Sunday, December 21, 2014

Get a room!

I had a lot of anxiety leading up to Jaden's birth,  not just about how how the delivery would go, but about how things would go after the delivery.  Much of it was logistical.  We didn't know up until the day of whether or not Jason and I would have a room following the delivery. 

In typical delivery situations, the baby rooms with the mother.  In typical delivery situations, the mother is the one delivering the baby.  So, since our situation was anything but typical, we weren't sure what that meant for Jason and I.  We were hopeful that the PBO we had in place would help.

At around 20 weeks gestation,with the help of our attorney Jason and I petitioned the court for a PBO or a Pre-Birth Order.  A PBO is a court order signed by a judge establishing parentage of an expected child when the woman giving birth to the child is not genetically related to the child.  The law assumes that a woman who gives birth to a child is the genetic mother of the child; if she is married her husband is presumed to be the father of the child. Invariably, the presumption about the husband being the father of the child has in some cases been wrong (when there's another baby daddy), but until recently, it was never wrong about the mother.   Enter modern science.  With the advent of surrogacy, some states (including Georgia) began the practice of utilizing Pre-Birth Orders to address this issue.   The fee for obtaining a PBO in Atlanta varies anywhere from $2600 to $5000.   While the surrogate can waive her right to an attorney for the contract phase of surrogacy, it is mandatory that she has an attorney for the PBO in order to ensure that she is not being coerced into signing the petition.  The Intended Parents are responsible for the surros attorney's fees as well, usually amounting to around $750.  What happens if you don't live in a surro-friendly state that grants PBO's?  You obtain a post-birth order, or in some cases, adopt your baby.  This makes the hospital situation trickier.   If the PBO is granted (thankfully it typically is), the hospital is ordered to put the names of the genetic parents (Jason and I) on the birth certificate.   Additionally, the court order states that Jason and I are to make all medical decisions for the child once he is born.

In theory, having a PBO in hand should have made the hospital situation pretty seemless.    With Jason and I being recognized as biological parents, we would both be given hospital security bands which allows us all access to our baby.  We also hoped that we would be given a hospital room following his delivery.   When Ellen was around 30 weeks pregnant, I called the hospital to see if this was possible.  I was initially told it would depend on the hospital census, but later told that we wouldn't be able to get a room regardless of the census since hospital rooms are only given to patients.  We asked if we could stay in Ellen's room with her, since she is technically the patient.  They told us only one person was permitted to stay the night in Ellen's room.   The Charge Nurse that headed up the Mother and Baby floor did say that there is a special "Family Room" that she has designated for families of patients who need to stay the night and told us we were welcome to stay there.  She said it isn't technically a hospital room but should be sufficient.  We were still hopeful the PBO would help get us a room, but grateful that there was at least a back up option in place.

The three of us decided it would probably be best to go to the hospital to introduce ourselves and speak to the powers-that-be (in this case, we started with the charge nurses). We also wanted to check out the "Family Room" in case we did end up having to stay there.   Unfortunately, the "Family Room" was less than ideal. The room was quite small and just had a chair and a bench in it.  No bed. No bathroom.  Not even really room for a bed.   After seeing the room and my clear disappointment, Ellen told us not to worry- we could just bunk up with her if we couldn't get our own hospital room.  We asked the Charge Nurse about this and were once again told only one person was permitted to stay the night in Ellen's room. Hospital policy.  We were also informed that once the baby is born he is given four security bands.   Two of the bands would go on each of the baby's ankles, one would go to Ellen, and the final one would go to whichever one of us Ellen chose.  We explained that Jason and I both should be given bands but they insisted since Ellen is giving birth to the baby, the baby goes with her.  No way around it. Hospital policy.  Okay, we said.  Well then can we get additional bands so that Jason and I can both have a band? No dice. They only come in sets of four.   The nurses we spoke to were quite nice, but it was clear that they were not familiar with surrogacy and weren't sure how to bend hospital policy to accommodate our situation.

With PBO in hand, we eventually asked to speak to the Director of Nursing.   We explained that we know our situation is unique but surely there must be a way around hospital policy.  She assured us that she is familiar with surrogacy but still insisted that Ellen gets the security band because she is the "birth mother".   Birth mother? Um....this is not an adoption.  The Director must have seen the look of discontent on my face in reaction to her choice of words so she corrected herself.   "She's not the birth mother. She's birth".  Vessel??   She told us that we need not worry though, because even if Jason didn't have an arm band, it would be communicated to the staff that he was the biological father and would be given all access to the baby.  The hospital isn't that big, she told us.  It would be fine.  

