It is 9:13am on Friday morning. The boys are enjoying a late breakfast of Cheerios and a sliced banana, and I am typing away from my kitchen office.
(Yes, I have a kitchen office. Where else do “working moms” handle their biz?)
The sun is shining through an open window; the sound of giggling and Treehouse in the background. And I am wondering why – after four long years – I am finally ready to tell the story of Ryder’s birth.
Perhaps it’s to reach out to fellow “Androids”. Perhaps it’s because my sweet little boy will be 4 years old in less than two weeks. Or maybe, just maybe, it’s because of a video I watched this morning, which included three key phrases:
Sick Kids Hospital.
And it is undoubtedly the way I felt in November 2008 when I left the neurosurgeon’s office for the final time, with a spring in my step and a profound wish to never see the hospital again, that I am riddled with equal doses of guilt and thankfulness Ryder is one of the “lucky” ones. Because not every parent exits Sick Kids with a spring in their step; and certainly they do not have the option of “never again”.
The Story Of Ryder
It is shortly after 11:00pm on Thursday, May 8th and I am experiencing tummy cramps that ebb and flow. Our little baby is not due for another three weeks, so I am confused as to why the cramps are taking on a predictable pattern – every 10 minutes or so – with equally predictable intensity. I decide to call Telehealth Ontario, my go-to resource for everything from a paper cut to a raging migraine. After I explain the symptoms and how far along in the pregnancy I am, the nurse (who to this day I picture to look like Aunt Jemima) chuckles and says, “You’re in labour, honey!”
As I hang up the phone, I realize that my prenatal education has not indicated any sort of emergency for contractions 10 minutes apart, so I decide to take a shower and make myself presentable for the welcoming of our first child. My husband is already asleep, wrongfully assuming he’ll need to be up at 6:00am for work the next morning. I decide to let him have his rest and sneak into the shower. As I shave my legs, I make note of the fact that frantically cleaning the bathroom the day before was obviously a sign of nesting, and not because I couldn’t find my MAC Spice Lipliner as I had incorrectly assumed.
I wake my husband just after midnight. My contractions are now 8 minutes apart and I think I want to at least pop by the hospital to check in; just in case I’m misreading my body or something like that. Thank goodness the hospital is only 15 minutes away, so the trip is uneventful and full of excitement for the two of us. After registering I am “checked” by a nurse and declared to be less than 2cm dilated – but certainly in early labour. We are advised to return home and come back when the contractions are closer together and/or more intense.
(Raise your hand if you found early labour contractions “intense”. I was quite put off by them.)
We decide to hang out at my mom’s house which is only 5 minutes from the hospital, and therefore as good a place as any to wait in anticipation. At breakfast I eat the bare minimum – dry toast – and pace in her kitchen while I silently hope the nagging pain away – even though I know it is wishful thinking, and it will most assuredly get worse. At noon, we once again return to the hospital and I am measured at just over 3cm dilated. At this point, I’m quite certain I want an epidural or a blow to the head which will knock me unconscious – anything to block out the damned contractions that are now coming every 5 minutes. But I am told that they cannot admit me until I am 4cm dilated, or in other words: sucks to be you… now go away.
At 2pm I half-jokingly suggest that maybe we could go to the mall so I could walk off the pain while window shopping. My husband is all for the idea, but my mom (who has been thankfully tagging along with us since we called her the night before) vehemently vetoes my suggestion.
(Damn. I kept imagining giving birth in Square One and then having a lifetime of free shopping privileges or something like that.)
At 5pm hubby and I just return home. By now, I am sick of being in labour and I ask you this: who the hell can tell a difference in contraction strength at 3.5cm and 4cm dilated. All those lucky b*tches just 0.5cm wider than me are now being hooked up to a blissful epidural, while I’m rotting away in Painville.
6pm. 7pm. 8pm. 9pm. 10pm. 11pm. 12am. I am now the Mayor of Painville.
