Kim

Labor and Delivery Nurse, Founder of Real Life Birth Workers

This is my first personal story that I am sharing on the site. This is the series of events that led me to becoming a Labor and Delivery nurse and one of the reasons I am the nurse I am today.

The story of how I became a Labor and Delivery nurse is not like others. I never wanted to work in birth, and I disliked my perinatal rotation during nursing school. It was just something I had to get through to graduate and do what I thought I was destined for: working in the operating room. I was attached to the idea of becoming an OR nurse because I had a number of surgeries as a child. The nurses that took care of me growing up made a substantial impact on my life and I wanted to help others in a similar way.

Before I was accepted into nursing school, I volunteered for a service-learning organization called Child Family Health International. I travelled to India with a group of (predominantly) medical students where we learned about the health system. The first surgery I ever saw was a cleft lip and palate repair on a toddler. I took it as a sign that I was exactly where I was supposed to be. I felt this way because I too had a cleft lip and palate.

After some years of working in a large volume operating room on the East Coast, I was fortunate enough to be offered an opportunity to cross train in the hospital’s CVICU. There were some days that I would participate in an open-heart surgery and then move with the patient to the ICU, where I continued to care for them for the remainder of my shift. I was living a nursing dream I never knew I wanted.

After getting married, I quickly became pregnant. We were trying but had not anticipated how fast it would happen. Our move back to the West Coast was suddenly urgent as we wanted to be within driving distance to our families once our first child was born.

I was scheduled to have an anatomy scan at twelve weeks gestation because of my family history of craniofacial anomalies. My father, like me, also had a cleft palate. After the ultrasound, my husband and I were escorted into a room where we waited to talk to a physician. We began to get nervous and thought something might be seriously wrong. The physician entered cautiously and gently told us that they had found something, we started mapping out worst case scenarios in our mind. “Your baby has a cleft lip and palate” he said. I remember my husband and I looking at each other with huge relief in our eyes. One of the conversations we had during our relationship was the possibility of our children having a cleft, it was something we were both prepared for and we could handle it. But the minute we got in the car, I burst into tears.

I realized in that moment that I had so many fears about having a child with a cleft. It was a complicated and layered mix of emotions. One of those fears was about surgery. I had to have six growing up and five of them took place while I was under ten years old. Another fear was that I experienced repeated torment by being made fun of for my nose, mouth and teeth. I’d like to say only kids are cruel, but I experienced this verbal harassment late into my twenties. I realized at the age of twenty-eight, I had not faced the majority of the problems that had affected me throughout my life, and I was terrified for my child to face the same things. I needed to begin to heal so that I may provide the support for him that he needed.

While preparing to have our son, we faced additional trials. I was diagnosed with gestational diabetes, something I was able to manage well with diet alone, so it didn’t feel too overwhelming. I remember sitting in our first birth preparation class at around six months pregnant and my husband getting a phone call. It was his sister. She told my husband that their father had been taken to the ER with shortness of breath. He had to have a trach placed emergently so that he could maintain his airway. We notified our teacher that we had to drive home to be with him. That was the last class we ever attended. We drove overnight and went to see him in the ICU. He had been diagnosed with stage III laryngeal cancer and his prognosis was about six months unless he received treatment. My father-in-law was on the fence about prolonging his life, especially if it was going to be a significant reduction in quality. My husband felt torn about being away from him during this time. Without thought or question, I told him that we would move home to help manage his care while going through chemotherapy and radiation. I gave two weeks’ notice at the hospital I was working at and we abruptly left Southern California for Northern California only four months after arriving from the East Coast.

Things continued to be busy in the last three months of my pregnancy. We were never able to attend another childbirth class because of all the additional stress. I felt that since I was a nurse and had experienced having a cleft firsthand, I would know what I was doing. I thought I knew what to do in labor, delivery, and caring for my newborn.

We had bought and moved into a new home a week before my due date and I was worried about having things set up before our baby arrived. I lifted all the boxes… nothing. Barely a contraction. Then a couple days before my induction, my last living grandfather passed away. We were able to spend a number of hours with him before his last breath and for that I was grateful.

