Really rough 1st draft of 1st writing assignment

Trimesters

According to Wikipedia, a normal human pregnancy lasts about 38 weeks after conception, a time span “somewhat arbitrarily divided into three trimester periods.” http://en.wikipedia.org/wiki/Pregnancy

1.     

 0-13 weeks

The first trimester carries the highest risk of miscarriage (natural death of embryo or fetus). http://en.wikipedia.org/wiki/Pregnancy  

You are two cells, zygotes that collide and merge into a blastula. By the time I apprehend you as a blue cross, a plus sign, materializing on a white field, you are a grain of sand.

I am newly married, working my first job not in a restaurant, a new associate in a large law firm in San Francisco.  My husband and I want many children, a houseful of children, a bevy of girls, an army of boys. When we see the blue cross, we are elated and stay up all night calling everyone we know.

I look in the yellow pages for a local OB-GYN. He has a kind face, years of experience. He congratulates me, takes my history, prescribes pre-natal vitamins. I am to return for routine checkups once a month until the last trimester.

You are a grain of rice.

2.     13-26 weeks

During the second trimester, the development of the fetus can be more easily monitored and diagnosed. http://en.wikipedia.org/wiki/Pregnancy

The first contraction connects me to the pulse of the universe, its mysterious diurnal rhythms and tides. The second one hurts. I am not supposed to see my doctor for three more weeks, but I make an appointment and go in. My doctor smiles,  nods, tells me about Braxton Hicks contractions. No reason not to keep working, he says, but I need to rest when I can and drink  lots of water. If the contractions come back, I am to put my feet up, lie down on my left side.

Premature labor, also called preterm labor, is when your body starts getting ready for birth too early in your pregnancy. Premature labor can lead to an early birth. But the good news is that doctors can do a lot to delay an early delivery. The longer your baby gets to grow inside you -- right up to your due date -- the less likely he or she is to have problems after birth. http://www.webmd.com/baby/premature-labor

Try to stop the contractions. Get off your feet. Change your position. Relax. Drink two or three glasses of water. Relax. http://www.webmd.com/baby/premature-labor

I keep working. I try to relax, rest when I can, sneaking into the darkened conference room to lie on my left side. I drink glass after glass of water. The contractions happen every day at 3 pm, then at noon, then as soon as I wake up, stopping and starting all day but then not stopping at all after dark. I call my doctor after hours three nights in a row, and he tells me to come in to the office the next day.

When I come into the office the next day, my doctor is not smiling. He gives me a wide elastic belt with a plastic monitor that lies flat over my belly. When the contractions begin, I am supposed to drink lots of water, relax, lie on my left side. And put on the belt to record the contractions or 15 minutes. Then plug the monitor into the phone and send its signal to an after-hours service that will determine if I need to go to the hospital. I can feel the contractions (they hurt) and can actually see each one ball my stomach into a tight, hard fist, and I can time them with a stop watch. But unless the service sees the signal I send over the phone line, they are not real.

You are a seed, a pea, a small lima bean.

Over the next few weeks, we settle into a pattern. I drink water all day, I carry an ocean of tap water inside me and a afraid you will drown. I sneak into the darkened conference room to lie down on my left side. As soon as I get home from work, I drink more water and lie down on my left side. When the contraction begin, I wear the belt and send the signal over the phone, over and over until the voice on the telephone line says it is safe to go to sleep. I do not have to call my doctor anymore after hours.

I see my doctor at a one of my routine visits, and he clears me for a business trip to New York. Things are stable, I have the belt, I have the glasses of water. Except for the hours on the plane and actually spent taking the deposition, I have the ability to lie on left side. I can relax.

In the middle of the deposition in a glass skyscraper in New York, the mother of the boy who died in the car accident begins to cry. I call a short recess to drink several glasses of water. I go to the ladies room where I relax, lie down on my left side, and wear the belt to record the contractions that are making me, when I am not drinking water or relaxing, bite my fist till it bleeds. The recess gets longer and a cab is called to take me to the only hospital in New York I know the name of, St. Vincents. I am put in a bed, given several large glasses of water to drink, and rolled over to my left side. A resident younger than the boy who died in the car accident tells me my two choices: stay at St. Vincents until the baby is born or the contractions stop, or take medicine to slow the contractions and try to fly home to California.

