Mixed Blessings (39 page)

She just didn't have the strength, and her belly was too heavy.

By late that afternoon, the pains were coming regularly, and Brad made her a cup of tea, and then everything stopped again. The nearness of it seemed tantalizing as they waited.

"God, I just want to get this over with," she said to Brad. But absolutely nothing more happened that afternoon, until her water broke just after dinner. And still the contractions didn't come, but the doctor asked her to come in to the hospital anyway. He wanted to get her settled and watch her.

"What is there to watch?" she complained, as Brad drove her to Cottage Hospital. "Nothing's happening. Why are we going to the hospital?

This is stupid." But as she said it, she looked so huge that Brad could only laugh at her, and he was relieved to be bringing her to the doctors. He had no desire to have his first lesson as a midwife delivering twins at home. It was enough, as far as he was concerned, that he had agreed to be at the delivery. He was faintly squeamish at the thought of it, but he knew Pilar needed him, so he'd agreed to be there when she asked him.

Dr. Parker checked her when she got in, and after he did, she had a few mild contractions. And he was pleased to find that whatever contractions she'd had that morning had continued to dilate her cervix.

It was obvious to him that it wouldn't be long till Pilar had her babies.

"Something will get started soon," he promised, and then went home.

But he said he'd be back again as soon as they called him. She and Brad watched TV for a while, and she dozed for a little bit, and then suddenly she awoke with a strange sensation. It was an enormous feeling of pressure.

She called for Brad, and she looked faintly panicky, so he called the nurse and let Pilar explain it.

"I think you might be in labor, Mrs. Coleman." She smiled, and went to call the doctor, and a little while later a member of the house staff came to check her. Pilar made some objection to it, and just as she was discussing it with him she had a huge contraction. Her whole enormous belly seemed to be caught in a huge vise and squeezed until it forced the air out of her and she almost couldn't bear it. She squeezed Brad's hand and tried to remember to breathe, and someone she couldn't see cranked her bed up.

"Oh, God . . . that was awful," she said softly when it was over. Her hair was damp, and her mouth felt dry, just from one contraction. But her body knew she had a lot of work to do, and before the attending physician could discuss examining her again, she had another. And the nurse hurried out of the room to call her doctor and tell him that Pilar Coleman was in active labor.

The second obstetrician came in to see her and to examine her and when he did, the contractions got instantly worse, and she tried to struggle against him. Suddenly things were getting out of control for her, two more doctors came into the small labor room, while two nurses worked on the IV in her hand.

Another nurse strapped a monitor to her belly to check the fetal heartbeats, and the size of her contractions. But the pre sure of the belt from the monitor made the contractions seem worse.

It was horrible, she felt like an animal, strapped and trussed and being pulled at from all directions. Too much was happening, and she seemed to have no control over it whatsoever.

"Brad . . . I can't . . . I can't . . ." She was trying to get away from all of them, but her enormous girth, and the ferocious pains, made it impossible for her to move at all. "Brad, make them stop!" She wanted all of them to leave her alone, to take off the belt and the IV, to stop hurting her. But they couldn't leave her alone, her babies' well-being was at stake, and Brad felt helpless as he watched her. He tried to say something to the head nurse, and finally to her doctor when he returned.

"Isn't there something we can do to make it easier for her?" he said hopefully. "The monitor is so uncomfortable, and I think the exams make the contractions worse."

"I know they do, Brad," he said sympathetically, "but she's got a lot of baby in there, and if we're not going to do a cesarean, we need to know what's going on. And if we do, all the more so. We can't fool around." And then the doctor turned his attention to the patient.

"How're we doing here?" he asked Pilar with a cheerful smile.

"Like shit," she said, and suddenly she wanted to throw up.

She retched with each pain, and all the other miseries were still going on, and with each contraction, she felt more pressure, and an ever greater urge to push down. Maybe she was getting to the pushing stage, she thought hopefully, maybe that was what she felt, maybe this was the worst of it and it was almost over by now, but when she asked the nurse, she said that pushing was still a long way off. This was only the beginning.