I walked into my first induction at 41 1/7 weeks gestation. I was closed/thick/high and had no response to multiple rounds of Cytotec. I had my second induction at 41 3/7 weeks. I was slightly dilated, and my physician was able to get a foley balloon in my cervix for manual dilation. After the foley balloon fell out, my amniotic sac was ruptured artificially, and oxytocin was started to augment my contraction pattern. I got an epidural at 5 cm dilated and was able to get some sleep. My epidural was positional, and I began needing to rotate from right to left to get adequate pain relief. I joke with my colleagues now that I had “all the things” in my vagina. I don’t remember about the sequence of events, but I know I ended up with an intrauterine pressure catheter and a fetal scalp electrode at some point. At 8 cm I got my epidural re-bolused and made it to complete about 17 hours after we had started the induction. I pushed for a couple of hours and was not making any progress in descent. I became exhausted and had a cesarean section in the early morning hours. I remember looking at his head and thinking how long and squished it looked. He was direct OP and his head measured at 37 cm.

The first hours with him were a blur between pain and vomiting, but I remember looking at him while he lay skin to skin on my chest. I recall being in total shock looking at his cleft. I had known for months about it. I had seen him up close on the ultrasounds. I had first-hand experience to refer to, but I still couldn’t believe it. I was filled with immense guilt that I had passed this congenital anomaly to my son.

The nurses knew my plan was to breastfeed and pump from the start. As I recovered in the PACA, the nurses hand expressed colostrum into his mouth to be sure that his glucose was maintained and that he wouldn’t be hypoglycemic. After transferring to post-partum, they set me up with a pump and soon assisted me with a feeding plan. I felt so completely supported by the staff to succeed in caring and breastfeeding him.

I realized, I knew nothing about what was coming for me and I couldn’t have done it without their support. Every single nurse I interacted with gave me so much love and support. Even though I didn’t have the experience I thought I would have, I was in awe of the care I received.

The following months after our son’s birth were incredibly difficult. We seemed to run into problem after problem. First it was with feeding & weight loss. He was burning more calories than he could consume trying to breastfeed, the specialty bottle was giving him ulcers on his nasal turbinates’, and the therapy we we’re supposed to be utilizing (nasoalveolar mold) until he had his first surgery was causing irritation in his nostril and on his cheeks. I developed significant post-partum depression and anxiety during this time. There were days that I was terrified to put him down. I wanted to hold him forever in my arms to make up for the pain he was experiencing and that ultimately, I gave to him through my genetics. The guilt I felt ate me alive and when I finally had to consider returning to work, it seemed to get worse.

I started a per diem job in the ICU at the hospital where I delivered. I wanted to make sure I could take time off for him for his upcoming surgeries when needed. I knew shortly after returning to work that my experience with the nurses in L&D had changed me and my heart was shifting in a new direction. I began talking with my manager in the ICU about the feelings I was having. She was supportive and encouraged me to reach out to the manager in L&D. My son had two surgeries over the course of seven months related to his cleft lip and palate and did very well overall. Handing him over to the nurses for surgery was one of the most difficult moments of my life. Even with all my knowledge and comfort I had with the OR, I felt sick to my stomach letting him go. When he got out and I was finally able, I held him for hours. I knew I could not take his pain away, but I promised that I would bear it with him.

During the same time my husband had repeatedly been sick with pneumonia and we couldn’t figure out why that was. After having numerous tests done, a large congenital mass that had been growing since birth was found in his left lung. We were told it was rare for children to make it past age eight without it being found. It was so large that it was taking up the majority of the space and was getting continuously infected. He had to have the mass and the majority of his left lung removed two months after my son’s second cleft palate surgery and one month after I began a RN to BSN program. To say that life felt a little overwhelming was an understatement.

After some months of communication, I was able to interview and get offered a position in L&D. I knew that it was going to be a change of pace, but I didn’t know that I was ultimately going to find the heart and soul of my career.

The nurses in the unit were just as supportive mentoring me in a nurse-to-nurse relationship as they were during my nurse-to-patient relationship when I delivered. They have helped me be present, be witness, and encourage the process of becoming a parent. This has allowed me an environment to learn how to heal, honor, and accept my journey so that I can be an unwavering support system for my first son on his. And ultimately for my patients who are on on their own as well.

There are many experiences throughout my life that have contributed to the nurse I am today. The special care I received as a patient, and the mentorship while I was orienting as a new L&D nurse have both significantly influenced that. I look forward to sharing other stories that have contributed to who I am in birth today.

Thank you for being part of this community and supporting birthers and birth workers alike. I hope that sharing one of my stories will encourage you to reach out to me and share one of yours. Sharing your story can be a catalyst for change.

Do you love birth? Heck yeah you do!

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