Wednesday, June 20, 2018

Imperfect but Still Perfect: My Second African Birth Story


As any pregnant mom going past her due date, I was starting to feel impatient for labor to start. Unlike most, though, I hadn’t been wishing for labor every day for the last few weeks. Quite the contrary, I was anxious that I would go into labor because the doctor and midwife I preferred were both out of the country for the two weeks leading up to my due date. So now, just a day past my due date, I felt a bit guilty for being impatient. I was genuinely just excited to meet her. My OB stripped my membranes at my appointment, and I was hoping I’d be one of the 1 in 8 that go into labor within 48hrs. I planned a game night that evening for distraction. We played games until almost midnight, and though I was feeling crampy most of the afternoon and evening, I didn’t feel like labor was imminent.

Around 1am, a strong contraction woke me. I let Ryan know that I felt we would have a baby in the morning, but I was really hoping for a normal time of the morning instead of at night. I was planning to walk to the hospital, and in addition to waking people up, I would probably have to call the security at the school to find out where the patrol dogs were, as my path to the hospital was on the guard’s trail that is patrolled during the night by huge dogs. 
Guard's trail
I slept fitfully, but made it through the night. The kids woke one by one, and I tried to keep our normal routine despite my contractions becoming more frequent. At 6:30am, I woke Ryan and sent a text to a staff member, also named Shannon, that I had previously asked to help me. I wanted to avoid trying to treat myself and trusted her years of experience as a labor and delivery nurse. She asked if we could wait until 8am as she was making her daughter’s birthday breakfast. I took a shower and got ready, putting some last minute supplies into our hospital bags. Ryan gave the kids breakfast and Nancy Rice, visiting us just for this birthing occasion, then took over watching them. Just after 8, Shannon M arrived, and we told the kids we were going to the hospital to have their baby sister and headed out the door.

Waiting for the stork
We walked out of our apartment, through the hedge, and out onto the guard’s trail. Thankfully, the walk to the hospital was all downhill. When I say downhill, let me help you picture our walk. We live on the side of a mountain along the Rift Valley. It’s steep- think stairs. And it’s a forest, at over 5000 feet of elevation. June is the rainy season. We live in Africa but it’s not hot nor dusty. So we walked in the cool of the morning, along the fence of the guard trail, out the gate of the school, down a road, down some stairs through the forest, and finally down a narrow sidewalk leading to the hospital gate. Along the way, I had to stop frequently for contractions, but it was peaceful otherwise. In my opinion, walking is so much better than driving in a car, especially on a bumpy road during active labor. Shannon M looked at me asking, “Is this how bad it gets for you?” I nodded, not able to speak. When the contraction was over and we had resumed our walk, I said that I thought I was in transition. Shannon M turned to Ryan and advised, “You need to listen to what she is saying and not how she is acting. And in case you were wondering, this isn’t typical.”

Mountainside forest- peaceful
I had texted the midwife and doctor that we would be heading down around 8am. We arrived around 8:30am and headed for the private ward. It was renovated in the last year, and the room was very nicely arranged with a bed, infant warmer, fridge, microwave, heater, private bathroom with shower and Western toilet, a couch/bed, and even a flat screen TV. As we entered, the midwife was busy preparing the room… by getting rid of grasshoppers! She straightened up as we came through the door, exclaiming, “Ewww.” A grasshopper leg had broken off into her hand. “I’m so sorry. That’s already the 7th one I’ve tried to remove!” Ryan set our bags down and took over the grasshopper hunt. 8, 9, 10…. Shannon M got heart tones, the midwife brought the birthing ball over. 14, 15… Ryan was hunting successfully on the bathroom ceiling. The OB came in and greeted me. Sure enough, I was 8cm. It was such a relief to have the people I was hoping for at my side. “I tried to make it to the morning so I didn’t have to wake you up,” I said smiling. The midwife said, “I’m supposed to leave at 9:30am for Nairobi though.” Challenge accepted. 18, 19… Ryan was throwing grasshoppers out the window.

We called the pediatrician, Dr. Arianna Shirk, our good friend since orientation with Samaritan’s Purse in 2014. She was just down the hall. She assured me that it was a good day as her formal responsibilities were minimal. 20, 21, 22. “I think that’s all for now.” Ryan announced. I was only on the birthing ball for a few contractions. I could feel the baby’s head descending. We raised the head of the bed and Ryan put my pillow up on the top so I could kneel and rest my head. After a few more contractions, I told the waiting crowd that I thought I would need to push in the next 5 contractions. Although it had only been 45 minutes since we had arrived, it felt like a long time. With my other two, I waited on my doctors because I had to push when I got there. 30 min for Sydney in the US and 15 min for Zack in Congo.

Sure enough, I needed to push with my 3rd contraction. I felt her head descend with the bulging amniotic sac in front. I waited until the contraction was at its peak and the work partly done, then with all the uncontrollable power of a reverse vomit, my water broke and I pushed her head out and then her body. Just like that, the excruciating pain is gone, and I just had to turn around and meet my baby girl. But I couldn’t move. I needed a few more seconds to recover. “Turn around,” they encouraged me a couple of times, and finally they gently nudged her underneath my body so that I could get a glimpse of her face for the first time. Will she look like me? I thought as I recalled my first excited words when I saw Zack for the first time. I looked down, and my breath caught. “Oh. She has a cleft lip.”