"Drugs," she croaked when the doctor came closer to her head again. She could hardly even speak now, she was in such anguish. "I want drugs."

"We'll talk about that in a while." He put her off, and she started crying again as she grabbed at the doctor's sleeve.

"I want them now," she said, struggling to sit up, but the monitor held her down, and so did the next pain, which left her clutching Brad's hand. "Oh, God . . . listen to me . . . somebody listen to me. . ".

"I'm listening, sweetheart," Brad said. But she could hardly see him.

There were so many people in the room, and there was so much going on.

How had all of it gotten so out of hand, and why weren't they listening to her? All she could do was lie there and sob between contractions, when she wasn't screaming.

"Make them do something . . . please . . . make it stop. ."

"I know, baby . . . I know . . ." But he didn't know. And he was beginning to regret the whole thing. All the hormones and the drugs, and the trips to Dr. Ward's, and this was what it had brought her. It agonized him to see her in such pain, and he couldn't do anything to help her. He had never felt so useless.

"I want her in the delivery room," the second obstetrician said to Dr. Parker. "If we need to section her, I want to be ready to go."

"That makes sense," Pilar's doctor agreed, and suddenly there was even more action in the room, more people, more machines, and for Pilar more exams, and more contractions.

They rolled her gurney down the hall, though she begged them to stop and move her while she was between pains, but they wanted to get her set up as quickly as possible. According to what the doctor told Brad, things were moving very fast now, and they wanted to be ready. They had to think of the babies' safety, and not their mother's comfort. It was one o'clock in the morning by then, and Brad felt as though they had been there forever.

In the delivery room, they switched her from the gurney to the delivery table, put her legs in stirrups, covered them in drapes, tied down her arms, and switched the IV to her arm, and she complained bitterly about her position between contractions. She said her back and neck were breaking, but no one was listening to her for a moment. They were far more engaged in other things. There were three pediatricians in the room by then, several residents, a fleet of nurses, and both her doctors.

"God," she said hoarsely to Brad between pains, "what are we doing?

Selling tickets?" The monitor was still on, and someone seemed to be checking her cervix each time she breathed.

According to the nurse, she was at ten, which meant she was ten centimeters dilated and could push now.

"Okay," everyone cheered, but Pilar didn't care, and it was obvious to her they weren't going to give her drugs now.

"Why can't I have anything?" she whined.

"Because it's not good for your babies," one of the nurses said firmly.

But a minute later Pilar couldn't ask for anything, because she was in so much pain, and she had started pushing.

It looked nightmarish to Brad as he watched, they shouted, she pushed, then screamed, and almost the moment the pain ended, it began again, and they began shouting, and she was screaming. He couldn't understand why they didn't give her anything for the pain, except that the doctor kept insisting it would depress the babies.

It seemed hours that she pushed and nothing came. And when Brad looked at the clock, he couldn't believe that it was almost four o'clock in the morning. He wondered how much more she could take before she became completely incoherent from what they were doing. And then suddenly there was fresh excitement. Two isolettes appeared, and the circle of masked faces drew closer. Pilar seemed to scream endlessly, it was a long endless wail that had no end and no beginning, and then suddenly everyone was shouting, urging, encouraging, and he saw the head of the first baby, pushing its way into the world, his long, slow wail matching his mother's.

"It's a boy!" the doctor said, and Brad was instantly worried by his bluish color, but the nurse said not to worry, and a minute later, he looked better. They held him out to Pilar for a moment to see, but she was too exhausted to pay much attention. Her pains were continuing as before, and the doctor had to use forceps to move the next baby into a better position.

Brad couldn't look at what they did to her, he only prayed as he held her hands in a death grip that she'd survive it.

"Hang in, sweetheart . . . it'll all be over soon. . . ." He hoped that he wasn't lying to her, but he had no idea, and she just cried as he held her.

"Oh, Brad . . . it's so awful "I know . . . I know . . . it's almost over But this baby was even more stubborn than the first, and at five o'clock he saw the two doctors conferring.

