An honest account of a woman’s eventful journey to birth in Colombia
By: Juliana Buenaventura
“If your blood pressure keeps rising by the time you get to the doctor’s office, I’m afraid we’re going to have to admit you and operate tonight”.
I should have seen it coming. I had a challenging pregnancy for a number of reasons, but as of week 28, my doctor had become especially concerned with my rising blood pressure, which wouldn’t respond to the medication. Coupled with the persistent protein in my urine, excessive swelling, and vision problems, the signs all pointed to a preeclampsia prognosis.
I was ordered immediate bed rest. By week 30, my doctor anticipated the likely course of action. “I’m sorry, but if your blood pressure doesn’t stabilize with the medication we’re giving you, we must perform a C-section at week 37.” Thirty-Seven. To me, that number rang perilously close to preemie territory. I attempted to brush off the sense of dread. I was a big, healthy baby, no way my own kid wasn’t going to be like that too.
The crushing reality that I would not have the vaginal birth I had so diligently been preparing for weighed heavy on me. I had selected her in part because unlike many of her colleagues in Colombia, my OB/GYN opposed scheduling C-sections for cosmetic or practical reasons. Early during our pregnancy, however, she had been very realistic about having to surgically intervene should I or the baby ever be at risk.
I just never thought I’d be one of “them,” part of that group of women who know so far in advance exactly what day and at what time their child will be born.
“So, once we reach week 37 can we revisit the possibility of a vaginal birth?”
“Let’s just focus on making it to 37.”
Sure enough, the medication was not effective at controlling my blood pressure. During the last weeks of my pregnancy, I was admitted to the hospital twice due to spikes in my systolic pressure and the onset of blurry vision and flashing lights. Vaginal birth was officially out of the question.
As part of the pre-surgery protocol, a week before my C-section, I had to attend an appointment with the hospital’s Anesthesiology department. In this meeting, I was to provide the specialist with my medical history, fill out waivers and consent forms, and learn about the medication I’d ultimately be administered based on my clinical data.
Before leaving home for the appointment, I took my blood pressure. As was usual for those days, I texted a picture of the monitor’s screen to my OB/GYN. She would often write back short, reassuring answers, but today there was silence.
About ten minutes into our drive up the hills of Bogotá, my phone rang. I put it on speaker so my husband could listen. Today, her usually calm voice expressed alarm. “I don’t like this one bit, Juliana. The meds aren’t working. If your blood pressure keeps rising by the time you get to the doctor’s office, I’m afraid we’re going to have to admit you and operate tonight.”
“What if it goes down again?” I asked, hoping this was just another abnormal spike.
“Then we operate tomorrow at 7:00 am”.
37 had just become 36. I was suddenly about to become the mother of a preterm child.
My mouth went dry. My husband and I drove to the hospital in dead silence, his clammy hand reaching for mine every so often. I held back the tears, trying not to succumb to the fear that something was terribly wrong. The appointment at the Anesthesiologist was a blur. All I remember is that my blood pressure had momentarily gone down again, buying me a few more hours to grasp whatever the hell was happening. I had had an extremely difficult pregnancy and often found myself wishing it could be over, but the psychological impact of hearing how my baby had to be yanked out of me so abruptly was devastating.
I was instructed to eat an early, light dinner. My mother, who had flown in a few days earlier, made chicken noodle soup which none of us touched. The mood around the dinner table was so ominous, an outsider could never have told we were actually preparing for the arrival of our firstborn. I started sobbing once I put my finger on it. This was my last supper.
This sad little meal was the last me and my husband would be sharing as a family of two, the last before our world would be rocked beyond recognition. Having a baby is a natural mix of fear and excitement, but knowing my health could unexpectedly take a turn for the worse wiped out any warm feelings. I also cried out of anger and frustration at feeling robbed of my picture-perfect pregnancy up until the very end. I never glowed, quite the opposite, my face was full of burst capillaries from throwing up so much. Every inch of me was swollen, even my nose and eyelids, and I needed neoprene support for everything. Now this. Where were all the Hollywood movies depicting journeys like mine?
After a sleepless night, I arrived at the hospital in a strange stupor. Fortunately, a new sciatic pain distracted me during the check-in and admissions process. It’ll thankfully be gone in a few hours, I thought to myself. My husband and I said goodbye to our parents (this was pre-COVID), and we went into the maternity ward, where he changed into scrubs, and I was put into a hospital gown. And then we waited.
We waited forever. Apparently, a mother before me had been late for her own C-section and there was only one functioning OR. What was supposed to be a 7:00 am surgery would start four hours later. The wait was brutal. Not only because it gave my mind plenty of time to run amok, but because I was so so thirsty. No food or drink was allowed, but a kind nurse snuck in a glass of water and some ice chips for me to chew on. Bless her heart.
