go through that trauma all over again. 

Monday, April 22, 2019

a missionary's guilt

She made my dad cry. Twice. 

I have only seen my dad cry a handful of times in my life, and only when someone close to him has passed away. At least those are the only times I remember. 

When Christian, Patricia and I were on the airplane from Amsterdam to Seattle, I told Christian, “I would bet money that my mom cries when she meets Patricia.” That’s a normal thing for grandmas to do. I wouldn’t exactly call my mom a normal grandma, but when it comes to emotions she is usually pretty predictable. 

After ten hours, our plane landed in Seattle. I tied seven-week-old Patricia to my chest, we grabbed our five bags and accessories (I’m not kidding) from the overhead bins, glided through customs, managed not to fall over on the airport tram, and stepped onto a very long escalator. Halfway up, we saw my parents leaning over the railing and waving vigorously. It was their first glance at their newest granddaughter, after all. 

When we got to the baggage claim I untied Patricia and handed her to my dad while Christian started pulling our bags off the belt. My mom and I were talking about the flight and how it was traveling with an infant when we heard a sniffle. We all looked over just in time to see my dad wipe a tear from his cheek, his eyes red and a bashful smile on his face. “She’s pretty much perfect, isn’t she?” he said. 

Two weeks in Morton was not enough. Technically, it was enough to see almost all the people we wanted to see and for the family to meet Patricia, but emotionally it was not enough time to feel like we were ready to say goodbye at the end. Annie and I baked cookies while blasting the Ice Princess and Ella Enchanted soundtracks only once. My mom and I drank margaritas at the Mexican restaurant only once. We went to Cody’s breakfast with my dad only once. We didn’t even binge watch any Alias. 

But Patricia was a great draw for a lot of people to come visit, and that is what they did. Family, high school friends, college friends, friends-of-the-family-who-might-as-well-be-family, supporters—she was a big hit among all. My grandma Pat (after whom Patricia is named) flew out from Iowa to meet her newest great-granddaughter and namesake. From the time we decided on Patricia as our girl name, I had been excited to tell my grandma about it, but seeing the Patricias together was something else. She spent several days rocking Patricia in the chair that she remembers sitting in with her mother. 

And then there was the day all three of my sisters were home at the same time. Considering for the past ten years the four of us have collectively lived in Washington, Oregon, Arizona, Wisconsin, Virginia, and Uganda, getting all four of us in the same state at the same time is quite a feat. This has been a big year for us, as we also had one day together in July during the family reunion, but there is something special about reuniting in the home where we all grew up. 

That evening we casually hung out in the living room and caught up with one another. We took turns holding and admiring Patricia, who loved being with anyone as long as she was comfortable. My dad came in and stood in the doorway, and it was a couple of minutes before anyone noticed the tears streaming down his face. This was not one bashful tear—he was downright blubbery. 

“Oh, Steve,” my mom said with a hint of incredulity in her voice. 

My dad sniffed. “I just never imagined… with all my girls here in one place, and a new little girl in the mix, all the people I love gathered together here… I never imagined it could be this good.” 

And it was. It was so, so good. 
And yet, two weeks later, we were packing our suitcases (again) and saying goodbyes. I cried while I packed. I cried while my parents gave Patricia one last bath in front of the wood stove before we left for the airport. I cried when I gave them one last hug before we entered the line for security. In my whole life, it had never been harder to board that plane. 

The whole time I kept thinking to myself, Who am I to take Patricia away from them? They loved her so much, and I loved seeing them with her—more than I expected I would. Patricia made them so supremely happy, and I felt like I was taunting them, Hey look! You have an adorable granddaughter! You can play with her for two weeks but not more than that because now I’m taking her away for a long, long time and I don’t know when you get to see her again. Never as a baby, that’s for sure. 

