For Harold

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Dear Harold,

You were born on the 21st of January, 2013. It was a pretty normal kind of day in most respects. We weren’t expecting you for another 3 weeks, and so the hospital appointment we had scheduled was tucked in around work meetings, lunch, and the regularity of everyday life.

It was a beautiful day, for summer in Perth. Warm and sunny, 29C though it felt hotter. At 10am I drove your mother to her regularly scheduled check-up at King Edward Memorial Hospital as I had every fortnight for the past few months. We were originally supposed to come in a week later, but it was the Australia Day long weekend, and the clinic wouldn’t have been open.

So I left your mother at the hospital and went off to a meeting nearby in West Perth. I met my client and a colleague and we discussed all the mundane details of a computer upgrade. I wasn’t worried when the meeting took a long time because every clinic visit we’d had so far would take at least 3 hours before we got to see anyone, so when I came back around 12pm I thought I would find her still in the waiting room.

Not so this time however. A midwife had come to check her blood pressure before going to see the doctor. “It’s a little high” she said… 130 over 90… But the instruments she’d been using had been playing up, and so she decided to check again. 140 over 90 this time. Higher. “I’ll need to check with the doctor” she said, and a few minutes later she came back. “We’re sending you over to get some blood tests done, but fingers crossed it’ll all be fine…” Your mother was more concerned about someone giving her a list of things she needed to bring to the hospital when she gave birth, so I don’t think either of us were really paying attention.

We collected her records and wandered over to the pathology department to do a blood and urine test. I stood awkwardly in the door of small examination room and got in the nurses way every time she wanted to move, so I eventually ended up perching on top of a table while the nurse slid the needle into your mothers arm and drew off what looked like an awfully large amount of blood.

Then we were told we should head up to the Fetal Monitoring Unit where they would check you over and make sure everything was OK with you. At this point everything to us seemed totally routine. Your mother was looking and feeling fine, not showing any signs of the high blood pressure affecting her, and I was waiting for them to tell us we could go home so I could get on with my day.

By this time it was around 2pm and your mothers work colleagues were wondering if she was going to be coming in, whilst I had people calling me in the waiting room wanting me to fix their computer problems over the phone. I said I’d be out later in the afternoon to take a look.

Then we were called through into the fetal monitoring unit room and a midwife came to take your mothers blood pressure again. “You’re going to be here for a while” she said casually as she wrapped the strap around her arm. “We need to take 4 readings over the next two hours and see how it goes”. “Great” I thought “There goes the rest of this day… We’ll be sitting here for another couple of hours and then when her blood pressure comes back normal we’ll just go home again.”

Here’s where things took a very sudden shift. The midwives changed over and another lady took over. She was short and blond with an Irish accent and a friendly demeanour but a serious look on her face. “I don’t mean to alarm you” she whispered loudly (because whispering is clearly more soothing) “but we’ve got your blood test results back and they’re not good. The doctor is coming to see you shortly, but I just wanted to let you know so you don’t get a shock later”… I’m not sure how the concept of an early shock to allay a later one works, but there we were. Sitting in a small exam room, curtain drawn, listening to the girl in the next cubicle talking about needing more antidepressants and wondering what the hell was going on.

Shortly the doctor arrived, she was young and fashionable and wore high heels, she was brisk and her tone was serious and I didn’t like her. She explained that all the signs were pointing to your mother having pre-eclampsia, which is a condition that affects pregnant women where the body starts to reject the pregnancy. They don’t know exactly why it happens, but it does. In severe cases the mothers organs begin to shut down, her brain can swell, and she dies. The only cure for this condition is to deliver the baby. Your mothers blood pressure was high, she had protein in her urine, and her blood tests were off the charts for liver function, it was beginning to fail, in short she was sick. They said the baby (you) needed to come out, now.

So we sat there silently processing this, looking at each other and then back at the doctor trying to comprehend the situation. To us, it didn’t add up. Your mother *looked* fine. No signs of sickness, no swelling or headaches or nausea or jaundice… nothing wrong with her that we could see or she could feel. Your heart was beating strong and you were moving a lot, so we knew you were ok, and I thought it would all just pass and we’d be on our way. Your mother was still concerned that the house was messy and she hadn’t packed a bag.

We asked for some time to think about what we wanted to do and the doctor asked if we’d like to see the blood test results ourselves. I said yes. We poured over the results, trying to make some sense of the series of tiny numbers in a small font in front of us and speculating as to what they all meant. We scanned down the page and there highlighted was the liver functions which showed a “normal” reading for ALT (an enzyme that indicates problems) was less than 40. Your mother’s reading was 3600. It started to sink in, regardless of how well she looked, things were not right, and there was a real risk of something going very wrong.

So we talked more, we cried. Our minds racing with all of the worst possibilities made us say things we didn’t want to, we pledged our love to each other and your mother made me promise I’d look after you if anything happened to her. I told her not say that, everything would be fine. Your grandmother and aunties were calling and every time I had to explain the situation I broke down. I couldn’t handle the thought of anything happening to your mother, and we were both scared at what was going to happen. I told your mother to call her mum in Colombia, but it was 4pm in Perth and 3am in Medellín, and she didn’t want to wake her up and worry her. That soon changed however, as the reality of the situation sunk in and we were taken into a birth suite and prepped to be induced. Your mother was still wearing her work clothes, a long flowing dress that showed off her casual elegance and and her collection of vibrantly coloured jewellery. She was stunning even on the brink of labour. The midwife asked if she’d like to change, but she decided she’d keep them on.