I haven’t slept in almost 40 hours and I have been in labour for 25 hours. We don’t know if baby-to-be is a boy or girl, but at this point I am convinced that only a man could leave a woman writhing in agony for so long.
Shortly after a 3-hour “Two and a Half Men” marathon at 1:00am on May 10th, I visit the bathroom to pee. When I get up to wipe (TMI ALERT!) I am shocked to see the mucous plug in the toilet. I have about 3 seconds to process this before I cripple over with the.worst.contraction.ever. Screaming for my husband to wake up (he doesn’t, lazy bastard) I crawl to the bedroom and briefly consider cracking him over the head with an iron.
On our final trip to the hospital, I shout orders for him to run every red light, pausing only to catch my breath. I am quite certain this baby is coming NOW. At the L&D registration, I speak quickly and with authority: “Get me a bed. Get me an obstetrician. I need to push. I want to push. I can’t stop the desire to push. I’m gonna start pushing. SO LET’S GET ON WITH IT, okay?”
A quick check from the nurse confirms that I am now almost 10cm dilated and the on-duty obstetrician has been paged. Fast forward twenty minutes, and the doctor walks into the room just in time to catch my baby. My beautiful baby boy, Ryder James, born at 2:05am. I look at the alien-like creature in awe. It’s you.
It is 24 hours later – Mother’s Day – and I am leaving the hospital with the best gift ever. We are scheduled to visit my family doctor for a “well baby” check up the next day. I am tired, and sore, but happy. I have a family.
Ryder is cranky. He is alternating between crying and sleeping and will not nurse. I am worried, but chalk up my concerns to new-mommy-syndrome and wait to see the doctor. I have too many questions to remember in my head, so I write them all down.
At the doctor’s, I rhythmically run through my list of questions and the doctor assuredly fires off the answers while she pokes and prods at Ryder. When I get to question #6, she pauses.
“What?” she asks.
“I said, why does he have a soft spot near the back of his head? It’s like a big, soft lump. What is that?” I reply.
She rolls Ryder over and gently touches his sweet little head. She parts his fine hair and stares at his scalp for much longer than I am comfortable with. She gently presses his head and frowns, turning my way.
“Did the doctor use a vacuum or forceps?” she demands.
“No,” I respond slowly. “It was a very quick and clean delivery”.
“I see…” she trails off.
She asks my husband to re-dress Ryder in his sleeper and comes around the desk to speak with me. I do not realize I am holding my breath until it comes out in a whoosh as she sits down.
“I believe Ryder has a cephalhematoma, which is basically a collection of blood on the top of his head. It is considered a birth injury and they are quite common with vacuum-assisted deliveries, but I’m quite stumped by the size and location of Ryder’s cephalhematoma in the absence of an instrument-assisted delivery. If you agree, I’d like to have an ultrasound of Ryder’s head so we can gain a better understanding of the extent of the injury.”
“Okay,” I whisper.
And I don’t remember another thing. I don’t remember the car ride home, I don’t remember my husband’s assurances that everything would be fine, I don’t even remember holding Ryder or caring for him in any way. I only remember going home and Googling “cephalhematoma”, staring at the computer for hours. Reading scary words like “subperiosteal hemorrhage”, “calcification”, “drainage”, “surgery” and “in extreme cases, neurological deficiencies”.
I hate extreme cases.
I even come across multiple pages dedicated to medical malpractice, showcasing extreme cases (there are those words again) of birth injury and brain damage as a result of cephalhematomas caused by doctor error. To say I am freaked out is putting it mildly.
At one month old, we strap Ryder down as a technician performs an ultrasound of his head. He screams and tries to dodge the probing wand but I hang on to him, holding his head steadily as I ponder the fuzzy black and white image on the technician’s screen. It makes no sense to me. As I hover over him, my tears fall on Ryder’s face below, mixing with his own.
Waiting on the results, I envisioned hearing “everything looks fine, we’ll continue to watch him as the hematoma resolves.” Instead, I hear, “We’d like to refer him to a pediatrician, and we’ll be forwarding the results of his ultrasound to a Pediatric Neurosurgeon at The Hospital for Sick Children. You’ll hear from them directly regarding an appointment.” No, no, noooo.