The airline rep tells me I cannot fly if I am in labor. I take the medicine the resident offers and get on the plane, a very long flight with lots of glasses of water and no place to lie down. I twist sideways in my seat, trying to sit on my left side. Other passengers smile at my belly. It is very important that I not appear to be in labor, so I try to smile back and ask for more water.

            You are a guppy, a minnow. I feel your flutterings.

I step off the plane into a wheelchair my husband has arranged, and we go together to our local hospital, Marin General. Another young resident gives me another pill to help me relax. I drink water, lie in the hospital bed on my left side.

           We see the first ultrasound. You are a boy. You have eyes, nose, a mouth. I can see your face.

The next day my doctor comes to the hospital during his rounds. He puts his hand inside me and then withdraws it, snaps off the latex. “You have an incompetent cervix,” he says.

If there had been Wikipedia then, it would have explained to me that the cervix is a the lower, elongated part of the uterus that clamps shut during pregnancy and opens at birth. If it begins to open before birth, the cervix is said to be incompetent or weak. A weakened cervix can be caused by one or more of the following conditions:

• Previous surgery on the cervix
• Damage during a difficult birth
• Malformed cervix or uterus from a birth defect
• Previous trauma to the cervix, such as a D&C (dilation and curettage) from a termination or a miscarriage
• DES (Diethylstilbestrol) exposure http://americanpregnancy.org/pregnancycomplications/incompetentcervix.html

In the first trimester of her pregnancy with me, my mother began to bleed. She was given the standard treatment at the time for miscarriage, a prescription of DES.

I’ve heard about was happening to me, but not that it was called an incompetent cervix. I feel inept, ineffective, unqualified, unequal to my task, weak and ashamed. I am a bungler.

I ask about a procedure called cerclage, in which the cervix is stitched shut to keep the baby from falling out. 

It’s too late for that my doctor says. You are thirty percent effaced; there is nothing to put the stitches into.”

A fetus is not usually viable before 28 weeks, my doctor ays. You might want to go home now, he says.

Why would I want to go home, I wonder. Wouldn’t it be better to stay here, in case something happens.

You might want to go home, my doctor says.

But, if the baby is born, I say.

Because if that happens, my doctor says, there won’t be, you know, a choice.

What choice? I ask. He does not answer, so I ask again. What choice?

About whether whether to try, you know, to keep the baby alive, my doctor says.

I’m staying, I say. 

When the nurse comes in later to check my vitals she asks me, Have you ever prayed?

            You have eyes, nose, a mouth. I can see your face.

3.    26-38 weeks

The point of fetal viability, or the point in time at which fetal life outside of the uterus is possible, usually coincides with the late second or early third trimesters, and is typically associated with high degrees of morbidity and mortality. http://en.wikipedia.org/wiki/Pregnancy

I stay at Marin General for a week, and not much changes. The contractions continue, my cervix is still thirty percent effaced, no more incompetent than it was the week before. It is stable in its incompetence. I lie on my left side, packed in ice for the pain, and drink glass after glass of water through a bent straw.

My doctor comes back, and he is smiling again. I have good news, he says. I am referring you to the high risk pregnancy unit at Children’s Hospital. They can do things for you I can’t do.

[Note: I am trying here to imitate Bolden's essay. I have more material for this third part, and for a fourth part called "Birth" but no time to write it out tonight. Bottom line is 90 days hooked up to an IV and subcutaneous needle pump, bedpan, complete bedrest. I do as I’m told and the pregnancy is brought to term and my baby is perfect, healthy, fully formed. But b/c my first doctor wants the delivery room fee, I am referred back to him—and to Marin General (a hospital without an intensive care ICU) for the birth.  He bungles it, and my child's brain is damaged. Not sure yet exactly where this is going, but might circle back to the idea of competence, maybe how being told I had an incompetent cervix became a self-fulfilling prophecy that stripped me of the confidence to refuse to go back to my original doctor. Or something to do with the irony that my incompetent cervix actually was exactly as competent as it needed to be, but that the doctor who labeled it as such was not.Not sure I want to end, as Bolden did, in righteous anger. I have ideas --such as telling the story of my son's life in "trimesters" (he is 26 now, and has high functioning autism)--that would swell this thing well beyond essay length.]

         

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