Who am I to take away something that makes them so happy? Who am I to cause them pain? Who am I to decide to raise my family so far away from my… family? Who am I to decide that Patricia doesn’t need to see her grandparents all that often? Who am I to make it entirely too difficult for them to have a close relationship? I was overcome by the guilt of the pain I had caused, and would cause. As we sat on the airplane, I wondered if I would be scared to visit again because the goodbye just got so much harder for everyone. I thought I was excited to return to Uganda, but was it worth it? Was that really home? 

Well, we came back to Uganda and started getting settled ,which began with unpacking 400 pounds of luggage into our two-bedroom house. The first week was settle-in week, and after that we would figure out how to start working again and how we would divide our time with Patricia. I know the first week was necessary to make our house feel a bit more like a home again, but I struggled. I struggled with being at Noah’s Ark without working, since that used to consume almost all of my time. I struggled with not knowing everything that was going on at school and in the libraries, since I had left someone else in charge. I struggled with the idea that I would have less time at school when I always felt like I was not there enough to start with. But most of all, I struggled with the desire to be with Patricia all day long and at the same time to be with the children all day long, knowing I cannot have both. 

I love the children here. I love them so much. When we were in the Netherlands, I missed having a house full of kids and block towers. When we were in America, I imagined Thomas and Isaac running around in the woods behind my parents’ house—the same woods Annie and I used to explore. I love the questions the children ask and the notes they write to me. I love to go jogging with them and teach them how to cook. I love when our doorway fills with little faces when school gets out. 

And this is where the guilt kicks in again, because no matter how much I love those kids, I’m pretty sure I love Patricia more. 

You might be thinking, Of course you love her more! She’s your daughter! You’re supposed to love her more. But then let me ask you this: Who is supposed to love these children more? If not me, then whom? Don’t they deserve that? 

When I was teenager, I began contemplating the reality of the body of Christ. More specifically, I began wondering how to reconcile being a well-off American with the poverty I read about all over the world. In the body of Christ, they are as much my family as the sisters with whom I grew up. 

I asked someone once, “If your child had crooked teeth and was starving, would you use the money you had to get him braces or buy him food?” 

“I would buy him food, of course,” the person replied. 

“Then why, when people’s teeth are crooked in America and people are starving in Africa, do we spend our money to get braces for our children with crooked teeth and not to buy food for our children who are hungry?”

Now that I have my own child, that question and that concept plague me. Is it fair to spend half my day with my daughter and the other half divided among dozens of children? Not at all. Is it fair to deny my daughter things because the children that surround us don’t have them? Perhaps, but the mother in me doesn’t want to do that. 

One missionary told me that the new group of toddlers hardly talks. I think of how much of my day is spent making eye contact with Patricia and listening as she squeals and giggles and coos and I act like it is the best story I have ever heard. It seems she will have no problem talking. She gets to practice with someone who is willing to listen. What about all the other babies? Who is listening to them? 

This guilt is not new. When Christian and I first started talking about having children, I had to ask, “Why, when we live with two hundred children who don’t have parents—at least not parents who can care for them—would be bring one more child here? Why can’t we be their parents instead?” I will never regret having Patricia, yet at the same time I don’t know if I will ever feel fully at peace with having brought another child into the world when I know there are already so many without families. 

This is not strictly a missionary problem, or an American problem, or anything like that. I would imagine at one point or another most of us feel that guilt to some extent and we all deal with it either in a way that seems most morally right to us, or in a way that allows us to maintain our comfort while keeping the guilt at bay. And some of us, myself included, are still sitting in the guilt and trying to figure out what to do with it. 

Sunday, January 27, 2019

i thought i loved you

Patricia Mirembe… 

In a few years, we are going to watch How the Grinch Stole Christmas and you will see an amazing transformation when the grinch’s heart grows several sizes so his capacity for love increases. Part of me hates to say I can identify with the grinch, but sweet girl, let me explain to you how you have grown my own heart in the past nine months. 