"We may have to do a cesarean if the girl doesn't come out quickly," they explained to Brad a few minutes later.

"Would that be easier for her?" he asked quietly, hoping she couldn't hear him. But she was in such pain, and pushing so hard, that she wasn't listening to what anyone was saying.

"It might be. She'd have general anesthesia, of course, we couldn't possibly get an epidural into her now, but it would also be a double whammy for her, a vaginal birth with an episiotomy, and a section. Not an easy recovery. It all depends on what the baby does in the next few minutes." The first one had already been checked, and was in an isolette, wailing loudly.

"I don't care what you do," Brad said distractedly. "Just do what's best, and easiest for her."

"I want to try to get the baby out vaginally first," the doctor said, and went at her again with forceps. He worked and pushed and squeezed, and just when they were about to give up, the baby moved, and slowly began moving down between her mother's legs. It was six o'clock by then, and Pilar was barely conscious, and then suddenly she was there, a sweet little face, she was a tiny little baby. This baby was half her brother's size, and she looked around worriedly, as though searching for her mother. And almost as though she sensed it, Pilar raised her head and saw her.

"Oh, she's so beautiful," she said, and then dropped her head back again, smiling at Brad through her tears. It had been excruciating, but it was worth it. She had two beautiful babies, and as she lay and looked at him, two nurses took the baby away the moment the cord was cut, and they lay her in the second isolette for the pediatrician to check her further. But this time, they heard no further cry, and suddenly the room was very quiet.

"Is she okay?" Pilar asked anyone who'd listen to her, but suddenly everyone was very busy. Brad could see his son in his isolette in a corner of the delivery room, with two nurses watching him kick his legs and flail miserably, looking for some comfort. But he couldn't see his daughter, and he took a step away from where Pilar lay so as to see her better. And then he saw them, suctioning her desperately, and trying to breathe for her. A doctor was giving artificial respiration, and then compressing her tiny chest, but the baby lay still now. She was gone, and nothing they did revived her. Brad looked in shocked horror at the doctor's face, and Pilar lay on the gurney just behind him asking questions. He almost felt his heart stop.

What in God's name could he tell her?

"Are they okay? Brad? . . . I can't hear the babies. .

"They're fine," he said numbly, as someone gave Pilar a shot.

It seemed a little after the fact, but she was instantly woozy and half asleep, and Brad looked at the doctor standing before him.

"What happened?" he asked numbly. It had been a grim experience, and even his son's birth was barely consolation.

"It's hard to say. She was very small. We think she lost a lot of blood to her brother. They call it twin to twin transfusion. It weakened her, and then she just couldn't breathe on her own. Undeveloped lungs, I suspect, and too small to survive so much trauma. Maybe I should have sectioned her," he said miserably, and Brad turned to look at his wife peacefully sleeping in the delivery room, drugged at last, oblivious to what had just happened, and he couldn't begin to imagine what he was going to tell her. So much joy had turned to agony so quickly.

But the pediatricians all agreed with the obstetrician, there was clearly something wrong with the baby's lungs, which no one had known, or suspected. Her heartbeat had been steady during the delivery, but having lost blood to her twin, she was snnply unable to survive out of the womb, without her mother.

They had done everything they possibly could to revive her.

Brad knew all the facts. But it was still impossible to understand why it had happened. And as Pilar was wheeled away to the recovery room, Brad stood looking at his little girl, as tears crept down his cheeks.

She looked so sweet and so perfect. She was as beautiful as she had been when she was born, and now she looked as though she were sleeping.

Her brother was crying unhappily, as though sensing that something had gone wrong. He was so used to being close to her, to kicking her, to being with her, and suddenly she was gone, as was their mother.

Without thinking, Brad reached a hand into the isolette and felt her.

She was still warm, and he stood staring at her, wanting to hold her.

What would he tell Pilar? What could he say?

How could he tell her one of them had died? She would wake expecting to find two miracles, and instead she would find she'd been stricken with a tragedy in a single moment. It was a cruel joke to have played on them, and he stood for a long time, looking at what seemed to be their sleeping baby.