Time stopped. A thousand questions went through my head. I voiced one to Dr. Shirk, hoping she wouldn’t immediately need to take her away from me for evaluation. “Will I still be able to breastfeed her?” I finally turned around and rested my head back against the bed, holding her to my chest as my mind continued to churn. She had had prenatal care in SIX countries, but I’d done most of the ultrasounds and I hadn’t been looking for this. Our anatomy ultrasound was done in the US with a high-quality ultrasound and hadn’t picked it up, although it was done a few weeks earlier than normal because of our inability to travel later. What would knowing have done except made me worry? Then again, I’ve always argued for prenatal screening and testing so that the parents are prepared and the delivery brings an expected gift (a beautiful child with Downs Syndrome or a heart defect etc) rather than the potential for disappointment. Disappointment. I quickly pushed that sentiment away.

My mind scrolled through emotions like an old-fashioned Rolodex, but I had no reference for how I was supposed to feel. I’d had three relatively easy pregnancies, three quick deliveries with no stitches despite big babies, and two out of three kids with no medical problems at all. Now I had a beautiful baby girl who happened to have a defect. How could I possibly be ungrateful or anything but happy? So I reverted to my tried and true defense mechanism, stuffed any negative aspect and focused on the positives. Keep this in mind as I recount the next moments and days.

Our baby girl was screaming. Really pink and screaming. She wasn’t so happy to be out of the dark and warm womb and into the world. So I got my wish and was able to hold onto her while we eventually clamped the cord, I delivered the placenta, and got cleaned up. Whitney was still loudly making her presence known. Ryan and I looked at each other, each of us thinking how loud her cry was compared to our other two. Buckle up. “What’s her name?” the four in the room looked intently at us. “Whitney Celeste.” Born at exactly 9:30am. We took a moment to stop and pray, thanking God for a quick delivery and a healthy mom and screaming baby. The midwife excused herself shortly after, only slightly delayed in her planned trip to Nairobi. We had successfully met that challenge.

Should I call David?” Dr. Shirk broke into my thoughts. I thought she meant her husband. Sure. I heard her talking to someone in a more impersonal, medical way. She saw my quizzical look and quickly explained, “Oh, David Nolen, the facial plastic surgeon, not my husband…. But I can call my husband too. He can bring his camera.” So confusing. We already had a few times where an instruction was given and addressed to Shannon and I wasn’t sure if they meant me or Shannon M. Now we had two very different Davids, both our friends from our medical orientation with Samaritan’s Purse, but Arianna’s husband is a professional photographer and runs a foundation and the other David is a surgeon. It was comic relief. But it was fun to have a professional photographer capture truly some of the first moments we had just with Whitney. She even cooperated and decided crying wasn’t the only option in the outside world. Silence. And peace.


Next came a parade of medical evaluations. Dr. Nolen came to assess the extent of her cleft lip. It was good news. There is no cleft palate and thus very little risk that her speech or feeding will be affected. Whitney will need a surgery mainly to address the cosmetic aspect of the defect and she can have it at 3-4 months and 10lbs. She may need another revision later in life and will likely need braces when most of her friends are probably getting theirs. Then, an audiologist came in to test her hearing, and both ears failed the test. “We’ll check again later. It’s probably fluid or wax.” I was struggling to stay upbeat. Dr. Shirk did a bedside heart ultrasound (echocardiogram) to check for a heart defect. I recorded the screen on her iPhone, trying hard not to move the phone when I wanted a different view. I’m so used to doing the ultrasounds myself! She then sent the recording by email to a doctor in the US who officially reads them for her. We’d have the results later that day, she promised.
Dr. Arianna Shirk
It was family time. Nancy Rice brought two very excited kids to meet their baby sister. They each brought a homemade card. Nancy had introduced them to Daniel Tiger (thank you, YouTube, and a good internet connection) and specifically the one where Daniel goes to see his baby sister in the hospital, so they were prepared. Zack came in and got an intense look on his face, saying “Baby!!” with clenched fists and a grin on his face. He quickly got up on the couch and gave her a kiss. His attention to the baby, although sweet, was short lived, and soon he was trying to play with the birthing ball (eww!) and climbing up the infant warmer. Sydney wanted to hold her sister, and lovingly bent over her. She was also very excited, but Whitney held her attention for much longer than her brother’s.
Homemade card



Watching the exam intently


Nancy took the kids back home for lunch, and we settled into watching our traditional movie: Pride and Prejudice. (With Sydney, this was the notorious movie that had made us go to the hospital nearly too late.) We hoped to go home in the late afternoon, after the results of the echo were back, but Whitney had other ideas. The audiologist came back and this time only one of her ears failed. “We can check in a couple of days. It could very well still be fluid from birth.” Sigh. Whitney didn’t pee, and the echo wasn’t back yet, so we resigned ourselves to staying in the hospital overnight. We had a few special visitors, and a few friends that brought flowers or food or just good company. Ryan was able to watch some of the opening of the World Cup, so that felt very similar to us staying for two days in St. Louis after Sydney’s birth so that we could watch the World Series :)