It turned out that Ryder’s injury was uncharacteristically severe; there was not only a collection of blood above the scalp, but below the scalp as well – situated very close to his brain. While a routine ultrasound would have ruled out any sort of lasting damage, this newfound information necessitates a complete examination and diagnosis from an expert. Our appointment was three weeks away.
I went through 50 shades of madness while I waited. Thinking of worst-case scenarios. Praying for strength; wondering where I would find it. Afraid to reach out to friends and family – not wanting to alarm anyone, but also not wanting to believe that anything could be “wrong” with Ryder. (I’ve used quotes around “wrong” because if there’s one thing I’ve learned, there is nothing wrong with a child – we just need to have the right amount of love and faith.)
I’ll never forget the day I walked through the doors of Sick Kids. Expecting to be surrounded by desolation and pain, I was surrounded by hope. Bravery. Fearlessness. Determination. Love. Yes, there were sick children. But those sick children were there with the hopes of getting better. They were there to live. For the first time since that fateful day in the doctor’s office, I decided to make peace with the diagnosis, prognosis – whatever the neurosurgeon sent our way. I decided to make peace with whatever was written in the stars for Ryder.
Ryder was lucky. Or blessed. Or both. Even though he sustained a forceful birth injury, the hemorrhage was still mostly superficial and did not reach his brain. The neurosurgeon, although he did want us to come back for two more visits until Ryder was 6 months old, was quite sure that the cephalhemotoma would go through a harmless process of calcification (hardening), ossification (turning into bone) and then begin a long, slow process of re-absorbing back into the skull. By the time he was two years old, the lump would be hardly visible to the naked eye.
(Not gonna lie; the thought of Ryder having a horn on his head for two years took getting used to, but considering the alternative, I was quite okay with it.)
I had just one more question.
“Why?” I asked. “WHY does he have such an extensive birth injury, when I had a natural vaginal birth, no meds, no instruments, and almost no doctor in the room! Why did this happen?”
“I was just getting to that,” he responded kindly. “If you plan on expanding your family, during your first ultrasound, ask your obstetrician to also include an analysis of the shape of your pelvis. Sometimes, women have pelvises that just aren’t conducive to vaginal birth. 9 out of 10 times, these women will experience a ‘failure to progress’ during delivery because it is unlikely that the baby can evacuate the birth canal safely. But in few instances – which I suspect is the case with Ryder – the baby hangs around for a length of time and then begins a ‘Hail Mary, let’s just slalom through and get this thing over with it’ approach, and barrels on – knocking his head on your very sharp pelvic bone in the process.”
Suddenly, it all came into focus. The 27-hour labour, stuck at 3.5cm dilated for much of that time. The eerily quick progression to 10cm. The overwhelming urge to push out a baby who made his appearance just 20 minutes later. And the instinct that Ryder would grow up to be every bit the adventurer – taking life by the horns and pushing through, setting his own pace.
(While pregnant with Reid, an ultrasound of my pelvis suggested that I have an “android” pelvis: “More triangular in shape at the inlet, with a narrowed subpubic arch. Larger babies have difficulty traversing this pelvis as the normal areas for fetal rotation and extension are blocked by boney prominences. Smaller babies may still squeeze through if they can successfully navigate around the bone.” We settled on a scheduled c-section with Reid, to avoid potential complications.)
Today, Ryder is an intelligent, funny, affectionate and dashingly handsome almost 4-year old. I often resist thinking about his birth story because the events following his introduction to the world were marred by worry, stress, late night Googling and too many terrified tears. The thought that something is – or could be – “wrong” with your child is maddening; we are thankful every day for being blessed with two wonderful children. I honestly never, ever ask for more.
(And when Ryder does something silly or quirky, we say he got knocked on the head at birth, and roll our eyes.)
Wow. It’s kind of surreal that I just opened up like that. Truth be told; it’s kind of therapeutic.