Hospital

Hospital Hostage

We were moved down the hall from the birthing room to the Mother Baby Unit just after midnight, an hour and a half after delivery. I rode on a gurney because my legs were still weak from the epidural. Etta’s little tongue thrust rhythmically from her rosebud mouth, so I attempted breastfeeding once we got settled into our new room. She suckled briefly and fell fast asleep. My husband sat in a chair beside the bed and held Etta most of the night while I slept lightly. He had been waiting nine long months to hold her, and he just couldn’t put her down.

I was instructed to wake Etta at 5:00am for a feed, but she was deeply asleep and refused to wake. At 7:00am rounds began and our room seemed to have a revolving door for the dozen hospital personnel and doctors who came to see us. My doctor and the anesthesiologist came to examine me, two pediatricians and a nurse came to examine Etta, a photographer took Etta’s picture for the hospital web site, housekeeping brought new linens and cleaned the bathroom, and catering delivered a tray of breakfast food.

An Unwelcome Surprise

Etta was increasingly unresponsive by late morning. After a second pediatrician examined Etta, a lab technician came to draw blood from Etta’s heel. My husband held Etta while the blood was drawn and she didn’t even flinch, but he was biting his lip and wincing. Later, a nurse came in and announced that she was taking Etta to the Special Care Nursery ("SCN"). We were stunned, as we had not been warned this was going to happen.   As the nurse gathered up the baby, she told us that Etta had "pathological" jaundice, which was more severe than the usual "physiological" jaundice that many newborns developed. Etta’s condition required triple phototherapy and continuous observation in the nursery to prevent a blood transfusion or brain damage.   Well, how could we argue with that? I sent my husband off to follow the nurse so he would know where our baby was taken, and left alone in the room I sat in my bed in shock.

Adjusting To The Special Care Nursery

My husband returned from the SCN in tears about 20 minutes later. He said it was horrible to see Etta among the sickly premature infants in incubators. I gulped hard and tried not to break down myself, shifting instead into a supportive role, my way of coping with crisis. I walked slowly down the hall with my husband to the SCN, my stitches were hurting, but the real pain was in my heart, for being separated from my new baby. At the SCN I was given instructions: every three hours I would be allowed 30 minutes to attempt breastfeeding, but until my milk came in Etta would be fed formula. To prevent "nipple confusion" I requested that Etta be gavage (tube) fed instead of receiving a bottle. Etta lay peacefully asleep in the glow of the blue lights, naked except for a patch for her eyes and a loose diaper.

A lactation specialist set up an electric breast pump in my room and encouraged me to pump after each breastfeeding attempt, even if just a few drops or nothing at all came out. She said that most women got their milk in between three to five days postpartum, but if I pumped regularly, I might get mine sooner.

When I returned to the SCN to feed Etta she was very sleepy. I spent the first 15 of my precious 30 minutes just trying to wake her. Although I was allowed to have Etta out of the isolette and in my arms, the spotlights were pointed on her little body so that she could continue to receive some light therapy while feeding. She had to keep the blinders on to protect her eyes, so we couldn’t make eye contact and I couldn’t tell if she was really awake or not. How different it was from the first hours after her birth, when she was so enthused about sucking. Because this was an "unsuccessful" nursing session, Etta was swiftly gavage fed formula upon returning to the isolette.

After a short nap I shuffled back to the SCN for Etta’s next feed. The shifts had changed and the new nurse was more positive and supportive of my desire to breastfeed. I told the nurse that I would rather feed "on demand" as opposed to every three hours, and she agreed and promised to call me whenever Etta was wakeful. About half an hour after I returned to my room the telephone rang and the nurse said to come on down, since Etta was whimpering. I rushed down the hall and the nurse settled me into a rocking chair, placed Etta in my arms, and adjusted the spotlights on us. Etta latched quickly and suckled with vigor until she fell into an exhausted slumber 10 minutes later. I felt encouraged by this success and was glad that this nurse still had another five hours on her shift.

Coping With The Unexpected

My husband spent the night in the room with me, sleeping fitfully in the recliner beside my hospital bed. When my doctor examined me earlier in the day he suggested discharging me home in the evening (less than 24 hours after the birth). With Etta in the SCN, there was no way I would leave the hospital, so the nursing staff delayed my discharge until the next morning. Although I looked well physically and my spirits were high (despite the circumstances), I was really grateful to still be in the hospital. I was so focused on Etta’s condition that it was easy to neglect my own care. The nurses brought me juice, sandwiches, hot blankets, clean gowns, and ice packs, while reminding me to rest.