I thought I loved you when I found out I was pregnant. At that point, you were the size of a blueberry. I knew you existed and your little cells were rapidly multiplying, but by then I was more in love with the idea of you because it was hard to imagine you as more than just an idea. I couldn’t see you, feel you, hold you, or care for you. I thought I loved you, but then… 

I felt you move inside of me. You became so real. You were not just an idea—you had a body that I could feel. You were undeniably there. Every day I would feel your flutters in my abdomen and be reminded that your little life was growing, developing, barrel-rolling… and my heart grew. I thought I loved you, and then…

You grew. Imagine that! Week by week, photo by photo, I could see my circumference getting bigger, and for the first time in my life I celebrated that fact. You moved more and more regularly, to the point where sometimes I would tell you to be still because you were distracting me from a sermon or a book or a student. (For the record, you never listened.) I cherished our moments together, the two of us sharing a bond that no one else could enter. Even before meeting you face to face, motherhood was such a sweet thing. The bigger I became—the bigger you became—the less I saw you as an idea and the more I saw you as a human—our human. I loved you, little human. 

I thought I loved you when we came to the Netherlands to prepare for your arrival. Knowing that we could meet you face-to-face any day made us the best kind of anxious. I loved being pregnant, but I was ready to see you, to know you. I was ready to actively be your mother. I loved when people would compliment my stomach because they were complimenting you. 

Last Monday when I went into labor, I thought I loved you. You were finally coming. It was scary, and it was new, and oh man, was it painful. People had been telling me I was in good shape and have a high pain tolerance and that I could do it. They may have been right, but I still underestimated the pain and the effort. My longest, hardest run ever was nothing compared to one-and-a-half hours of trying to push you out. Especially in the last thirty minutes, between every contraction and every push I prayed to God that the next one would be the last one—not because I was anxious to meet you, but because I was exhausted and wanted labor to be over. But before I prayed that prayer every time, do you know what I said? “Thank You, God, for this child of ours.” In the hardest time, I wanted you. I loved you. 

As soon as you made your appearance and they laid you on my chest, I knew the love I had for you in the womb was nothing compared to how I felt then. You had eyes! You had a cute little nose! You could wiggle and squirm and I could see your limbs moving! You looked disgusting and beautiful all at once and in the middle of the pain and the effort and the relief and the excitement, I could not help smiling—not because the hard part was over, but because of you. You were there. I was holding you. When I saw the photos from those moments, I was surprised at how profoundly happy I looked, and it was because of you. 

Well, then they cleaned you up and you turned from blue to pink and when you weren’t covered in slime anymore you became a whole lot cuter. After a while the midwives left, the maternity help left, your grandparents left, and we laid you in your bed for the first time. From two feet away in our own bed, we could hear you sucking your fingers. We could hear you breathing. We could hear your coos and whimpers. At one point I realized that was the farthest you had ever been from another human being. I felt my flabby, awkward stomach and I missed you. I loved you so much that two feet was too far away. 

Over the next days, we learned the first things about how to care for you. We bathed you. I fed you. We took turns carrying you around the apartment in the night while you screamed and we wondered if the neighbors would ever forgive us. The day after you were born, we agreed that if you were put in a lineup of babies, there was a high chance we wouldn’t be able to pick out your face from the others. Now, after spending a week staring at your precious face, we have memorized every line, every half-smile, every pre-fuss contortion. For the ten minutes a day you are awake enough to open your deep blue eyes, we fall headlong into them. Without even trying, you have captured our hearts, sweet one. 

I thought I loved you in all those moments… and I did. I did love you. But now, you are one week old and curled up on my chest. Sometimes I can hear you breathing and sometime I have to put my hand on your back and feel your little body move up and down to assure myself that you, who seem too good to be true, are in fact real. Your cheek rests on your hand and I could not have posed you better myself. From my perspective, your button nose sticks out just a bit and I can see your top lip, but your Berkman chin is pushed in too far to be visible. Mirembe means peace, and you embody that. I cannot imagine anywhere else I would rather be right now and I know that the love I felt for you before is nothing compared to this. I find your twenty inches and eight pounds utterly overwhelming… and I love it. 

You have grown my heart in the best of ways.