True Knots

eveys-first-days-0111Jamie: Dying’s okay. It was the general anaesthetic I didn’t like.

Truly Madly Deeply

Around 1:40 AM (I suppose) the consultant doctor, a small birdlike woman in glasses and scrubs, said to me solemnly: “I do not like the way this labor is progressing. There is something wrong with your baby. I am ordering an emergency section with a general anasthetic. I want this baby out in the next five minutes.”

This proclamation had the effect of a spell. As far as I could tell there were six people in the room when she began speaking– me, Trev, Mom; the doctor, the anasthesiologist, and Kim the midwife. When the doctor finished speaking I was suddenly surrounded by gloved hands and masked faces. For an instant, I saw my husband standing helpless and stricken behind them. Then I was being wheeled out of the room away from him by the mob, and I thought: please don’t let this be the last time I see him. 

I watched doors open and corridors go by and passed a grim notice: OPERATING THEATRE. They parked me under bright lights while people I could not see said things I don’t remember in clipped, efficient, urgent voices. The anasthesiologist appeared and began to recite whatever disclaimers and information he was obligated to relate. I only remember that he warned me I would feel pressure in my throat. Kim the midwife, masked, with her braids under a hat, held my hand. “I’m frightened,” I told her. Then they put the needle in and intubated me.

I woke up between three and four in the morning. Mom was saying, “You had a beautiful baby girl– seven pounds twelve ounces– healthy–“. Then Eve made a noise and I saw her, a little pile of black hair in a bundle, and cried, and so began our life together, there in the hospital.  

Soon Eve and I were taken off to the recovery ward. Before we were allowed to sleep a nurse asked me if I had nappies– poor Bean was only wrapped in a towel– and I realized that Mom and Trev had taken the baby bag I’d prepared with them. NHS hospitals do not, as a rule, provide clothes or nappies. The nurse sternly told me off for not being prepared, even though I tried to explain that there was a bag but it had accidentally been taken away. Another nurse, observing this, went off and scrounged up what she could for Bean. When she returned I was alone, holding the baby and crying. She told me not to mind her unfriendly colleague, gave me some Pampers and a onesie and a cardigan. So Bean started life on a hot, noisy ward, in borrowed clothes and a towel, with a morphine-addled mother whose IV, wound drain, and catheter prevented her from sitting up properly or even lying on her side to nurse.  We were a mess.

I kept telling myself and anyone else that I didn’t feel bad about the c-section. It was clear that Bean was in trouble when it was ordered and a healthy baby was the main object of the birth, no matter how I had hoped it would happen. In the days after we came home I began to worry, however, that I had missed out on some bonding of some sort. There were times I looked at Eve and thought “baby”, neutrally, indifferently, without the feeling she was my baby. I cried some, I told Trev what I was feeling.

Then I read the postnatal notes they’d sent home with me from the hospital: 

Reason for Section: Fetal distress

Section findings: Thick meconium liquor. x 2 true knots in umbilical cord.

True knots of the umbilical cord are rare. They occur in less than 1% of pregnancies. They are associated with a four-fold increase in the risk of, as one site puts it, “fetal demise”, because the blood vessels and arteries that feed the baby are constricted. This constriction can be worse in labor due to the pressure of contractions, and more so when those contractions are augmented by pitocin (as mine were after 6 cm, when the midwives didn’t think my contractions were progressing fast enough).  A c-section is often the only way, in the case of true knots, to avoid the baby being brain damaged or killed by oxygen deprivation.

I had planned for a natural birth, am the sort of person who could handle a natural birth, took care of myself throughout the pregnancy to ensure a natural birth and avoid surgery, but in the end, given a choice between a dead baby and surgery, I will take the surgery every time.

So, really, truly: I don’t feel bad about the c-section. Thank God we chose the hospital birth centre. Thank God we have Bean.


  1. As one who has experienced what you have (the emergency part, not the knotting part), I know where you are coming from. Although Hunter appeared as the Michelin man when he arrived, he still had that “lack of O2” thing going on…kinda like pulling them from a pool. The NICU nurses were wonderful, but I too was not able to have that immediate time with him.
    Knowing what I know now about how the whole thing works, let me just say….the love, admiration, astonishment, and sheer awe is something that will encompass your entire life from now on.
    So, with all that said, enjoy the sleepless nights, as they don’t last forever and someday you will miss them (I know, doesn’t seem like it). But, as my now 2 year old tells me that he can “do it myself”, it breaks my heart, just a little. Hope you don’t mind if I live through you just a tad!!

    Love to all of you and can’t wait to see you this summer!!

    Chris and all my boys!!

  2. I think you’re amazing an did an amazing job. All women likely have a notion of how we want our babies to be born. You prepared for what you wanted and put yourself into excellent, competent hands – the rest isn’t up to you. I’m so happy you have your healthy, gorgeous baby. And by the way, I think most moms get that neutral baby feeling at first.

    Much love

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