This didn't sit well with us so when I got home I immediately contacted our attorney.  We have an incredible relationship with our surrogate but there are some surrogacy journeys that don't go as well as ours.  In fact, I have heard of cases where there is such a breakdown in the relationship that the surrogate and Intended Parents don't speak at all and only receive updates about the pregnancy from their attorney.  If our situation was like that, we certainly wouldn't feel comfortable with our surrogate having armband access to our baby while one of us was denied this access.    After several emails, phone calls and weeks of waiting, our attorney spoke with hospital counsel and got the security band situation straightened out.  Jason and I would both be given armbands.  Ellen would not receive a band.

As for the room? We were told that we still wouldn't be given a room but, if there was a room available, we would be given the opportunity to purchase a room for $450.  This wasn't exorbitant, but was no steal either.  We figured we would just make a game-day decision and see how we felt, and packed an airbed and a sleeping bag just in case. 

Stay tuned for the next blog post to see what we ended up deciding...

Monday, December 15, 2014

Saturday, December 6, 2014

#Jadenwatch2014 or Our Surrogacy Birth Story

Little man has been here just over 72 hours (well now more like 120 hours- its hard to get things done with a newborn!)  so I wanted to get down his birth story while its still fresh in my mind.

#Jadenwatch2014 (hashtag complements of my friend Mary) started about two weeks ago when Ellen was already dilated to 3cm at 37 weeks 4 days.  The OB scheduled the induction initially for Black Friday but then switched it to the Monday after Thanksgiving since staffing would be better following the holiday.  Two different OB's told us they doubted we would make it to the induction so we had our hospital bags packed and were on high alert all week.  My parents came in town Thanksgiving day and joined us on #Jadenwatch2014.  We all thought it would be pretty fitting if he came during the Florida/Florida State game but Jaden had other plans and decided to stay put until the induction.

We arrived at the hospital Monday at 8am.  Since Ellen was positive for Group B Strep she needed to get IV antibiotics in order to prevent passing anything to the baby.  We were hoping she would have time to get two doses in, as at our last OB appointment on Wednesday the doctor told us the baby would have to stay in the hospital 48 hours if she didn't get both doses. Given that this was Ellen's fifth pregnancy, the doctor doubted she would have time for both and predicted the baby would be here by noon.  Thankfully, that didn't turn out to be the case.

My parents and Jason's mother set up camp in the waiting room while Ellen, Chris, Jason and I headed to the Labor and Delivery Room. Ellen's mother joined the other parents soon after.   Our nurse Meg was really amazing.  She had donated her eggs twice before so was very familiar with the process of IVF as well as the struggles so many go through to create a family.  She asked me for my birth plan so she could understand my desires and assured me that she would help make sure my wishes were respected.  She even read the instruction manual for my skin-to-skin shirt and told me she would help me get him situated in it.  It felt really nice to have her support, especially since I felt slightly crazy wearing that shirt.

 Ellen got hooked up to the monitors and the nurse explained that the top lines measured the baby's heartbeat and the bottom measured contractions.  Contractions were minimal when we arrived.   They had to special order Ellen's antibiotics so they didn't start her first dose until around 10:30 AM.  Ellen was hoping the doctor would break her water and allow her to walk the halls in lieu of starting the pitocin (aka "the devil" in Ellen's eyes) but the doctor opted to just start her on a tiny dose of pitocin along with the antibiotics. After about an hour there was very little movement, so Meg said she was going to ask Dr. Ramani to break her water.  We had to wait a while since the doctor was in a C-section (Chris almost took matters into his own hands when he found the "poker") so it was about 12:30 when her water was finally broken. We all gave a sigh of relief when we saw the water was clear (which meant no meconium) .  Meg bumped up the pitocin shortly after in the hopes that this would speed thing up.  She told us she had a woman next door who was also dilated the same amount.  This was good motivation for Ellen, who is as competitive as Jason and I.  "Oh, we are so going to be first,  Ellen said.   About an hour later, she bumped up the pitocin again and around 2:00 the strong contractions started kicking in.  The nurse checked Ellen and she was dilated to about a seven.
I probably should mention that Ellen opted not to get an epidural.  She has never had one- apparently for Ellen, the idea of not being able to feel below her legs is worse than the excruciating pain that comes with labor.  By this time, the charge nurse Kenna had joined us since Meg was next door tending to the other delivery (she was still behind us, and she was already on her second epidural) I asked Kenna how many women don't get epidurals and she replied "On purpose? Maybe five percent".  I was pretty surprised by that number and Ellen was too- she didn't realize she was in such a minority.   I'm not sure how Ellen feels about it, but in retrospect, I think that her decision not to get an epidural actually enhanced the birth experience for me.  It was undoubtedly difficult to watch someone I love and care about be in so much pain, but it really made me appreciate her even more (as if that was even possible).  And the fact that she was going through this pain for me, for us, for our baby...