We made a video call to your grandmother in Colombia and through fits of tears your mother explained what was happening. Your grandmother was only barely awake but soon snapped into consciousness as she realised what was happening. Worry and sadness at the other end of the camera made it both better and worse. She was supposed to be here for your birth, but delays with the visa, and a due date still 3 weeks away meant that wouldn’t happen. I did my best in faltering Spanish to reassure her that we were ok, and I would be here with your mother and look after her. I don’t think it helped.

A roughly spoken South African midwife was dealing with us in the birth suite. I didn’t like her, and I’m almost certain she didn’t like me. She knew we were still struggling with the decision to induce and so she drove the point home by saying “Now I know you don’t believe us, but your wife really is sick”… and “You know whatever you choose to do, it’s on you… We give you the option, but if you don’t do anything, it’s your responsibility”. I knew that of course, but I didn’t need her telling it to us like that.

I remember looking out of the window that faced the city, it was 5:30pm, people finishing their working days and going home. A light breeze was blowing through the trees outside the window. “This is the day that everything changes” I thought. Our fate now set, we let the process of inducing begin and waited for you to join us.

Now the midwife told us, “Oh it’ll be a long time, 12 hours, 18 hours…Nothing is going to happen for a while”. So I had made myself comfortable in the birth suite. Your Aunties had arrived and bought me food, my camera, clothes, and toiletries for your mother. Finding basically everything in the house that looked useful, including a laptop with no hard drive in it that they thought was working.

I asked the midwife if I could get a bed, and they rolled out a little fold out bed for me.

Your mothers contractions were starting now. After bungling the IV line three times, the doctor had finally gotten two drips into her hand. One for the Syntocinon to start the contractions, and the other for Magnesium Sulfate to limit any chance of a seizure during the birth. As the fluids slowly dripped into her and did their work the contractions began… Her body would twist a little with each one, and she’d squeeze my hand, not firmly, but with pressure. She’d made soft little cooing noises to run the pain away, much like someone would who had just bumped their elbow. I was pretty certain that nothing was happening, and this labour was going to take a long time because I hadn’t seen anything resembling the stuff on TV yet, not even the real life documentaries version of childbirth.

So we continued on, your Aunties came and went. Your Godmother Gloria arrived and chatted to your mother and Grandmother over Skype. I took photos, held your mothers hand, stroked her hair, and told her how strong she was and how I knew she could do this, and all of this was happening at the right time, regardless of whether we thought so or not.

Then at about 9pm the midwives changed over their shifts. Our surly friend went home for the evening, and a young midwife called Ariana from Donegal, Ireland came into the room. She was friendly and efficient and had keen attention to detail. Your mother had started to shift more in the bed now, trying to find a comfortable position, but with the tubes going into her hands she couldn’t get up or walk around. The previous midwife had said she didn’t want to check how dilated she was too often, because it was going to take a long time, and you’re more prone to getting infections the more often you check… However Ariana took one look at your mother and knew something was happening. She was saying she felt like she needed to go to the toilet, which an experienced midwife will know is a sign that the baby has started to enter the birth canal and is putting pressure on the bowel.

She did a quick examination and very promptly stated… “Well Marcela, you are now fully dilated and this baby is coming now… Don’t you do anything, because i’ve got to get the room ready”.

Your grandparents who had been staying with us had only just gone home to get something to eat, expecting it was going to be late night as well, so I quickly got back on the phone to them and said “you better get back here now…”

The inducing had started at 6pm, and now at 10pm we were ready to bring you into the world. It’s not common for a first pregnancy to progress so quickly, but some of the doctors and midwives had mentioned that when you have pre-eclampsia the body is preparing to bring the baby out quickly so it can get back to normal.

So the pushing started… All I can say Harold, is that your mother is a strong, strong woman. We had come through the contractions without having any pain killers and now the time to push came and she gave every bit of energy she had to push. Your grandmother (my mum) had arrived back in the hospital and so I handed her the phone with your grandmother in Colombia on the other end, a brief Grandmother reunion took place, and then the pushing continued with force.

Two pushes with each contraction is what the midwife wanted, and your mother gave it. At one point tensing her face and pushing so hard she gave herself a blood nose. I did what I could to help, telling her to keep pushing, to be strong, that she could do it. All the standard things that helpless husbands say in the hope that they’ll help cut through the pain. I could see your little head start to peak out, and knew things were close, so I just gave as much encouragement as I could. The midwife assured us everything was going fine, and managed the whole birth process on her own, without doctors or anyone else getting in the way. And so then it came time for one big push and your head appeared outside. Some small gentle pushes more and the rest of your body came out. You were startled and gave a big cry for about 20 seconds and then just stopped. The midwife placed you onto your mum’s chest and you settled, tired but secure and happy.

I can’t really describe the feeling of seeing you there, resting on your mother, eyes blinking open, turning your tiny head to take in all the sounds and shapes around you, but it was amazing. I kissed your mother, I cried, she cried. From such a shocking start to the day, to have you in ours arms that same evening was like some kind of surreal dream.

And that Harold, is the story of how you entered the world and our lives.

NB: I wrote this post just after you were born and now have posted it just after your second birthday. You have blessed our lives in so many ways and continue to do so on a daily basis.