My husband had sat by my side the whole time, calling or texting our relatives out in the waiting room every so often, but for the most part, trying to be supportive while brushing off his own concerns. Finally, when they were ready to wheel me into the OR, he stood up to walk in with me, but was stopped at the doorway by a nurse. The fear that had been numbed by the wait suddenly invaded me again. I pleaded to have him with me but was cut off in that condescending tone that nurses in Colombia are so adept at. “Mamita, Daddy will have to wait outside until you’re cleaned off and prepped for surgery”.
The room was very cold. Shiny tools glimmered under the surgical lighthead, monitors beeped, and so many people in scrubs scuttled around me, almost oblivious to my presence. I started shaking, partly out of fear, but also due to how cold I was. A friendly doctor kindly asked me to do my best to stop shaking and bend forward so she could administer the anesthesia in my spine. As I uncomfortably bent forward, aware this was the last time I’d have to struggle with my belly, I heard her whisper to my OB/GYN something about how high my blood pressure was. “That’s why we’re here today,” she answered matter-of-factly.
I didn’t feel the prick of the needle. Just some pressure in my spine, and then a warm tingling feeling invading my legs, like static on a TV. I searched for my husband, who was peeking in through the door’s porthole, still waiting for instructions to enter. Still nothing. Nurses then laid me down, mentioned how the catheter was going in, and then strapped both my arms crosswise to the operating table. The religious parallel jumped at me again, and with it, an intense level of self-awareness at how ridiculous my victim mentality had become at this point and how I should just get a grip. Women with preeclampsia successfully delivered babies every day. At that moment, I decided to trust the medical team and let them do their thing.
Once the curtain went up at my chest, my husband was finally allowed inside and placed on my left, where he held my hand. By then, my nerves had subsided and I was starting to act like my chirpy self again. When we were all in place, everyone introduced themselves, walked us through the procedure, and just began casually chatting away. I’m a strawberry blonde and look quite foreign in Colombia on account of my German heritage, while my husband has dark brown hair and to me, is the spitting image of Tom Cruise. This prompted everyone present to begin wondering what the baby would look like. Suddenly, someone started taking bets as to who she would take after. I yielded into the jovial spirit of the moment and said she would look like my husband, so did my OB/GYN. Most of the other people there went for blonde. And then, the procedure began.
The smell of burning flesh was the first thing that made it real. It was followed by a lot of pressure and moving and shaking, but no pain. An instant later, I started feeling dizzy and disoriented, almost as if I were going to faint. I said this out loud and without stopping the procedure, the anesthesiologist pumped medication into my IV to counter the effect. I immediately felt better. And then, after only 10 minutes, I heard my OB/GYN giggling “She’s a blonde! She’s so blonde!”
My daughter cried softly as she was wiped clean and put close to me. “Take a picture, Dad!” someone said as they held her above my head to see. My first impression upon meeting my daughter was disbelief. I couldn’t believe that she was real, and that she had been inside my belly all along looking like that, so perfect.
I observed as they took her to the Giraffe omnibed, a warm lit work station where the pediatrician took her vitals and where she received TB, Hepatitis B, and Vitamin K shots. As they began doing this, my husband stayed by my side, still gripping my hand. I began feeling anxious about her being there all by herself so I urged him to go to her. “I’m sorry, I didn’t know whether I should leave you,” he said, clearly still trying to figure out the change in our dynamics. And as he reached her, and touched her ever so delicately and said “Hi baby, I’m your Dad,” I thought to myself, it’s over. This is finally over. And I cried tears of relief.
Of course, silly me, it was far from over. It was only the beginning. As soon as I was sewn up, about 20 minutes later, my daughter was placed on my chest to feed. Although I was startled at the sheer strength with which she latched on, I was just glad she ate with so much appetite and strength. She was a fighter for sure. My legs were still numb and I was still thirsty, but the newness of being a mom just overwhelmed me in the most beautiful way.
Although at the time I thought childbirth and the days leading up to it were the most stressed out I’d ever been, they paled in comparison to those first few months of becoming the parent of a preterm child. But I look at my daughter now, almost 3 years old and thriving, so smart, funny, tall, and beautiful, that I can only look back in gratitude. Obviously, I still wish she could have had a more peaceful way into this Earth, but overcoming those challenges together and watching her flourish into this amazing little person fills me with pride and confidence in her, and in me and my husband as parents. If I ever do decide to have another child, my odds of getting preeclampsia again are anywhere between 5-80%, meaning that most likely, another C-section will be in order. Is that nerve-wracking? You bet. But do I have time to worry about that right now? Of course not, I’m too busy taking deep breaths, acknowledging the feeling, and being patient while my toddler is in the middle of a tantrum on the floor.