Around 2:30, I could tell by Ellen's face and lack of ability to talk that she was in immense pain so asked if the nurse would check her dilation again.   The nurse said they don't like to check too often as this can promote bacteria but felt like Ellen would know when it was time.   Really?!? You don't want to try something a little more scientific than a feeling?  The nurse was about to leave the room when Ellen said "If I'm still a seven, I'm gonna need that epidural".  Thankfully the nurse checked again because the next thing you know, she asked Chris to hold one of her legs and had me hold the other.  Jason initially stood by Chris near Ellen's head and then kind of floated between Chris and I, still remaining by her head.  Ellen was clearly in a lot of pain and I heard the nurse say, "This is the part where most patients give up and feel like they can't do it but you are really close.  I  know that you can do it". Really close?  My heart was beating a mile a minute.  I mouthed to Jason "Where's the doctor?"

No sooner did I say that then the doctor arrived and instructed Ellen to lift her legs higher and begin pushing.   Still holding her leg, I was standing on my tippy-toes trying to brace myself against the weight of her push.  I told someone I was on my tippy-toes and they brought me a stool, which was a relief.  I remember thinking I didn't have the strength to keep holding her leg and it would have been terribly embarrassing if I gave up before Ellen did.   Ellen pushed just three times and during the last push, at 3:17 PM,  we were instructed to go watch our son being born.  Jason was always a bit reluctant about doing that- I think most men are uncomfortable about that with their own wives, never mind someone else wife.  All that discomfort went out the window when, mid-push, Ellen looked at Jason and said "Get down there!".

I cannot adequately describe what that felt like.  It was truly surreal.  When I first saw the crowning I was in shock.  His head was itty-bitty- like a kewpie doll- and I was like- oh my god, he really is a tiny baby!  As more of his head came out I saw that it wasn't quite as small as I initially thought.  He was small, but he was amazing.  Dr. Ramani pulled him out and placed him on Ellen's stomach and you know what? I didn't even care.   I think it was probably just habit for the doctor to lay the baby on the woman and when he realized what he did, he looked back at me like "Oh crap- I wasn't supposed to do that, was I?" I just said "It's okay, it's okay" with tears streaming down my face, then went to Ellen and said "He deserves to go on you first because of all that". He was just on her for a few seconds- they clamped the cord, Jason cut it,  and then the NICU team whisked him away.

They began examining him while Jason and I looked on.  He was crying, which is a good sign, but I guess his breathing was a bit coarse. They said this was because he came so quick and didn't have time for his lungs to get cleared in the birth canal.   They spent several minutes, which felt like hours, attempting to clear his passageways by sticking a tube up his nose and down his throat and using the bulb in his mouth and nose.  They were all business and it was pretty scary.  I finally asked if he was okay and if he failed his APGAR, and they assured me that he got a 9 and an 8 and was just fine.

Finally, they let us have him and the nurse helped me into my Nuroo shirt.  As soon as he was all nestled up inside of the shirt, skin-to-skin, I no longer felt crazy for wearing it. I just felt like mom. At last.

EDITOR'S NOTE: If you are reading this on your phone,  you may want to go to a computer when you can and watch these videos.  After we were home about four days Jason said "Oh yeah, I forgot about these".  Apparently he snuck a few videos during and just after the birth.  They are so amazing.  It was really interesting to watch it back.  There have been a few times in my life when I have just wailed- when I could hear this sound coming from me and wasn't sure where it was coming from.  Up to this point, those times were following a miscarriage.  It was surreal to hear that same sound coming from tears of joy.  And my exclamations, "Oh my G-d, Oh my G-d, Oh my G-d"! That was fitting too.  Our son's name is Jaden Court.   We knew early on that if we had a girl, his middle name would be Ellen.  Since it was a boy, we chose Ellen's maiden name, Court, to honor her and so that he would always know his birth story.   His first name is Hebrew for "G-d has heard".  Indeed he has.

Tuesday, December 2, 2014

Introducing Jaden Court

Little man arrived yesterday at 3:13 PM.  5lbs15.4oz and 19 inches of perfection.  We couldn't be happier.
This is what five years of waiting to be parents looks like...

We are eternally grateful to these two who helped us become a family...and who are now part of our family too!

I will update about the birth story later...