The SCN was closed to parents for a half hour at every shift change when the departing nurses could give report to the new nurses coming on. I was waiting outside the door when the new shift began so that I could introduce myself to the nurse assigned to Etta for the next eight hours. There were five other babies in the SCN and their mothers were following the unwritten rule to let the nurses completely handle the care of their babies. I wanted to hold and feed my baby as often as possible and my hovering over Etta’s isolette irritated a few of the nurses.

I was officially discharged in the morning, but was allowed to stay in the room one more night as a "roomer." I didn’t receive any nursing attention or food, but linen and housekeeping services were still provided, so I remained in the comfortably "disposable" gowns and robes. I continued the rhythm of resting, visiting Etta in the SCN, and working my breasts with the pump.

Due to my determined pumping, my milk came in at 40 hours postpartum. I was amazed at the sudden size and hardness of my breasts, although I was still only able to get a half ounce from each breast. When I took my expressed milk down to the SCN for storage in the milk refrigerator I felt a bit foolish putting my bottle with a mere ounce on the shelf next to the full bottles of other women’s breast milk.

In the evening my mother, or Grammy as we now called her, came to visit. She arrived while I was attempting to feed Etta in the SCN. The nurse on duty was warm and friendly and helped Grammy hold Etta for the first time. We had very few visitors while in the hospital because word got out that our baby was in special care and that I was spending as much time as I could in the SCN, which was a restricted area.

Moving Into The Car

In the morning my husband carried the last of our personal effects out of the room and down to his car. My car remained in the parking garage and became my "room" until Etta was discharged home. My husband had loaded the trunk with a cooler of snacks and beverages, a blanket, and changes of clothes for me.

Initially I was almost glad to be out of the room because it forced me to get dressed and out of the "invalid" mode. However, by mid-afternoon I longed for a more comfortable place to rest than my car. The Childbirth Center was one room short of full capacity, and swarms of people filled the halls. I had to wander far into the depths of the main hospital building to find a vacant couch to rest on. My husband spent the day at the office and returned to the hospital in the evening to have dinner with me and visit Etta.

After the 11:00pm shift change and feed I went down to the parking garage and tried to get comfortable in my car. I "slept" for awhile reclined in the front passenger seat, but couldn’t escape having my neck at an odd angle which became painful after an hour. I then tried to sleep across the back seat in the fetal position, the top of my head pressed against one door and my tailbone against the other door. I was weary and dispirited as I hid under the blanket in my car.

Around 2:00am I returned to the SCN to give Etta her feed. Instead of sitting in a rocker in the nursery, I took Etta into the lactation closet where there was a small vinyl settee and a dim lamp. I was so physically exhausted that I couldn’t sit up anymore, so I lay down on the settee to try side-lying nursing. I was horrified to wake up almost an hour later, having had Etta out of her isolette longer than allowed. As I rushed her back to the SCN I noticed that the nursery hallway was filled with bassinet carts, a baby screaming in each one. Rooming-in was encouraged, but apparently on this night a majority of the new mothers decided to send their babies to the nursery. On previous nights there had been just one or two healthy babies tucked into the SCN for "baby-sitting", but on this night there were about 15 babies overwhelming the three nurses assigned to the SCN.

The nurses hadn’t even noticed my prolonged absence amid the chaos, and I was glad that I had opted to stay the night at the hospital instead of going home as they suggested. Etta wouldn’t have received any attention if left in the care of the nurses. I looked at her chart and noticed that her bulging diaper hadn’t been changed since the last shift. I started to change it, knowing that it needed to be given to a nurse for weighing, inspection, and charting, but before I could even get it off a nurse appeared and told me I wasn’t "authorized" to change my baby’s diaper. She pushed me aside and roughly changed Etta, clearly irritated that I was interfering.

"Please Let Us Take Her Home!"

My husband arrived at the hospital around 8:00am and we anxiously awaited the pediatrician’s rounds. I was ready to beg on my hands and knees (I was too tired to stand up anyway) for Etta to be discharged on home phototherapy. Dr. U, whom we had chosen to be Etta’s physician, arrived around 9:30am and had no problem giving discharge orders.   In fact, he was surprised that his colleague assigned to rounds the day before hadn’t already discharged her.

One of the nurses brought me a form to sign, checked my wrist band alongside Etta’s, flipped out the lights on Etta’s isolette, removed the eye patch, peeled the monitor leads from Etta’s skin, closed the chart, and told me I could dress her to go. I dressed Etta in the smallest outfit of three I had brought to the hospital, and she looked lost in it. We buckled her into her car seat, covered her with a receiving blanket, and the nurse escorted us to our car. We were finally on our way home.