Whitney finally peed late that night, an occupational therapist came in to evaluate her nursing ability, and the echo result came back good. Things were looking up. In the morning, however, we got a blood test result showing elevated thyroid stimulating hormone, giving her a 24% chance of having congenital hypothyroidism. Sigh. As we were preparing to leave, we had another scare which seemed to indicate that she could have an infection based on her temperatures. Sigh. I just wanted to have a normal baby that I could take home and cuddle. Thankfully, after further review, the temperatures had simply not been recorded correctly and she was cleared for discharge.

We were home finally, but not without some lingering concerns. How will I tell people this? So many of my acquaintances are on Facebook, and how do I tell them she isn’t perfect? What will people do when they see her face? Students, staff, are all excited to see her and I can’t bear the thought that they will look at her differently. So I struggled with posting much on Facebook or even walking around with her. We repeated the thyroid test after a couple of days. I was so worried about it, but I tried to push down my fears. We’ll just deal with it as it comes, I thought. Thankfully, it has decreased significantly so it is most likely going to normalize with a final lab draw. We retested her hearing and she passed.
Proud brother who knows he is not the baby anymore. "No, baby. I BOY."

Our househelp made a birthday cake for Whitney. So sweet. We sang Happy Birthday when we got home.

First morning at home as a family of five.
With the number of unknowns and scary false positives decreasing, I feel my defenses going down. I finally allowed myself to feel sad and cry for her. I’d rather be sick and need surgery than have a child that needs surgery. I am still nervous about how people will react to the news or react to seeing her. In many ways, I feel like my birth story is not nearly as impactful as her story will be. I’m learning to embrace her physical defect. I do love her little nose. Her eyes look like Zack and her chin looks like Sydney. She has smiled at me, which I didn’t know was possible with a cleft lip. I’m incredibly thankful that she was born in a hospital that is set up as a center for cleft lip/palate with 4 surgeons and speech and audiology and occupational therapies available. I doubt we would have gotten a facial plastic surgery consult within 2 hours of her birth even in America. God provides for our needs before we even know we have them!

I have a bible app on my phone, and do you know what the verse of the day was for Thursday, her birthday?

Every good gift and perfect gift is from above, 
coming down from the Father of the heavenly lights, 
who does not change like shifting shadows. -James 1:17 NIV

She is perfect, through her imperfection.

12 comments:

  1. Beautiful birth story for a beautiful girl! Congratulations! What a blessing our children are, right?

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  2. Thanks for sharing your birth story Shannon.....she's beautiful!!! Missy

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  3. Incredible story and beautiful baby girl. Congratulations Potter Family! Welcome Whitney!

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  4. She is beautiful. Congratulations to all of you!

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  5. She is so beautiful! I think she looks like her mommy! So precious! Congratulations!

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  6. Tender, sweet story; and precious pictures. What a labor and walk to the hospital, and all the details that fell into place! But... Oh the mother-emotions!
    Thank you for sharing about God's grace in the midst of the unexpected. Our love and prayers!
    'Before I formed you in the womb I knew you,
    before you were born I set you apart.' Jer 1:5
    Have a feeling she will be a special channel of God's blessing!

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  7. Je suis contente que tu a partager l'histoire avec nous. Je comprend mieux quand tu a dit un "roller coaster". Il y a beaucoup de chose à processus à le mème temps...et des hormones melange aussi. Mais Dieu est fidèle. Il n'a pas été surpris par les evenements. Il marche avec vous à travers les ajustements difficile. Whitney est adorable. Nous nous attendons à la récontrer face à face. - Kathy

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  8. Congratulations Ryan and Shannon! She is beautiful! It is opportunities like these we get to learn more about our Creator and grow in our understanding of what "perfect" and "normal" actually mean in God's vocabulary. Enjoy these days...they grow so fast!! Praying God's continued favor and blessing to y'all!

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  9. Congratulations! God’s plans can seem hard to understand, but in the meantime observing His hand and presence is so reassuring and you conveyed that well!

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  10. Life has ways of surprising us with the hard and the good. We are so glad you and Whitney are fine and healthy! Congratulations to you and Ryan.

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  11. Dr. Potter!!!! Congratulations!!! Whitney is absolutely beautiful, so full of the light of the lord :). Your story is touching and I understand all of your thoughts, worries and fears. God will handle it all without a doubt. Keep strong in your faith. This is just one little stepping stone that will raise you to a new level in your profession. It will allow you to have a true connection with your patients that are or will be going through the same thing! God bless your family! ~Rita Douglas, RN, BSN; St. Mary's Antepartum nurse, St. Louis, MO

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  12. I am deeply moved and grateful for the hope, anguish,trust, joy, compassion--and peace!--your birthing story evokes in me. I hope to let this testament to the process of life begetting life do its unpredictable thing in me.

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